Mandy Freeland broke her femur in an accident and realized how challenging it was to take care of herself in her house the way it was conventionally designed. We talk about what the issues were, how to address accessibility issues using universal design, and what we might all keep in mind as we alter our houses to really improve them.
About our guest:
Mandy Freeland is a mother, wife, architect, and firm owner based in Bakersfield, California. Her passion for making communities better and the architecture profession stronger has lead her to years of volunteerism in AIA, local small business organizations, historic and cultural preservation committees, advisory committees for the local high school and junior college architecture programs, and community empowerment groups. Her firm currently provides services for planning, custom residential, commercial, education, and industrial projects throughout California.
Photo credit for episode art: Stacy Zarin. Designer- Grey Hunt Interiors from the blog https://greyhuntinteriors.com/my-master-bath-reveal/
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Listen to the episode here:
Universal Design Is For Everyone With Mandy Freeland
My guest is Mandy Freeland, who is an architect from California. She had an unfortunate accident where she broke her femur. She’s been recovering from that and realizing that her house isn’t as accommodating as it could be. She and I were talking about this and I asked her if she would come on the show to talk about how she wouldn’t redesign her house if she could, knowing what she knows now. If we are going to be modifying our houses, building additions and creating new spaces, we should be accommodating as we can to all people, including ourselves and our family, who may need extra space and help in the house. Here’s my conversation with Mandy.
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Mandy, thanks for joining the show.
Thank you for having me, Katharine.
It’s my pleasure. It is not my pleasure, though, to hear about your accident where you broke your leg and it has left you not as mobile as you used to be. You’re having more difficulty maneuvering around your house. I thought it would be interesting to talk to you because I tried to encourage clients to think about universal design or the idea of getting around a house if someone has a walker or a wheelchair. We might not be the ones who need the wheelchair or the walker but it might be our friends who come to visit or anything could happen to any of us at any minute.
I’ll give a brief introduction to the injury. I was in Lake Tahoe with my family water skiing and broke my femur. I had some emergency surgery and ended up not needing a cast. Nobody thinks they’re going to break their femur. That’s the last bone that anyone ever thinks they’re going to break, like a foot, ankle, arm or something. That brings us back to what we’re talking about of having an unexpected injury that has a long recovery time.
I’ve been recovering for a couple of months now and it is surprisingly difficult to survive, take care of myself, eat, sleep, get up to use the bathroom, get to the car or go to doctor appointments. The survival part in my home on the first month of it, which is a lot of days of not being able to move or take care of myself by myself. Getting dressed, washed and having assistance widened my eyes on what is needed in the home for people who have unexpected injuries. When we think about disabilities, we might think about hearing, vision impairments or wheelchairs.
Wheelchairs are the extreme. They are the biggest maneuvering device that a person needs when they’re disabled but there’s also that temporary disability of injuries where someone needs a walker, crutches or an assistant like another adult person to help with lifting, pulling and assisting. Considering the recovery of a temporary injury on people with this kind of injury, back injury or neck injury can take 6 months to 1 year to heal and function again. A lot of people, since I got my injury, talk about hip replacements and knee replacements. It takes six months to get back fully functional again.
There are little considerations in a person’s home that we can keep in mind and we call it universal design. A universal design is not just for completely disabled people but it’s for people like me who could use a little extra thought. The first step of having a temporary injury is survival mode and that’s what the person is like an adult helping, lifting, pulling, helping you get comfortable, bringing you food, making sure that you’re clean and washing, the basic needs.
The second part is learning how to recover and live independently. That might take a lot longer. A person might not be able to stand for very long. The number of steps a person can take might be five steps and that’s it. They might have to use a walker to get around all of the spaces of the house. I’m interested in what you think of, Katharine.
I am an architect but I normally do commercial projects and school projects. I’m used to designing for accessibility. When it comes to the home, it’s not something that is a typical design thought process in designing for a person’s home but I would like it to be because you never know when you’re going to get injured or something’s going to happen and you’re going to need consideration in the design of your house.
