Home Modifications
Adapt your home for safety and access
Review status: Waiting for team review. An AI editorial check was completed on 2026-08-14 by claude-opus-5. It checks clarity, attribution and scope against the sources, and it is not a Compass team or clinical sign-off. Waiting for clinical review. Last updated 2026-08-14.
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Planning 3
- Identify the biggest barriers at homeFocus on the entrance, bathroom, bedroom, and the routes between them.Why it matters: Difficulty at home tends to concentrate in a few places, so a short list often covers most of the benefit.
- Separate urgent from later changesStart with immediate safety and access problems.Why it matters: Splitting the list stops a long-term plan from delaying the change you need this month.
- Get practical adviceAsk for a home assessment by an occupational therapist.Why it matters: An assessment often finds a simpler fix than the one you were planning to pay for.
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As ALS/MND affects movement, a home that once worked easily can start to feel like an obstacle course. Steps, narrow doorways and a bathroom that is hard to use can all get in the way. Changing the home, rather than struggling against it, can make a large difference to daily life.
What home changes can do:
- Keep you safe. Removing steps and trip hazards, and adding rails and good lighting, can lower the risk of falls. A fall can set things back, and many of the hazards behind falls can be removed.
- Keep you getting around. Ramps, wider doorways and level access mean you can keep using your home, and get in and out of it, as mobility changes. This includes using a wheelchair.
- Make daily tasks manageable. Bathroom and bedroom changes can keep washing, using the toilet, and getting in and out of bed safe and dignified.
- Make caregiving easier and safer. The right setup can reduce the strain on the people helping you, and makes support smoother for everyone.
- Support independence. The aim is to keep you doing as much as you can, yourself, for as long as possible.
Home changes range from small and quick (a grab rail, a threshold ramp) to larger projects (a wet-room shower, a stairlift or through-floor lift, widening doorways). You do not have to know which you need. An occupational therapist assesses your home and your needs together.
The key idea is the same as for equipment: planning a step ahead is easier and safer than reacting after a fall or a crisis. The next questions cover what changes help, how to prioritise them, and who arranges them.
Evidence for this answer
The sources the Compass team used to write this answer. Highlighted phrases in the answer above correspond to the statements below.
Statement 1 of 2. Adapting the home, rather than working around it, can make a real difference to everyday life.
Supports this. NICE MND guideline — NICE · Clinical guideline
The UK MND guideline treats equipment and adaptations as the way people keep taking part in everyday activities and hold on to their quality of life, and tells services to provide them without waiting.
“Provide equipment and adaptations that meet the person's needs without delay, so that people can participate in activities of daily living and maintain their quality of life as much as possible.”
1.10.2Link checked August 2026
Statement 2 of 2. Removing steps and trip hazards, and adding rails and better lighting, can lower the risk of falling.
Qualifies this. Environmental interventions for preventing falls in older people living in the community — Cochrane · Research review · March 2023
A review of programmes that find and remove fall hazards at home; its own examples include stairs without railings and poor lighting. It found fewer falls, but only for people already identified as being at higher risk of falling, and no reduction when people were not selected for that risk. The trials were in older people living in the community, none in ALS/MND.
“We found high-certainty evidence that home fall-hazard interventions are effective in reducing the rate of falls and the number of fallers when targeted to people at higher risk of falling, such as having had a fall in the past year and recently hospitalised or needing support with daily activities.”
Authors' conclusionsLink checked August 2026
Adds context. ALS Home Safety — Your ALS Guide · Practical guide
An ALS-specific guide that treats changing the home as fall prevention, and names clearing clutter, removing trip hazards like throw rugs, fitting grab bars, and having railings that run the full length of the stairs. It gives no measure of how much difference this makes, and it does not mention lighting.
“It is important to make modifications that will minimize your risk of falling, as falls can lead to injuries.”
Preventing FallsLink checked August 2026
Used across the whole answer
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There is a wide range of home changes, from small additions to larger building work. A good way to think about them is by area, and to start with safety and access. That means the things that prevent falls and keep you able to move around and get in and out.
Common changes, roughly by area:
- Getting in and out. Threshold or full ramps, handrails by steps, or a lift for changes in level; level (step-free) access to the main entrance.
- Moving around inside. Clearing trip hazards, widening doorways, rearranging rooms so what you need is on one level, and stairlifts or through-floor lifts where stairs are a barrier.
- Bathroom. Grab rails, a shower seat, a level-access (wet-room) shower, a raised or supportive toilet, and space for help if needed. Bathrooms are a common priority because they involve water, hard surfaces and transfers.
