It can happen slowly over time, or in an instant: our living space feels more like an obstacle than the "home sweet home" it has always been. The doorknobs in the house seem difficult to turn. The cabinets seem awfully high. The toilet seems too close to the bathroom floor. Moving somewhere else could be the solution, but then you lose the familiar walls and spaces, and maybe the good neighbors across the road. An estimated 83 percent of older Americans say they want to stay in their current homes for the rest of their lives.

Seeing the Possibilities
"It's all about revealing the possible," points out Sharli Rogers, executive director of the BEST Center for Independent Living in Bowling Green.
Today, there are many possibilities for making a home more accessible, and in the process, also making your home much more comfortable.
When Carl and Doris Byrd of Eighty Eight built their home about 30 years ago, they were a young couple with two young sons. But an auto accident in 1981 made them see their home in a much different light. Then-19-year-old Tim suffered a spinal cord injury and came home from the hospital in a wheelchair. With fewer services back then and the ADA (Americans with Disabilities Act) not yet in place, the Byrds had to invent ways to make the house more accessible, such as building pocket doors to allow wheelchair access into the bathroom and building a ramp on the outside of the house. "We had to feel our way through it," says Tim Byrd.
At first, though, Doris Byrd didn't want to accept what the doctors were saying: that her son had a 99 percent chance of always being in a wheelchair. "This is my son," she said. "He is so smart and determined. He'll be among the 1 percent who walk away from something like this." But no amount of positive thinking could heal such an injury. Making the modifications to the house began to signal a sense of acceptance, Tim recalls. Then in 1993, ironically, Carl Byrd suffered a stroke and temporarily required a wheelchair. Modifications made years earlier proved to be a blessing then, and even today as Carl uses a cane.
In 1998, the Byrds added a separate 700-square-foot apartment for Tim onto their 1,200-square-foot home. At first there was the question of whether the home addition would diminish the house's later marketability, but Tim knew from his previous work with Lexington architect Helm Roberts and with the Lexington Fair Housing Authority that accessible living space today is highly sought after.
A draftsman by profession, Tim designed the apartment with knee space under the bathroom vanity and kitchen counters, lower clothes rods in the closet, and even a generator that provides power to the house in the event of a power outage-the latter benefiting both generations in the house.
As Americans, we greatly value independence, points out Lexington social worker Rebecca Keefe. When a disability or the inevitable aging process takes away our basic independence, it's difficult to face. "We don't make changes until we're forced to," Keefe says. "It offends our pride and takes away part of our individuality."
And yet not to make a house more accessible is to overlook the possibilities. "For me, I don't focus on what I can't do but going for what can be done and thinking clearly about the possibilities," says Sharli Rogers, whose work at BEST Inc. entails helping people see these possibilities.
That can sometimes be difficult in helping a family member adjust to health- or age-related problems. Rogers knows this firsthand in trying to guide her own mother's care. Unless there are extenuating circumstances, you have to accept that the parent is an adult and can make his or her own decisions, she points out.
"It's how we deal with it that's important," says Doris Byrd, who at age 64 is grateful for her own good health and strong family ties. Think ahead and think positively, she advises. Modifications make a house more convenient, and enable a family to stay in their own home rather than having to seek other living arrangements.
Rebecca Keefe, who today works for the Independence Place Center for Independent Living, learned at age 15 what most people discover much later in life: "We live in a society that takes for granted being healthy." In a wheelchair as a result of a shooting accident, she lives in a home that she and her husband designed. Walls can restrict one's space and impede a wheelchair, so the 1,200-square-foot house has a 21-foot great room, fewer walls, wide halls, lowered light switches, and raised electric outlets that are more than two feet off the floor.
If you're looking for ways to make your own home more accessible, here are some suggestions.

