Alterations to a home for someone who is physically challenged is very precise and customized work. The contractor must know the particular codes pertaining to the project as well as the specific needs of the individual for whom the alterations are being done. When I am called out on a project, I like to have all concerned parties involved in the initial interview. For me, it is most important to know what the disability is and its prognosis. With this information, I can try to anticipate future needs, if changes are going to be required or adjustments made.

If different apparatuses are used such as walkers, crutches, or wheel chairs, I also need to see them in order to obtain sizes and measure possible turning radius. For example, adult wheelchairs can average a length of 41" to 45", a width of 21" to 28" with a seat height of 19" and arms set at approximately 30" from the deck. Setting an average adult into his/her chair, you can add approximately 6" to 8" to the width and chair length. However, such items as foot rests, air tanks, power packs, etc. can further add to these dimensions. This, in turn, can affect the turning radius, which may in turn affect the placement of cabinets, and so on. A good radius to maintain should be between 63" and 65"; however, if it's a manual chair, I have seen as little as 60" work in some instances.

When I interview, I also try to obtain accurate measurements of the user's motions. Their vertical, horizontal, and angled reach will tell me if cabinets need to be altered and to what extent. I will also realize if code variances may be required to meet the needs of the individual.

I also check to see which hand is dominant. This is used for switch, outlet, and appliance placement. It is also useful in determining cabinet door hinging and the type of hardware to be applied. In the case of support-assistance, I will be able to determine what type of safety grab bars are needed, the length and bar configuration, as well as the diameter.

The important thing I've found during the initial interview is to keep all present informed of what measurements I am taking and why. It is also important to get their input. I an recall a number of times when clients have told me, "No one listens to me. The contractors come in with the social workers and carry on as if I weren't even in the room." This isn't right in any situation.

Another thing I like to do is make sure when I communicate with a chaired person that I am also sitting. In this manner, I can see things from their perspective, and we can communicate comfortably eye to eye. I never felt that there was anything useful to that "dominant height theory" where one stands while others sit until I myself was put into that situation. I soon found that level eye contact can make or break any project.

During this interview, it is also a good time to do preliminary sketches of object locations such as for tables, appliances, work areas, outlets and so on. I often take instant camera photos of areas. With instant photos, we can place them on the table and mark on them, if needed instead of waiting for standard processing to tell me I took the wrong shot or shot at the wrong angle.

I also ask if the client has any ideas or sketches. We can then mix our ideas to come u pwith the best possible solution to suit the requirements and needs of the individual.

In short, I'd say, the first place to start any alteration project is to sit and listen. Communicate on an even level. Use three dimensional thinking. Just because an appliance is located in one area, that does not mean that it must stay there. Closed minds lead to tunnel vision and restrictive ideas. I've found that is why there are only a few firms that get involved with specialty alterations. In my opinion, the improvement and remodeling industry is both fulfilling and rewarding as a career. Adding to that, the opportunity of giving someone something that most people take for granted becomes a very nice bonus.