- Bedroom. Rails or an adjustable bed, space beside the bed for transfers or a hoist, and keeping the bedroom reachable without stairs if needed.
- Around the home. Better lighting, lever taps and door handles, and assistive technology to control lights, doors and appliances as hand function changes.
Where to start: the simplest place is the changes that remove immediate risk and keep you getting around. That is typically trip hazards, rails, access at the door, and the bathroom. Bigger projects (lifts, wet rooms, widening) take longer to plan and fund, so they are worth raising early even if they are not needed yet.
You do not have to plan this yourself. An occupational therapist looks at your home and how you live in it, and recommends what will help most for now and a step ahead. The next question covers how to prioritise when there is a lot to consider.
Evidence for this answer
The sources the Compass team used to write this answer. Highlighted phrases in the answer above correspond to the statements below.
Statement 1 of 2. The bathroom is one of the areas people most often change first.
Supports this. ALS Home Accessibility — Your ALS Guide · Practical guide
Says the bathroom is where most home renovation work for people with ALS ends up, and lists widening the doorway, a barrier-free roll-in shower, a wheelchair-height sink and non-slip flooring as the usual jobs.
“The most common renovation projects inside the home for people living with ALS involve the bathroom.”
Deciding to RenovateLink checked August 2026
Statement 2 of 2. Larger building work has a long lead time, so it is worth raising before it is needed.
Supports this. ALS Home Accessibility — Your ALS Guide · Practical guide
Warns that home renovation projects overrun on both time and budget, and that thinking about future needs early is what lets you make changes in time rather than being caught out by them.
“Home renovation projects can be disruptive to your daily lives and take longer than expected.”
Deciding to RenovateLink checked August 2026
Used across the whole answer
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When several changes could help, it can feel overwhelming. Changing your home also carries practical and emotional weight, including cost, disruption, and seeing your home change. A few principles help you and your occupational therapist prioritise.
Things that usually guide what comes first:
- Safety and access first. Changes that prevent falls and keep you able to get around and get in and out generally come before comfort or convenience.
- What affects daily life most. A bathroom you can no longer use safely, or steps you cannot manage, matter more than a change you would only notice occasionally.
- Plan a step ahead, not just for today. It is often worth designing changes so they still work as your needs change, so you are not rebuilding it later. One example is making a bathroom usable with a wheelchair or with help.
- Lead time and cost. Quick, low-cost items (rails, a threshold ramp) can happen soon; larger work (a lift, a wet room) takes assessment, funding and building time, so start those conversations early even if the need is months away.
- Disruption and what matters to you. How much upheaval a change involves, and how it fits your life and your home, are legitimate things to weigh. Your priorities count.
A practical approach is a staged plan: address the urgent safety and access items now, and map out the larger changes so they are ready to set in motion when needed. An OT can help you build this plan and sequence it sensibly.
It is also worth knowing that not everything has to be permanent or expensive. Rails, ramps, shower seats and hoists can sometimes be borrowed or are removable, which is helpful while you decide on bigger steps. How changes are funded and provided varies by location, so ask your OT or local MND association what applies. The next question covers who carries out the assessment.
Evidence for this answer
The sources the Compass team used to write this answer. Highlighted phrases in the answer above correspond to the statements below.
Statement 1 of 2. It is worth designing home changes so they still work as needs change, rather than redoing them later.
Supports this. NICE MND guideline — NICE · Clinical guideline
The UK MND guideline puts this on services as a requirement: adaptations and equipment are to be matched to the person's changing needs, not only to the needs they have on the day they are assessed.
“Ensure that equipment, adaptations, daily living aids, assistive technology and wheelchairs meet the changing needs of the person and their family and/or carers (as appropriate) to maximise mobility and participation in activities of daily living.”
1.10.5Link checked August 2026
Supports this. ALS Home Accessibility — Your ALS Guide · Practical guide
Frames a home assessment as producing two answers, one for what to do now and one for when mobility is more limited, and says planning for the later one is what keeps you from being stuck.
“Thinking ahead and planning for your future needs can help you make timely adjustments and avoid getting stuck in a situation where you have limited accessibility.”
Assessing Your OptionsLink checked August 2026
Statement 2 of 2. Some of the equipment involved can be borrowed rather than bought.
Supports this. Mobility and ALS — Your ALS Guide · Practical guide
Says many local ALS organisations and clinics run loan closets that lend out certain assistive devices and medical equipment free of charge. It describes loan closets in general and does not list which items any one of them stocks.