Getting Started
As with any home building or remodeling project, it's best to first educate yourself about the possibilities. Books, catalogs, and Web sites detail adaptive equipment and provide how-to advice. Some of the best research you can do is just seeing what has been done in other people's homes. Connections through senior citizen centers, support groups, and Independent Living Centers enable you to ask questions, get information, and compare options.
"You should avoid the mistake of starting to replace and update doors, remodel rooms, and add grab bars until you have planned out what all your current needs are as well as what your future needs might be," recommends contractor Don Wright of Perry Park.
Don't assume that accessible fixtures will look unattractive. "A lot of times, these changes are aesthetically pleasing," Tim Byrd points out. For instance, rocker light switches, casement windows, or the typical side-by-side refrigerator/freezer are considered standard accessible features. Widening doors to 42 inches with attractive six-panel wood-constructed doors are now available to blend in with existing interior and exterior doors, says Wright. Grab bars are one of the smartest modifications you can make to a home, and today are readily available at many home improvement stores. Ironically, though, only 6 percent of American homes occupied by people over age 80 have grab bars, points out Lexington environmental access consultant Susan Bachner. Studies show that most home accidents occur in the bathroom, and that one-third of all people over age 65 who live at home fall each year.
Bachner worked for 37 years as an occupational therapist before specializing in doing evaluations and consultations for home modifications. This work-and the Universal Design concepts she uses-are about accessibility for all people, she stresses.
She works with architects and contractors, and recommends this team approach so that good accessibility decisions can be made on a home modification. Anyone can install a grab bar in a shower stall, she says, but the height and angle of the bar need to be considered in view of the person in the household who will most likely use the bar.
Four years ago at age 55, Bachner did what most people don't bother to do: add features to her own home that will eliminate potential barriers in the years to come. For instance, her home includes a tiled entryway with an artistic pattern that mimics the look of a rug. (Scatter rugs can easily lead to a fall.) Casement windows and lever handles on doors and faucets are also part of her home's décor. The shower stall includes a built-in seat.
Bachner recommends that Universal Design be incorporated into one's living space. The concept of Universal Design evolved from North Carolina State University's College of Design in 1989 with the belief that built environments and products can be made usable to the greatest extent possible by people of all ages and abilities.

Disabilities Act Awareness
Being well-informed can save you money on some modifications. For instance, if you call a contractor with no experience with ramps and say, "We need a ramp," a contractor will spend time not only building the ramp but designing it, Rogers points out. If, however, you approach a carpenter with a drawing of the ramp you want and with ADA specs, the overall price will likely be much less.
The Americans with Disabilities Act details requirements for public buildings and privately owned spaces used by the public, such as restaurants and theaters. While the ADA does not require compliance in private homes, it has helped-by example-to increase awareness of public and private accessibility.
Still, the mindset to adhere to ADA requirements remains elusive on some projects. Kentucky's Americans with Disabilities Act office has been receiving an increasing number of complaints from across the state about buildings that are not accessible to people with disabilities. "The complaints to the office are increasing as people with disabilities become more knowledgeable about accessibility issues," says Norb Ryan, Kentucky's ADA coordinator.
In Kentucky, there are more than 700,000 working-age people with disabilities. Kentucky is ranked in the top five of states in the U.S. that have working-age people with disabilities.
More than half a million of Kentucky's population-12.5 percent-are age 65 or older. Kentucky's Area Agencies on Aging (15 offices throughout the state) work to improve the quality of life for older adults. Some counties also have councils or committees on aging committed to this same goal. For instance, the Harlan County Committee on Aging makes critical home modifications, but with more than 6,000 seniors in the county, there are never enough funds to go around. Volunteers from Sharing with Appalachian People and the Christian Outreach Co-op assist the committee and Harlan seniors by building ramps and essential accommodations.
"Life is what you make it," Keefe stresses, pointing out that one's attitude will greatly affect one's quality of life and coping with unwanted changes. Each morning we make a choice: whether to say "hello" to people and be considerate of their feelings, or to blame people for the way life is. The family member who suggests making a change in the house might well get criticized at first. But ultimately, Tim Byrd points out, a house is just a structure and changing it to make it more accessible and comfortable just makes sense.
Doris Byrd echoes these sentiments, always remembering a lesson she learned from her father. "Doris," he used to say, "when you get feeling sorry for yourself, that's the worst thing that can happen to you."

Accessibility Agencies
The following agencies can provide insight and/or referrals in their particular areas of specialty.

Office on Aging Services
(plus 15 area agencies on aging throughout Kentucky)
275 E. Main St., 5 C-D
Frankfort, KY 40621
(502) 564-6930
http://CHS.state.ky.us/aging

Kentucky ADA Office
Capital Plaza Tower
2nd Floor, 500 Mero Street
Frankfort, KY 40601
(877) 423-2933
1-502-564-6606
http://ada.state.ky.us/

BEST Inc., Center for Independent Living, Bowling Green
(270) 796-5992

Center for Accessible Living, Louisville
(502) 589-6620
www.calky.org

Center for Accessible Living, Murray
(270) 753-7676

The Center for Independent Living Options, Edgewood
(859) 341-4346

Disability Coalition of Northern Kentucky, Covington
(859) 431-7668

Independence Place, Lexington
(859) 266-2807

Pathfinders for Independent Living, Harlan
(606) 573-5777


For a list of Web sites offering information related to home accessibility, go to Home Accessibility Web Info.