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Home safety and access

Grab bars, ramps, thresholds, and lighting. Most of these are cheap and get installed years later than they should have been.

Home safety and access: 9 items

What to change first

The bathroom, almost always. It is where the falls happen and where a fall does the most damage. After that, the route between the bed, the bathroom and the front door. Our guide to home modifications gives the order and the costs.

Doorways: clear width, not frame width

What matters is the clear opening once the door and its stop are in the way, which is narrower than the frame you measure. Swing-clear hinges recover an inch or two without rebuilding anything, and that is often the whole difference.

Ramps: the slope is the number that matters

A ramp is defined by how much length it gives you per inch of rise, which is why a few porch steps need a surprisingly long ramp. A threshold ramp handles a single lip at a door. Anything taller needs real length, or it becomes something nobody can push a chair up.

Grab bars and poles go into structure

Into a stud, or into a backing plate fixed to studs. Not into drywall with plastic anchors. A floor to ceiling pole works differently, bracing between floor and ceiling joist, and it needs a solid ceiling above it rather than a suspended one.

Lighting is the cheapest thing that works

Motion sensor night lights along the route to the bathroom prevent more falls per dollar spent than almost anything else on this page.

What this equipment costs, and who pays

Medicare Part B covers medically necessary durable medical equipment when a provider prescribes it for use at home. After the Part B deductible you pay 20 percent of the Medicare approved amount. Hospital beds, commode chairs, walkers, wheelchairs and scooters are all on Medicare’s own list.

Whether one specific item qualifies is decided case by case, so ask the clinic’s social worker before paying out of pocket. Check that the supplier is enrolled in Medicare and accepts assignment, and ask whether the item is rented or bought, because that differs by equipment type.

Our guides to free and low-cost equipment programs and financial resources cover the routes that are not Medicare, including loan closets and nonprofit grants.

Coverage details from Medicare on durable medical equipment.

Guides on this site

• Home modifications: what to change first
• What to do when someone falls
• Wheelchair to car transfers
• Toilet transfers in tight bathrooms