“Many local ALS organizations and clinics loan certain types of assistive devices and medical equipment at no cost.”
Equipment Loan ClosetsLink checked August 2026
Used across the whole answer
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The central person for home changes is usually an occupational therapist (OT), sometimes working with a physiotherapist. You do not arrange this alone or guess what you need. The OT assesses your home and your daily life and recommends what will help.
How it typically works:
- The OT visits or reviews your home. They look at access, the bathroom, the bedroom, getting around, and how you manage daily activities, alongside how things may change.
- They recommend changes and equipment. These are matched to your needs now and a step ahead, and they explain the options.
- They help you arrange them. They advise on what is involved, who carries out the work, and how it can be funded or provided where you live.
- For building work, qualified builders or contractors do the installation, and larger changes may need building approvals. The OT and local services can guide this.
- Your ALS/MND team or local MND association can connect you with an OT if you are not already working with one, and often have advice or loan equipment.
How home changes are funded and provided varies a great deal by location. It may be through health or social services, disability schemes, grants, charities, or private arrangement, and the rules and timelines differ from place to place. Because of this, the practical step is to ask your OT, ALS/MND team, or local MND association what applies where you live.
If you are not yet in touch with an OT, asking your ALS/MND team or doctor for a referral is a good first move. It is best to do this before changes feel urgent, since assessment and any building work take time. The next question gives you prompts to raise.
Evidence for this answer
The sources the Compass team used to write this answer. Highlighted phrases in the answer above correspond to the statements below.
Statement 1 of 2. An occupational therapist assesses the home and how the person lives in it, and recommends what would help.
Supports this. NICE MND guideline — NICE · Clinical guideline
The UK MND guideline names occupational therapists among the professionals who should assess this, and lists what they should be looking at, which includes the home environment and whether it needs adapting alongside daily activities and getting around.
“Healthcare professionals and social care practitioners, which will include physiotherapists and occupational therapists, should assess and anticipate changes in the person's daily living needs, taking into account the following:”
1.10.1Link checked August 2026
Supports this. ALS Home Safety — Your ALS Guide · Practical guide
Describes the same sequence from the person's side: a physical or occupational therapist comes and looks at the home, and what comes back is a set of recommendations covering devices, ramps and other changes.
“Once professionals are able to see and assess the safety and accessibility of your home, they can make recommendations such as using assistive devices, installing ramps, and making other home modifications.”
Home Safety EvaluationLink checked August 2026
Statement 2 of 2. It is better to start the assessment before changes are urgent, because assessment and building work take time.
Adds context. NICE MND guideline — NICE · Clinical guideline
Delay is what the guideline keeps pressing on in this section: adaptations are to be provided without delay, and access to a funding assessment for home adaptation is to be prompt. It is written for services rather than for the person, so it backs the point that time is the constraint rather than the advice to ask early.
“Enable prompt access and assessment for funding for home adaptation. If the person is not eligible for funding, continue to offer information and support in arranging home environment adaptations.”
1.10.8Link checked August 2026
Supports this. ALS Home Accessibility — Your ALS Guide · Practical guide
Covers both halves of this. It says home renovation work runs longer than people expect, and, where it describes assessing your options, that planning for future needs is what lets you make changes in time instead of being caught out by them.
“Home renovation projects can be disruptive to your daily lives and take longer than expected.”
Deciding to RenovateLink checked August 2026
Used across the whole answer
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A few questions ready for an occupational therapist or your ALS/MND team helps you get the most useful advice. Pick the ones that fit your situation.
Assessment and planning
- Can I have a home assessment, and who would do it?
- Looking ahead, what changes are worth planning now, before I need them?
- Can we make a staged plan for what to do soon and what to line up for later?
What would help
- What changes would make my home safer and easier to get around?
- What would make the bathroom and bedroom safe and manageable?
- Can changes be designed so they still work if my mobility changes further, or if I use a wheelchair?
Getting it done
- How are home changes funded and provided where I live, and what might it cost me?
- Are there grants or schemes I could apply for, and how long do they take?
- Who carries out the work, and do any changes need building approval?
- Are there things I can borrow or that are removable, rather than permanent?
If I rent or may move
- What are my options if I rent, or if my current home cannot be adapted? (See also the housing card.)
It can help to note what has become difficult at home before the assessment, and to have someone with you. Useful things to note are where you struggle, where you have nearly fallen, and what you most want to keep doing. If adapting your home is not workable, the housing and long-term care cards cover other options.
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