Having an unexpected injury that has a long recovery time can really change your perception of things.
There are a couple of standard things that I try to get people to do, like to consider installing 32-inch doors so they’re slightly wider than the standard 30 inches. That’s very minimum. Also, think about how people get into your house especially if you have visitors who may need a walker or even a wheelchair. Sometimes it’s hard to get to be that accessible but make sure you have railings on your stairs at the very least and then the clearances around things. Make sure that everything’s not too tight. These are the very minimum that I would suggest to people.
With universal design, there are various standards for bathrooms. I am designing something now for a woman who is in her early 80s and is planning on living in this house for the rest of her life. We’re planning on a barrier-free shower, the one that you don’t have to walk over a little curb to get into or big enough for somebody else to be in there with her and assist.
We’re planning on being able to take out the vanity that she has in there and then eventually installing one that her knees could go under in a wheelchair if she ends up in a wheelchair. It’s planning for the future like that. I try to get people to think about that. We were talking about all these little things you’ve noticed around the house. I was wondering if you could share those with us, things that people might think about if they’re building an addition and there’s a new bathroom going in, a new kitchen or anything.
My husband, a few years ago, also dislocated his elbow and was a one-handed person. He’s recovering one-handed. I can frame it around that too when you don’t have use of two arms or hands. I broke my femur, which was an injury to my knee, upper leg and hip. Sitting for very long is difficult and standing was impossible for the first four weeks. In our master bathroom, we have a walk-in shower and we have a garden tub, which is pretty standard for master bathrooms in my area. I’m in California.
A garden tub is a big, deep, oversized oval tub with a tub deck. The tub deck is up high and the tub is deep and low so you’d have to climb in. It was something that if I wanted to take a bath, I couldn’t get in because I couldn’t lift my leg that high to get up and over. If I could lift my leg enough to get over, I can’t use my leg to lower myself into the tub. You would think with an injury or recovering that taking a bath would be a very nice thing to do but it’s almost impossible unless there are grab bars or another adult or two to help you get in. That’s not something you want to do when you’re undressed.
Especially the two, usually. One, maybe.
I don’t think I could do it with one person. They’d have to be in the water helping me get in. It’s a no in the bath.
What would be helpful then? To have a shallower bath or to have grab bars?
It’s a grab bar on the wall. It’s in the corner of the bathroom. Also, something to stabilize the other side. I would need two-side stabilization. If it were a long-term injury, I wouldn’t want to never take a bath again. If I need to make it a permanent thing, I will probably put in a handrail up and over the side and make sure that I have steps on the inside that can be taken out and set aside while I’m inside the bathtub. Other than the bathtub, it’s the shower. The tub deck is very helpful for sitting and dressing. It’s been very helpful as a sitting spot for anything in the bathroom.
The second thing is the shower. We have a walk-in shower and a built-in bench so the shower is over the tub deck about 1 foot. The tub deck extends into the shower and acts as a built-in bench. A built-in bench inside the shower is awesome. I need to take the walker into the shower to help me and then bathe myself by myself, which is something that you want to do by yourself. Dignity in the whole having an injury or disability is an important thing. You have to give up your modesty when something happens where you need assistance. Being able to do things independently is awesome.
My bathroom is a tub shower so it would be hard to get into the tub and take a shower on my own. That’s not going to happen.
You can get a bench that you can put inside and sit on it. I would try and do that but lifting the leg to get up and over would be hard.
I’m not going to do anything too exciting. Hopefully, I won’t break. Do you have a barrier-free shower or a curb?
We have a curb. It’s about 6 inches. It’s not high but getting my leg up and over and having the walker inside the shower, holding, balancing and shifting my weight up and over that curb was hard. That curb was a barrier. If I were to do it again, I would say barrier-free.
People don’t want to install grab bars because it makes them feel old. I try to get them to do at least a blocking for grab bars but also with the barrier-free shower seems to be in fashion now. That’s the good news that you don’t have to feel like you’re building an unfashionable bathroom. It can look beautiful.
