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Climbing and descending stairs demands considerable strength from numerous muscles in the legs. The hip flexors must be strong enough to lift the foot from one step to the next. Moving the body up to the next step requires adequate strength in the hip extensors, quadriceps, and gastrocnemius (calf) muscles. Steeper steps are more challenging to ascend than shallower ones. The use of railings and grab bars is required when lower limb strength alone is insufficient to overcome gravity.
Falling backward down a flight of stairs is highly dangerous and can result in severe injury or even death. It's important to lean slightly forward while climbing, maintaining balance so that, in the event of a fall, it is more likely to be forward rather than backward.
Stair lifts should be considered when climbing or descending stairs requires more than moderate adaptations.
Many homes and other buildings have one or two steps to ascend between split level flooring. These steps often do not have railings or may not be near walls or other touch points to help maintain balance. The same precautions taken when climbing flights of stairs should be taken when climbing or descending a few steps.
A threshold is a piece of material that forms the bottom of a doorway, or a transition between different floor surfaces. Thresholds can be difficult to traverse for a person walking or a wheeled device such as a wheelchair. Care should be taken when crossing thresholds, as with staircases and steps.
Thresholds as shallow as 1 inch (25 mm) may require the use of a ramp or threshold riser to safely traverse them.
Door knobs with a circular profile can be difficult to grasp and rotate for individuals with muscle atrophy in their hands and forearms. Knobs which have a prominent handle that can be pushed downward are easiest to operate. Knobs which lock may be impossible to operate if they require the use of fingers to operate the locking mechanism.
Doorways must be wide enough for a walker, wheelchair, or wheeled commode to pass through. Often, the door itself reduces the effective width of the doorway when the door is open. Measurements of applicable doorways should be made before purchasing equipment that is intended to pass through them.
Sliding doors used to access decks and balconies may be too narrow for a wheelchair or a walker to pass through. Modifications to the door handles may allow for some valuable increased opening width in some cases. Many sliding doors in North America have a standard overall width of 5 feet, or 6 feet. 5-foot models will almost definitely need modifications to provide clearance for a large wheelchair.
Sliding doors also have a threshold on the bottom that must be cleared. Commercially available products exist that make going over the threshold much smoother. A ramp is placed on either side of the door, and a removable bridge is placed between them when passing through the door.
A power wheelchair with an individual sitting on it may weigh as much as 600 pounds (270 kg). A deck or balcony that is not able to bear that amount of weight should not be used by anyone at all.
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Reduced mobility and increased care needs necessitates the ability to communicate within the home without much movement. Signalling for help, answering doors, and speaking with others in the homes, such as caregivers requires assistive devices.
Smartphones can be used within home to communicate using voice, video, or text.
Video communication can be useful in circumstances where the disabled individual needs to see a room or area of the house that they are not able to access on their own. The assistant can use their own phone camera to look around on behalf of the other person.
Text communication can be useful when the individual's need is not urgent and can be dealt with when the assistant has a spare moment.
Call bells are a simple and affordable tool for in-home communication. Many call bells are sold with multiple transmitters and receivers. The receivers should be placed in zones where caregivers will be able to hear them easily, while transmitters should be placed within easy reach of the individual that needs them. It is best to have one that is always with the individual themselves, while others can be kept in fixed locations such as the bedside, or near the toilet.
Call bells vary in cost and complexity; some have audible alerts when the batteries are weak, distinct ringtones based on which transmitter button was pressed, and other useful features. These features can add value to the users and should be sought when possible.
Call bells should be tested periodically and their batteries replaced every few months.
Answering the front door of a home can be difficult for an individual with mobility issues. Friends, family, and recurring visitors can be educated about the inability to answer the door, and to simply knock and then let themselves in. Delivery drivers, door-to-door solicitors, and other people, would benefit from the presence of a speaker placed outside so that they can be told to come in, or be given other instructions.