Visitability

Visitability is the design approach for new homes whose main principle is that a non-resident using a wheelchair should be able to visit the home. A social visit requires the ability to get into the house, the ability to pass through interior doorways of the house, and the ability to get into a bathroom to use the toilet.

Newly constructed homes often contain the same major barriers as older, existing homes: steps at every entrance and narrow interior doors, with the bathroom door usually the narrowest door in the house. Supporters want to change new home construction practices so that virtually all new homes, whether or not designated for residents who currently have mobility impairments, offer three specific accessibility features that will make it possible for most people to visit:

1. at least one zero-step entrance on an accessible route leading from a driveway or public sidewalk,
2. all interior doors being wide enough to allow a wheelchair to pass through (approximately 81 centimetres (32 in)), and
3. at least a half bathroom on the main floor.^[1]

These features are designed around the needs of a person using a wheelchair while visiting, but they are also helpful to people with other kinds of mobility impairments, for example, if a resident breaks a leg. Living permanently in the home with a significant mobility impairment requires two additional basic features on the main floor: a full bathroom and a bedroom (or a space that could be converted to a bedroom).

Visitability is similar to Universal Design in general intention, but is more focused in scope, more specific in parameters, and more explicitly grounded in a social reform intent.

Visitability features make homes easier for people who develop a mobility impairment to visit friends and extended family rather than having to turn down invitations, or not be invited at all. These features also provide a basic shell of access to permit formerly non-disabled people to remain in their homes if they develop a disability, rather than forcing them to do expensive renovations, relocate to a different house, live in an inaccessible home which endangers their health and safety, or move from the community into a nursing home.

Specific goals

1. A focus on single-family homes instead of public buildings. Access to new public buildings, such as government offices and restaurants, is typically already required under various national laws, such as the Americans with Disabilities Act of 1990 in the United States. Outside of the UK, single-family homes are the one kind of building which is still routinely constructed without regard to access.
2. Every home instead of just "special" homes. Being able to attend the party is better than isolation, or the risk of being "helped up the steps." People who use wheelchairs or walkers, or are impaired by stiffness, weakness or balance problems are blocked by steps at every entrance of a home. Wheelchair users are stopped by inches from fitting through the bathroom door in a friend or relative’s home.
3. Narrowing the emphasis to the most essential features, which are:

• entering a home,
• fitting through the interior doors, and
• being able to use a toilet.

While there are many possible or desirable features, strongly prioritizing the few features which are most crucial to visiting or residing in a home greatly increases the likelihood of widespread construction change.

Basic access goes beyond visiting. It also helps a person of any age who develops a temporary or permanent mobility impairment. Without basic access in place, architecture forces severe choices:

• Expensive renovations, assuming that the necessary changes are possible.
• Being unable to enter or exit the home independently, or to use the bathroom at all.
• Moving to another home or to a nursing home or other specialized facility.

These issues can apply equally to a person who is recovering from surgery, or to a person who has used a wheelchair for decades.

Construction issues

Zero-step entrances on new homes are nearly always easy to construct, whether the terrain is flat or hilly. The entrance can be constructed at the front, side or back, wherever is most feasible for the topography. A driveway or sidewalk can be a tool for access to the best entrance. Porches and decks can be used to incorporate access, often in a manner where it is not as obvious as many ramps.

On new construction, a zero-step entrance can usually be incorporated without a “ramp” per se, i.e. without a structure that has 90-degree dropoffs at the edges and rails at the sides. In most cases, this type of ramp is not necessary because the entrance can be achieved by deliberately grading the lot in a way that permits the sidewalk to meet the porch without a step.

For the 40% of homes built with a slab-on-grade foundation, the zero-step entrance is typically extremely easy. The methods for homes are virtually identical to those used for slab-built commercial buildings such as banks and restaurants. For homes with basements or crawlspaces, several solutions can provide low-cost, attractive zero-step entrances. Among these are using a porch as a bridge to the sidewalk; lowering the first-floor rim joist into a notch in the foundation wall at the time of construction; a short, conventional ramp tied into a side or back deck or porch; creative use of a small retaining wall; and constructing the zero-step entrance from the garage. With all methods, siting the home properly on the lot and grading the earth with the zero-step entrance in mind are essential.

History

In the United States, the Visitability movement was begun by grass roots advocates led by Eleanor Smith in an organization called Concrete Change. She originated and developed the concept in 1986, at that time using the term "Basic Home Access". In 1990, when US advocates learned that the term “Visitability” was used in the United Kingdom (UK) for a similar concept, they adopted the term to emphasize that the goal is not the traditional “more homes for the disabled” but rather a change in standard homebuilding procedure.