It’s more of a modern look. If you need assistance and you need to lean on things and you have this big open space, the open space makes it another barrier where you can’t take ten steps. You can take three steps.
There’s too much room in between things you can hold on to.
I did have another bathroom. Bathrooms are a big deal for disabled people. In my master bath, we have a toilet room that separates the toilet with the door, wall and everything. It’s a private little toilet room in the master bath. The door is wide enough for me to get in with the walker but it opens in and it’s only wide enough for the toilet and the door to open fully. I can get in but I can’t close the door with the walker. Thinking about that, I would have switched the door swing to open out.
You can still have a small toilet room and you can use it.
Anyone can use it. I know we’re not talking about obesity but as our culture shifts to larger size people and larger accommodations where we’re seeing this in commercial design a lot. We’re providing more room in the bathroom stalls to open and close the doors. There is more room front to back and more room side to side. It’s not a bad idea to also consider that in private residential projects.
I’m walking 50% without the walker. I can pretty much walk around my kitchen without a walker but my counters are close together. I have a full L-shaped island and I have one wall that has the stove and refrigerator. My L-shaped island starts right across the refrigerator, which I love. When I am at the refrigerator, I get stuff out and set it on the island on the counter, which is handy because then I don’t have to try and walk carrying anything. The counter with the stove is one step away. I can take one step and shift things from the island to the other counter to cook. Everything’s within reach.
When we built the house, I designed it for multiple people to be in the kitchen at once. We like to accommodate large family gatherings and we have a lot of cooks in our family. I wanted to make sure that we weren’t stepping on each other’s toes. We have a space for food prep, washing and cooking. I didn’t design it for disabilities but I designed it for space and maneuverability.
When you think about the kitchen design and you use the triangle so you can go from one space to the other. I did that in small versions and it works out well for me now. I only have to take 1 or 2 steps to get something, like a step to get a glass, to the refrigerator and everything can be counter-to-counter transitions. That’s important when you’re not carrying things because not everyone is able to carry.
When we go back to think about my husband, who had one usable arm and one dislocated elbow, that was helpful for him too to use one hand for things and not need two hands for things. It’s different when you have a leg injury and an arm injury because you can get around pretty well when you have an arm injury but it’s more practical, like carrying things, opening doors or lifting things. You want to keep everything low. If there’s anything heavy that you need two hands for, keep it low so it can be pushed along instead of carried along.
A lot of days of not being able to take care of yourself following an injury can open your eyes on what is needed in the home for people with unexpected injuries or disabilities.
Also, having levers on the doors instead of knobs.
All of our doors have levers.
It’s hard for a lot of people to open the doorknobs if you don’t have strength in your hand for whatever reason. You can open a lever almost with anything. I have noticed that my clients have been opting for levers over knobs. It’s an observation I’ve had.
It’s a good thing to do. I have two kids and they’re teenagers now but back when they were little, between the ages 3 and 6, we didn’t want levers on our doors because we didn’t want them getting outside by themselves. They couldn’t handle the knobs but they could open the levers.
Your recommendations for the kitchen would be to design it so that you could potentially pivot on one leg and move things that way instead of having to carry it and walk on both feet across the kitchen.
Have everything in arms distance and counter-to-counter. We have a great room. We have a kitchen-living room connected open space. For a while, when I had to use the walker fully but I wanted something to drink and no one else was there to help, I’d get a cup of coffee and set it on the counter. My island is long and it leads to the living room. I would take a couple of steps, scoot the cup along, take a couple of steps and scoot the cup along. I figured out a way to make it work.
I got my coffee cup over to my chair, where I wanted to sit and drink coffee. It took me a minute to figure out how to do it without having to carry it. Having that physical counter connection from one space to the other helped a lot. I’m not saying you have to design a counter to stretch from one space to the other.
