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Objectives

Establish tools and strategies to prepare for successful and collaborative housing viewings.
Identify accessible building features and spaces.
Consider the role of the client in housing viewing process.
Review Housing Viewing Checklist as a resource for evaluating accessibility.

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Some Key Considerations to Find the Best Fit

Come prepared with all necessary materials and information

Consider ALL building spaces and features

Have the client demonstrate, and consider how their performance may fluctuate on any given day

Consult your OTs!

Come prepared with all necessary materials and information:

Review clinician notes and client records – What limitations does the client have? Do they use a wheelchair or ambulatory device? Has the OT recommended any DME or home mods?
Be prepared to take measurements and photos

Consider all building spaces and features

Spaces include other areas in the building, beyond just the unit itself, that the client may need to access --> mailroom, laundry, common areas
Features should be considered both in the unit and other spaces in the building --> entrances (doors and doorways, handles and knobs, stairs/steps and thresholds, hallways, lighting, and flooring)

Have the client demonstrate!

It is natural to want to help (e.g., opening doors for clients, pushing a w/c if they become stuck), but think about the level of independence the client will be expected to perform these tasks at, once they transition.
Utilize the information you have regarding their baseline and any fluctuations in function, because they will be expected to do these things independently even on their worst days
Also consider impact of ambulatory device when viewing a space, even if the client is not using it on the day of the viewing

Don't hesitate to consult your OTs! More on this in later slides

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General Considerations

Doorways

Lighting

Steps/stairs

Door knobs and handles

Hallways

Flooring

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Doors & Doorways

Handles and doorknobs

Traditional knob vs. lever vs. fob entry

Swing

Which direction does the door open? Can the client open the door while manipulating their mobility device?

Clearance

ADA standard minimum requirement is 32", measured at the narrowest part of the doorway
Wheelchair users:

Doorway must be wide enough for wheelchair to fit at its widest point
Consider extra space for clients using a manual wheelchair
Bariatric wheelchairs may require clearance greater than 32"

Threshold

Can the client safely and successfully get over the threshold?

Handles & doorknobs – Does the client have the grip strength and wrist mobility to turn a traditional door knob? Door levers provide a more natural grip and require less effort to operate. If a knob or lever requires the use of a key, consider whether the client possesses the fine motor skills necessary or if they would instead benefit from a key card or fob entry.
Swing – Observe which direction the doors swing and ensure there is ample space for the individual to maneuver either a wheelchair or ambulatory device while opening the door. Don't forget that all doors will need to be opened toward the client at some point – make sure they are able to pull the door while safely maneuvering their wheelchair or ambulatory device
Clerance – The minimum doorway width per the ADA standards is 32". If you look at the image in the lower R, you'll see that the doorway should be at least 32" at the narrowest part – keep this in mind when taking measurements. For wheelchair users, the doorway must be wide enough to fit the wheelchair at its widest point, plus additional width for hand propulsion with a manual wheelchair. Bariatric wheelchairs may require additional clearance. If a client uses a wheelchair but will not have it at the viewing, it can be helpful to obtain important measurements prior.
Threshold – If a client is ambulatory monitor their gait for any shuffling as this may increase their fall risk. If I client uses an ambulatory device, ensure they can lift it and still safely maneuver themselves over the threshold. Wheelchair users should be able to propel their wheelchair over the threshold without assistance.

Don't forget to keep these considerations in mind when examining all doors throughout the building, both internal and external. Best practice is to observe the clients completing all steps on their own, for both entering, and exiting, to ensure they can do it independently.

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Other Important Considerations

Hallways

Enough space to maneuver through hallways AND turn around
More space required when opening doors toward a wheelchair user

Flooring

Wheelchairs and ambulatory devices may be more difficult to maneuver on certain types of carpeting

Lighting

Does the lighting provide sufficient visibility?

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Building Features

Is member able to access building without struggle?

Ramp for WC users
Door accessibility (width, handle, surrounding space)
Steps or tall threshold� ��

Laundry

Mailbox

Entrances

Is the mailbox height appropriate for the member?