The Atlanta chapter of Habitats for Humanity became the first organization to commit to going beyond accessibility in homes with disabled family members. By including these basic access features in every home built their commitment contributes to an inclusive neighborhood for people with disabilities. Concrete Change continues to grow in number of participants and number of open-market houses built with the basic features.

The UK has applied the most widespread legal application of the concept to date. In 1999, Parliament passed "section M", an amendment to residential building regulations requiring basic access in all new homes.^[2]

Advocates maintain that the philosophical underpinning of Visitability is as important as the list of features. They maintain that building homes with steps at all entrances and narrow interior doors is an unacceptable violation of human rights, given the harsh effects the barriers have on so many people's lives: physically unsafe living conditions, social isolation and forced institutionalization.

Benefits

• Residents in the community can welcome guests who use wheelchairs, crutches, canes, walkers (walking frames), or have some other mobility impairment such as stiffness, weakness or poor balance. When visitability is in place, mobility-limited people are not socially isolated by architecture.
• If a family member develops a disability though illness, accident or aging, the person and their family are more likely to be able to remain in their existing home, rather than having to do major, expensive renovation—or move to another house, or be forced to commit that family member to a nursing home.
• All residents find it easier to bring in baby strollers, grocery carts, or heavy furniture.
• Visitable homes enhance sale and re-sale in an era where both the number and the percent of older people are growing rapidly. Non-disabled buyers are attracted to well-designed homes that welcome their aging relatives and friends and provide easy-use convenience for themselves.
• Temporary disabilities, i.e. broken leg, surgery, etc., can require use of a wheelchair or other mobility device during the recovery/rehabilitation period. This can be a major problem in most existing homes lacking these basic accessibility features. In some cases forcing a person out of their home during the recovery period.
• Visitability features cost little up front - unlike the much higher after-the-fact cost of widening doors, adding ramps or electric porch lifts and other remodeling.
• Besides human rights, advocates cite the economic implications of visitability. By 2010, research by the National Association of Home Builders indicates that half of all US homes will be headed by persons 55 years old or older.^[3] Average nursing home costs exceed $60,000 dollars per year per resident,^[4] while nearly 70% of nursing home costs are paid with public funds.^[5] Staying out of institutions as long as possible is a strong desire of most people and also financially beneficial to individuals, families and society.

Disadvantages:

• The adoption of visitability over the broad spectrum of newly constructed dwellings could lead to a built environment deemed sterile and disengaged from regional and traditional practices.
• This can be easily overcome by incorporating visibility features into traditional designs and not trying to make it a cookie cutter design.

Adoption of visitability laws

Because not all locations use the term “visitability” in their efforts, it is difficult to definitively track the adoption of visitability across the country. Other factors complicating the research include the lack of an organization assigned to monitor visitability ordinances, and ordinances and laws that often do not specify the agency responsible for implementation.

In the United States, successful Visitability legislation has been passed in many localities, including Atlanta, Georgia; Pima County, Arizona; Bolingbrook, Illinois; San Antonio, Texas; and the State of California.^[6] As of June 2006, 46 state and local municipalities had a confirmed visitability program in place; while 25 of these programs are mandatory ordinances, the other 21 are voluntary initiatives (i.e. cash and tax incentives for builders and consumers, consumer awareness campaigns, and certification programs).

In addition, there are numerous efforts to establish visitability programs in other states, counties and cities across the country. The research identified another 30 initiatives currently underway. They range from organized groups of individuals with an expressed interest in beginning a visitability program to locations that are in the final stages of developing a program.^[7]

References

1. Concrete Change website
2. "Doors to Be Swept Away in New Rules for Builders," Rachel Kelley, The Times, December 5, 1997.
3. "Profile of the 50+ Housing Market," Nations Building News, July 31, 2006.
4. GE Financial Survey, 2003
5. “Medicaid and Long-term Care,” Kaiser Commission on Medicaid and the Uninsured, May, 2004.
6. Concrete Change, op.cit.
7. Maisel, J. (2006). Toward inclusive housing and neighborhood design: A look at visitability. Community Development: Journal of the Community Development Society, 37 (3), 26-34

8. "Increasing Home Access: Designing For Visitability" AARP Public Policy Institute, Jordana L. Maisel, IDEA Center; Eleanor Smith, Concrete Change; Edward Steinfeld, IDEA Center; August 2008