Barrier Free Design for Man with Traumatic Brain Injury

Universal/accessible design of the home from an occupational therapy and a construction perspective. This blog is part of a quest for cool, convenient, functional design that makes life safer, easier, and as maintenance-free as possible. It's about the lifestyle.
This is a Cape Cod Style home we're redesigning for a man who has a brain injury and is ambulatory with assistance.  People with brain injuries tend to decline faster than the general population when aging so we are designing the house to be accessible for a wheelchair.  Designs are below the case details.  Click on Designs to enlarge.
Click on design to enlarge.
Click on 'Read More' to read more about this case.

Overview:  Cabby is a man in his late 40’s who has sustained a severe brain injury 2 years ago.  Cabby has been living at home with his family for the past year.  Cabby’s home is a 2-story Cape Cod with bedrooms and a bathroom upstairs, which are not accessible to Cabby, and a master bedroom, full bathroom, kitchen, dining room and living room downstairs.

Mobility Skills:
• Ambulatory with a cane and stand by assist.
• Requires a wheelchair for long distances. 
• Independent with stand by assistance for safety for sit to stand transfers.

• Independent with feeding.
• Moderate assistance with dressing, grooming and bathing due to sequencing and motor issues.
• Dependent for all higher-level ADLs.
• Continent with bladder and bowel during the day but needs assistance with toilet transfers.
         o Over anticipates toileting so requires multiple trips to the bathroom.
• Continence difficulties at night, is unable to get to bathroom on time due to mobility issues.  Gets up
   several times a night, Cabby’s wife gets up with him.

Goals for Handicap Home Modifications:
Increase safety.
        o Cabby falls in bathroom, the bathroom is not accessible for a wheelchair and too small to
           transfer safely.
        o Cabby falls often when transferring in/out of shower.  Bathroom floor is linoleum, which is
           slippery when wet. 
        o Cabby needs a clear path to the bathroom with something to hold onto to assist with
           balance.  Cabby requires furniture/wall or walker to assist with balance when ambulating.  At
           night Cabby tries to ambulate to the bathroom independently without his walker, his wife tries
           to help him but is not always fast enough.
Easy access egress.
          o Currently several handicap stairs to access home, takes Cabby 10-15 minutes with assistance
             to get from the car to the house. Very difficult in the winter, and dangerous for Cabby due to
             body temperature regulation issues.
Place to exercise.
• Main floor laundry.
• Increased storage space.
• Accessible master bedroom and bathroom.
         o Bathroom to have roll-in shower for Cabby and Jacuzzi tub for his wife.

*Wife would like current living room converted into therapy room. 

Click on 'Read More' below to see more designs.

Any thoughts on these designs?  Any advice to improve designs by adding something or taking something out?

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