Dale Etchells was diagnosed with primary lateral sclerosis (PLS) in 2000. Concerned about his disease progression and increased muscle weakness, he’s seeking information on resources available to help keep him safe and independent in his home. This Q&A explores the various options available to help Dale keep his independence, as he prepares himself to be bound to wheels.
Here is the official transcript of this interview, with timecode to allow anyone to jump to each discussion point.
DALE ETCHELLS 00:08
Thank you, Aaron, for seeing me. I have some questions about accessibility in my home. I’m kind of curious. I’m getting a wheelchair in the next few months, and I’m not quite sure how to get it in my home since I have a cement step going in and leading into the house, and the same way in the garage.
AARON DEVENDORF 00:30
Yeah, Dale, it’s a common, very common problem that we run into. Fortunately, we have a number of options available in order to help with that. Entry into the home is usually accomplished in a wheelchair by either using a modular ramp, we can also provide a concrete ramp or wooden ramp, whatever you’d prefer.
These ramps are going to provide plenty of weight capacity for any kind of chair that you have now or in the future. We also have a space-saving option utilizing a vertical platform lift, which we can install, and it’ll allow a vertical transition to overcome that step.
My daughter has pretty much the same set up, and I’d like to visit her every so often. Do you have any suggestions on how I can get a ramp put there? Do I have to buy one for her as well?
There’s so many options available to you as far as equipment that you can take with you, or even leave at your daughter’s that can be put up when you visit.
So portable ramps are fantastic devices. They can fold up. They can roll up. There’s a number of solutions in order to get in and out of your daughter’s house.
This ramp that I can use to get into my home, can my next door neighbor build one for me, or do you suggest that I reach out to somebody or what are your ideas.
We live in a time where people do want to help. Our neighbors, our friends, our family will go out of their way to do whatever they can for us. When it comes to accessibility, my recommendation truly is to have someone who is familiar with the equipment, familiar with long term diagnosis and progressive disease to recommend and install the right solution.
In the case of a ramp, it’s very important to understand how a person is getting in and out of a house, what equipment they’re using to do that. A person needs to be able to look at a set of stairs, an exterior set of stairs, and calculate exactly the correct length of ramp to lower the slope angle to a safe measurement.
It’s great when a neighbor is willing to help, and there certainly are very crafty people in my community and many. But oftentimes those solutions will not last. We’ve seen where a neighbor might do their best to build a wood ramp, say. But unless it’s done correctly and at the right slope angle, it can cause headaches from a maintenance standpoint, but also it can put the user in an unsafe situation. So I really do recommend having a professional evaluate the area being proposed for the ramp and then recommend the right material and ramp length for a safe and easy transfer.
We can put a ramp on the front of the house and I’ve got a big backyard and I really don’t have a good way to get around to it in the front, but I do have a deck in the back. Is it possible to make that accessible as well? Unfortunately, the deck has steps going down, so I’d like to get down that way as well. Do you have any suggestions on that?
When we look at egress in and out of the home, it can be very important to have multiple points where you can get in and out, not only from a safety standpoint, but also just from an enjoyment standpoint of your property. So I definitely would recommend not only a ramp, maybe in the front of your house or in your garage, but on your back deck, there are several things that can be done in order to help get in and out.
There are exterior vertical platform lifts that do not take up a tremendous amount of room, allowing you access onto and off of your deck so you can enjoy your backyard.
You can use a ramp as well. It takes up a little bit more space, but is another fantastic solution with the right slope.
There’s even things like exterior stair lifts that can be mounted to exterior steps in order to provide safe entrance and exit off of the deck.
Ah, very cool. Very cool. Now with my wheelchair, it’s quite heavy. Do I need to modify the floors in any capacity? Do I need to take the carpet out, or…?
Generally not, but we have to look at barriers in and around the home. Things like carpets, or other floor decor that might cause a barrier to transition from one room to the next. We wanna look at things like thresholds, transitions from one room to the next, to make sure and just verify that the wheelchair won’t have any obstacles to overcome.
My bedroom is upstairs. And as I progress, I’m debating whether to move my bedroom to the main floor. But in the meantime, is there any options for me to get my wheelchair up to the second floor?