I know that we’re not designing furniture. We’re designing walls, floors, roofs, windows, doors and that stuff but we thoughtfully think about where the furniture layout is going to be when we design. It’s considering like, “If the furniture was laid out this way, if a person injured could scoot along the counter and get over to where they’re going to sit and rest,” that makes it a lot more thoughtful.
Maybe a travel mug and some cup holder on your walker would help.
Architects could probably think of a million things that we could do to improve like walkers for carrying things.
What about getting in and out of your house? Do you have a lot of steps getting in and out?
I live in a single-story and in California, we don’t have steps up to the house. We don’t have a raised floor. We have a slab-on-grade. The threshold is higher than the outside patio but we go in and out through the garage and make sure there are no obstacles as well. That’s one of the things that garages accumulate, big bookie things. Making sure there is a clear path is one of the things.
We go in and out of the garage so being able to fully open the door while the car is parked in the garage is important. Some garages are small and you can’t fully open a door while it’s inside the garage. You have to pull out and then fully open your door. I hate to see the garages that are designed very minimally and don’t leave enough room for a door to open.
In our case around here, we have a lot of differences. Usually, there’s a big difference between the grade and the first floor. It’s usually around three feet or more. Sometimes getting in between the living space and the garage involves a bunch of stairs. If you need any stairs in your garage then you need to have a bigger garage so you can have enough room to maneuver around the cars, stairs and the whole thing. There’s a lot that goes on in there.
Thinking about getting upstairs is still very scary to me. Stepping over the threshold in my shower is scary enough but putting all of my weight on one leg to climb a stair is very scary to me. In a two-storey house some of my thought processes and design would be to make sure that there’s a flex space designed on the first floor that can transition to a bedroom. When people have a back injury or if there’s an elderly person that you’re taking care of that can’t maneuver up and down the stairs, there’s a very large hospital bed brought in. If someone has to sleep on the couch, make sure there’s a flex space so the person isn’t out in the open sleeping on the living room couch among the family members. That’s another thing. We have a guest room but my master bed is very high and I still can’t get up onto it. We’re on our lower guest bed now.
The accessibility of furniture is a point as well, which is not our domain but the idea of having at least an option where you don’t have to climb up into bed in case you can’t. I was working with a person who has a chronic condition, which means that stairs and moving around the house are difficult for her. She’s going to end up installing a little home elevator, a limited use one so that she can go up to her second floor.
That is an option for people and it’s not very inexpensive but that does allow people who live in the two-story houses to get onto both floors. Also a chair lift on the stairs but not all stairs could accommodate that. It’s too bad if people live in a house like that long-term. They’re never going to be able to get to their second-floor again but they can walk on a level surface.
My mom has cancer and she’s been in treatment for a few years now. She’s a fighter and everything’s going well. She got great news and everything’s great on that side. We talk about injuries and stuff but a lot of people have cancer or other things that aren’t physical bones broken or something but are going through a multiple-year treatment process that makes them unable to do the normal things or need assistance. The house that my mom lives in is built on a hillside. It’s a single story with a walk-out basement. I don’t know if you would call it a two-storey but we would call it.
The front doors are on grade and built on a hill so the basement walks out to grade at the back. We talk about remodeling her house and moving the laundry room to the basement but in doing that, we’re thinking ahead of things like a laundry chute or installing a dumbwaiter. I know it’s been really difficult for her. Her office is downstairs and all the living spaces are upstairs, the bathroom, bedroom, kitchen and everything so going downstairs is a luxury. It’s not necessary but it’s the extra space. Carrying anything down the stairs is not the easiest thing especially if it’s big and heavy. It’s impossible for her.
The dumbwaiter is good for that.
It’s the things like that to accommodate the stairs on multilevel houses.
If people are planning on staying in their houses, who knows what’s going to happen? Let’s say someone’s thinking they’re going to stay there until the very end. That could be twenty years from now but they are going to need some accommodations as they age so you might as well build them right away. Plus, you get a little extra room. Having a little extra room in your toilet room is not a bad thing.
Let’s say you decided to build a dumbwaiter or a laundry chute. It is not a big deal. There’s room for it.
