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Promoting Independence for Wheelchair Users: The Role of Home Accommodations

Correspondence: Address correspondence to Susan Allen, PhD, Associate Professor, Deputy Director, Center for Gerontology and Health Care Research, Brown University, 2 Stimson Ave., Providence, RI 02912. E-mail: Susan Allen{at}Brown.edu

Purpose: The objective of this research is to investigate whether home accommodations influence the amount of human help provided to a nationally representative sample of adults who use wheelchairs. Design and Methods: We analyzed data from the Adult Disability Follow-back Survey (DFS), Phase II, of the Disability Supplement to the 1994–1995 National Health Interview Surveys (NHIS-D). The analytic sample consisted of 899 adults aged 18 and older who reported using wheelchairs in the previous 2 weeks. We conducted logistic regression and ordinary least squares (OLS) regression analyses to test the influence of home accommodations on the receipt of any human help, and among respondents who received help, on the hours of help received, respectively. We analyzed paid and unpaid help separately. Results: Home accommodations were related to the receipt of unpaid, but not paid, help. Relative to having no home accommodations, the presence of each additional accommodation decreased the odds of having unpaid help by 14% (OR =.86; 95% CI =.76,.97). Additionally, we observed an inverse relationship between the number of accommodations in the home and hours of unpaid help (p <.01). For wheelchair users who live alone, specific types of home accommodations were also inversely related to hours of unpaid help. Implications: Policies that reimburse for home accommodations may be an efficient response to the growing demand for home-care support while enabling greater autonomy and independence for people who use wheelchairs.

Key Words: Long-term care • Architectural accessibility • Disability • Wheelchairs • Caregivers

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