There certainly are options. Question I might have for you is what would you prefer to see in the future? Would you prefer to leave the bedroom upstairs? Would you prefer to move it downstairs? Depending on your preference, there’s a number of equipment options that we can install to get you from your first to second floor.
These options include stair lifts, simple stair lifts requiring transition into a seat, or even residential elevators providing the opportunity just to roll into a cab just like you might see in an office building, and head upstairs to your bedroom. So there’s certainly options available to overcome those stairs.
The stair glider, does that require widening my stairway or can it be just fitted into the stairs existing today?
That’s a phenomenal and very common question. With staircases these days, because of code, typically we have plenty of room to install a stair glide or stair lift. These stair lifts are capable of holding several hundred pounds. There are custom options as well for stair lifts that can provide a very snug fit.
The rail will mount directly to your stair tread and our professional installers will keep the equipment as close to the wall as possible, allowing yourself and other users of the staircase to walk up and down the stairs.
Oh okay, so it doesn’t impede other people going down?
That’s exactly right.
Oh, that’s kinda cool. Is it battery operated, or…?
That’s a great question, and the answer is yes. Stair lifts are battery operated. The idea behind the battery operation is in the case of a power outage, you would still be able to get up and down your stairs, and depending on the brand of stair lift, you can use the stair lift in a power outage dozens of times. Two to three dozen times you’d be able to get up and down those stairs in a power outage.
The rail plugs in to a simple 110-volt outlet just like any appliance in your home or a lamp and that keeps those batteries consistently charged without you having to do much thinking about it.
Oh, so low maintenance.
Very cool, very cool. And then you mentioned an elevator. My house is kinda situated where I don’t know where to put it. Do you try and put it in a closet space area, or do you take out a wall?
That’s very fair, and we can do a number of things. So we will pair with a structural engineer and our own contractors to find a location in your home where we could retrofit and elevator.
What’s exciting about today is the number of options and the technology has improved that we really do have a tremendous array of available elevator options where we can find the equipment that will work best for the space that you have.
We can use pneumatic technology, requiring a simple floor penetration, just a hole in your floor. We can find a place that will even add value to your home as residential elevators become more and more desirable.
Oh, that’s a good idea ‘cause I was kinda curious between the glider and the elevator. The glider sounds like I’d have to have a second wheelchair on the top floor so I can transition to that into my bedroom.
Yeah, and that’s something that we need to think about. Where an elevator may be initially more expensive to purchase than a stair lift, requiring more installation than a stair lift might. The elevator is gonna provide potentially a longer term solution than the stair lift.
As your diagnosis progresses, and mobility becomes more difficult, an elevator gives you the user the ability to stay in your wheelchair as you go from floor to floor rather than transferring.
The stair lift works phenomenally well while you can get up and move from one seat to the next. As that might change, the stair lift might not be the safest option, and that’s where installing an elevator now and looking towards the future may be the right solution.
We’re thinking of moving, and we’re gonna rent a home. And I’m not sure how much we can modify that house. Are there any, like, maybe possibly temporary options for getting into my rental home, ‘cause I’m sure it’s gonna have steps.
For cases in which heavy modifications aren’t possible, there is great solutions with aluminum modular ramp systems. These aluminum ramps do not require caissons. You don’t have to do any concrete work for the ramp to be installed. The ramp essentially sits on its own weight, and there is almost no impact to the home itself.
So I would recommend looking at an aluminum modular system in the case of renting and trying to get in and out of the house. Those typically are gonna be less costly than maybe a concrete ramp solution or a wood ramp solution that might be more permanent. And it allows the landlord to… they can have it removed very easily with no damage done to the property.
In the case of getting up and down stairs in a rental property, typically a stair lift installation, for instance, a stair lift mounts solely to the stair tread. They do not mount to the wall, so there’s no wall modification necessary. You don’t have to remove things like handrails in most cases.
And so with that stairlift being mounted directly to the stair tread, especially in the case of carpeted steps, which are so common, once you remove the stair lift it’s invisible that it was even there. In a rental situation, as you’re looking for your rental house, having that discussion with the property owner about what they will allow you to do before you rent is extremely important. And just being open and upfront about what your needs are is also very important in determining what you will be allowed to do.
Aaron, thank you very much for seeing me today.
My pleasure, Dale, you’re very welcome.