It’s planning where it might go and you don’t have to put it in right away but you’ll know where it will go later with all the framings in there and everything. That makes sense.
When a person gets injured or goes through cancer, it’s thinking ahead about how they can keep their dignity. Sometimes they do need a full adult to assist them. You have to accommodate two people instead of one person. Also, helping them function independently is second. Taking care of them, survival mode first is important. That’s a two-person thing and making sure they can eat, rest, stay clean and minimally get around to what they need to do.
The second is when they start recovering, they don’t want to have to ask somebody to get them a glass of water. They want to be able to eventually take care of everything themselves and function independently. You don’t always want to have to ask people for help. When you’re left alone, you want to know that you can take care of yourself.
You can make your own lunch and if you’re thirsty, you can get your own drink. The 1st is survival mode and the 2nd is independence. Make sure that someone can pull and lift themselves with grab bars. Even if you provide the blocking in the wall and install the grab bar later, you’re set. It’s great. Take it back out if you recover from your injury and don’t want to see the grab bar.
Regarding grab bars, people object to the tubular ones that look like they’re in a commercial stall. I’ve been seeing some on the old house community on Instagram where it seems there are these wooden rails. They’re more like these beautiful pieces of wood. I assume they’re strong enough to pull yourself up because they’re supposed to be grab rails. It would seem like there are alternatives to the grab bars that make people feel like it’s an institutional bathroom.
I’ve seen them around too for residential use. If you pay attention to hospitals, they have chair rails and grab bars and they’re not always using the stainless steel stuff. They hire talented healthcare interior designers. There’s a lot of products available that are designed to support a person’s weight, like a grab bar but it doesn’t have to be a grab bar. It can be designed into the wall.
With my injury and I’m visiting hospitals and doctor’s offices a lot, I see how much talent is out there with the interior designers and the products that they find that make it look more comfortable and less institutional and cold. I know stainless steel is a very cold feeling institutional product. It’s anything that’s not. What is very warm, comfortable, with color or different shapes other than round?
You can use them for towels in the meantime until you need them.
Don’t install a towel holder and use it as a grab bar.
That’s not going to work out very well. I appreciate you taking the time to talk to me about all this, Mandy. When you were mentioning it, I was thinking that people don’t think about that necessarily and it would be a good idea to accommodate different abilities in the house.
I appreciate you asking me to talk about it. I do commercial design a lot so I’m always preparing for the worst cases like wheelchairs, making everything wheelchair-accessible. In my own home, when I was injured, I was not in a wheelchair. I’m using a walker and I need a person to help me. It’s the things that we don’t think about when we think about disabilities. We think wheelchair, blindness, deafness or it’s something like that. It’s not as common to think about crutches, casts or temporary injuries that take six months to recover from.
Any of us could get any illness or I have an accident at any time that could end up being a permanent thing. We’re not necessarily always going to be completely and fully able to do everything. It’s to be good to think about that or the other people in our family. Thanks a lot, Mandy. You gave me some stuff to think about.
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About Mandy Freeland
I am currently serving as a committee member on AIACC’s Communication Advisory Committee as a way to use my passion and education in public relations. I served as my local chapter President and Executive Director to get our AIA chapter back on track as a resource to our community, our members, and a fun association to be a part of. Since my involvement, our chapter has grown the member programs for Emerging Professionals, Public Outreach, Advocacy, and mentorship with the local junior college, high school, and elementary school students. We have been recognized with awards from AIACC’s Academy of Emerging Professionals for the Chapter Award. I now am a Blueprint for Better Communities Champion for our chapter and local community, working on impact actionable programs in collaboration with our local architecture professionals, community civic groups, government agencies, and individuals, to make our community better. I serve locally on a Cultural Preservation Resources Committee for the upcoming construction of the high speed rail station in our downtown area. I
also serve on the Governance Committee for our local Habitat for Humanities association. My experience with AIA has given me leadership tools and knowledge that I am happy to use for other nonprofits to benefit our local community.