If home becomes an assault course

People with special needs need special houses. Richard Phillips on where to get advice

The Sense of helplessness created by a new disability can be devastating, to family and friends as well as to the sufferer. At home, the problems can be magnified as a once safe environment becomes a daily assault course, with little reprieve.

But it doesn't need to be like this and one of the first ports of call for determining the best approach for redesigning a home is the occupational therapist. As well as providing essential information for adapting a daily routine to accommodate a disability, OTs are expertly trained on changes needed at home.

The OT can advise on the dimensions and measurements needed for alterations and whether these are viable in the present property. In addition, their prognosis will provide a longer term view of the disability and how it may develop in the years ahead - vital if the changes are to reflect future as well as current needs.

The OT can then advise on the precise modifications needed - for example whether a bath hand grip, a flat access shower, or a different type of bath is going to be necessary in the bathroom. He or she will also have a good working knowledge of the best equipment available for each condition, and who the leading manufacturers are. This last is important because as one disability adviser at a local centre warned, "There are an awful lot of small companies springing up in which the quality of goods is poor."

This proliferation, on the other hand, is also a result of technology continuing to advance, and more and more designs are arriving on the market which tackle all sorts of different activities, from cooking to mobility, and which help to alleviate different conditions.

The first problem is keeping track of which new items exist. The second is being able to track down a supplier. A charity called Care and Repair can provide useful leads on this. It can also give technical planning advice, and has a list of architects nationwide who have specialist knowledge of designing for the disabled at home.

Money is usually an issue. For owner-occupiers or those living in private accommodation, the OT will advise on obtaining a disability facilities grant to help pay for the changes. This is means-tested and funded by the Department of the Environment. There are also numerous charities which provide funds for different conditions and needs. A full list of grants is available in the directory A Guide to Grants for Individuals in Need which should be available in your local library. If they don't have it, ask them to get a copy.

If a major alterations is required, such as a stairlift or a platform lift or even an external platform lift, it is worth commissioning a chartered surveyor, or a building engineer to advise. This may seem like an unnecessary expense when money is short but it will help ensure the work is carried out the the highest possible standard and that it lasts as long as it should. Good advise could save money in the long run.

It is common to convert the ground floor of a multi-storey house for a disabled person to live in. Where there is a family involved, this needs careful consideration - everyone's needs have to be met. Again, the advice of an architect with experience in this area would be a good investment.

The Royal Association for Disability and Rehabilitation (0171-250 3222) produces several information packs, including 'Disabled Facilities Grant - A guide to applicants' and 'Finding Appropriate Housing'. Disability Living Foundation (0171-289 6111) produces 'Accommodation for Disabled People of all Ages'. Care and Repair: tel 01159 799091.