Home Modifications
Listed below are some areas to consider when modifying an environment for the wheelchair user:

Rearrange furniture to make wheelchair access and movement easier.

Install ramps (12:1 in slope) and guardrails or lifts in place of stairs.

Doorways should be at least 76 cm (30 in.) wide. They can be widened by removing the door and hinges, or removing inner mouldings and installing a sliding door or curtain. A “narrower” may be necessary to decrease the width of the wheelchair by 5-10 cm (2-4 in.) temporarily to permit passage through a doorway.

Hallways should be 92 cm (36 in.) wide to accommodate the chair's turning radius. A cleared turning space of 1.6m2 (5 sq. ft.) is necessary for safe and easy turns.

Space under sinks and counters to accommodate wheelchairs can be made by removing cupboards and exposed pipes must be insulated.

Carpets can hinder the movement of a wheelchair. Hardwood, vinyl or Berber flooring are good choices for wheelchair use.

Many people with ALS have trouble with grasping and manipulating objects. It is often possible to modify everyday tools or to substitute specially designed versions of such tools to compensate for weakness in the muscles of the fingers, hands and wrists. For example, a knife, fork and spoon with extra-thick handles can make eating much easier. There are also sets of cutlery available with thick, long handles that compensate to some extent for impaired shoulder movement.

Mugs with oversized handles will allow you to slip all fingers under the handle, reducing the danger of spills. A plate guard gives a slight vertical edge to a plate so that food can be pushed against it onto a spoon or fork. The double action of gripping and turning a doorknob can be a problem for you. A doorknob adapter could be the answer since it allows the door to be opened by pushing down or pulling up the lever. A fat wooden or plastic handle attached to your door key can help with the turning motion necessary to turn the key in the lock. Thick pens or pencils are easier to grasp than the usual thin variety, or a writing aid may be used which consists of a block holding a pen or pencil.

Clothing fasteners are finicky and difficult to use if your hands and fingers are weak. There are devices to assist in fastening buttons. Velcro is a popular replacement for both buttons and zippers. Best of all, such items as pullover tops and pants or skirts with elastic waistbands need no fasteners at all.

Modifications to radio, light and television switches allow a person with ALS to turn the set on or off with the palm of the hand, a head movement or even a puff of breath. Telephones that do not require the use of hands are also available.

We have mentioned just a few of the modified or special tools available to make everyday life easier for you. There are many more such tools that your therapist can tell you about. It is important to discuss any tool with your therapist before making a purchase. Some devices are reasonably priced and some are expensive. Some will assist you for a long period, others may be useful only in the very short term. Your therapist can save you disappointments as well as costly errors.