Is the member able to grasp and manipulate a key?�

Is member able to access and utilize laundry room and machines without struggle?

Door accessibility
Steps or tall threshold
Washer dryer setup (height, front load vs top load, knob placement)

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Stairs

When should stairs be avoided?

If the client uses ANY mobility device

Client will need a first floor unit or unit that is accessible via elevator
Consider stairs throughout the building and whether they limit access to any spaces or features
Entrances should be 'zero step'

Factors that may limit an individual's ability to do stairs

Endurance

Do you notice frequent and/or easily triggered shortness of breath?

Pain

Do they have a diagnosis that causes chronic pain?

History of falls
Client is receiving dialysis --> Remind them that they will need to do stairs, even on their worst day!

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Unit Considerations

Bathroom

Kitchen

Accessibility of:

Fridge and freezer
Countertops
Cabinets and drawers
Appliances

Gas vs. electric stove

Accessibility for:

Wheelchair and AD users

Toilet
Tub/shower
Sink

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Bathroom Accessibility

Wheelchair users:

Must be enough room to get the wheelchair into the bathroom and make a full 360 degree turn
Same with walkers and rollators, even if a client does not always use it!

Sink:

Wheelchair users must be able to maneuver closer enough to turn faucet on/off

Toilet:

Can the client transfer to and from the toilet independently?
Are there grab bars? (If need for grab bars indicated by OT)

Tub/Shower:

Does the unit have a walk-in shower or tub/shower unit?
Can the client safely and independently transfer?
Are there grab bars? (If need for grab bars indicated by OT)
If need for shower chair or tub transfer bench is indicated by OT, ensure adequate space

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Pictures for ATU: Bathroom

From doorway looking in

Sink (facing straight on)

Showerhead area

Toilet (facing straight on)

Door swing area (with door closed)

Any grab bars or towel racks

Checklist created by Nicole Barker, OTR/L

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Examples

When photographing the bathroom, you want to try and include … for example a photo of the tub/shower unit should include all three walls, the tub spout, and shower head if possible. If you're unable to capture all of this in one image, you can take multiple photos but try to take pictures that make the layout of the bathroom as clear as possible. When photographing the toilet, make sure you have the toilet itself as well as any walls or fixtures on both sides (e.g., sink/vanity, tub, grab bars)
It is best practice to take the necessary photos at all viewings, even if you may not need them, a) to get in the habit of taking photos for ATU and b) prevent you from having to go back and photograph the unit should there be any change in client status or new recommendations for DME/home mods. You can use the checklist created by Nicole Barker while out on apartment viewings to ensure you gather all photos that could potentially be needed by ATU.
Please be sure to send these photos to the OT and upload them to wherever your agency stores apartment/unit photos for team member access.

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Housing Viewing Checklist

We created the Housing Viewing Checklist as a tool to prepare for and reference during housing viewings.

It includes a) space to document relevant client information, b) important tips and reminders, c) helpful strategies for taking quick measurements, and d) a full checklist of spaces and features to assess during a viewing.

You can use this resource to standardize your process for housing viewings, increase opportunities to collaborate with your OTs, and efficiently share housing information across team members.

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Helpful Resources

Functional Needs: Assistive and adaptive technology and minimizing fall risk

UIC ATU Furniture/Household Item Checklist

UIC ATU Webinar: Tools for Setting up Appropriate & Supportive Home Environments for Class Members Using a Collaborative & Client-Centered Approach

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References

Angell, J., & Hein, E. (2023). Accessible housing training [PowerPoint Slides]. Department of Occupational Therapy, Trilogy Inc, Chicago IL.

Barker, N. (2021). Photos for preliminary apartment accessibility assessment [Checklist]. Department of Occupational Therapy, Kenneth Young Center, Elk Grove Village, IL.

University of Illinois Chicago College of Nursing. (n.d.). Colbert & Williams training. Colbert & Williams Training | University of Illinois Chicago. https://colbert-williams.nursing.uic.edu/