Patient Resource · STRIVE Physical Therapy | Las Vegas

Home Modification Guide

Practical changes to make your home safer and more accessible after a neurologic event

These recommendations are provided as a general educational resource. Your STRIVE therapist can perform a full home safety evaluation tailored to your specific diagnosis, home layout, and functional level.

Bathroom Modifications

5 recommendations

Install grab bars at the toilet and shower

Mount securely into wall studs — not just drywall. Place one bar beside the toilet and at least one inside the shower or tub. These are the highest-impact modifications you can make and significantly reduce fall risk during the most vulnerable bathroom transitions.

Non-slip mats inside and outside the tub or shower

Place a textured non-slip mat on the floor of the tub or shower, and a second mat on the bathroom floor immediately outside. Wet feet on a smooth surface is one of the most common causes of bathroom falls.

Shower chair or tub bench

Allows bathing in a seated position, eliminating the need to stand for extended periods and reducing fall risk. Essential for patients with weakness, fatigue, or balance deficits. Ask your therapist which style — transfer bench, shower chair, or fold-down seat — is best for your setup.

Handheld showerhead

Enables bathing from a seated position and allows caregivers to assist more easily. Adjustable-height wall brackets add additional flexibility. An inexpensive and highly effective modification.

Raised toilet seat

Reduces the depth of sit-to-stand, which is one of the most physically demanding transfers in daily life. Particularly helpful for patients with hip or knee weakness following neurological injury. Models with armrests provide additional support.

Bedroom Modifications

6 recommendations

Adjust bed height

When seated at the edge of the bed, both feet should rest flat on the floor with hips and knees at roughly 90 degrees. A bed that is too low makes standing significantly harder; too high creates fall risk. Bed risers or a lower frame can adjust height as needed.

Bed rail or half-rail

Provides a stable handhold for repositioning in bed, rolling to the edge, and pushing up to sitting — all movements that become effortful after stroke or spinal cord injury. Half-rails attach to the bed frame and do not restrict full movement the way full side rails do.

Remove or secure all loose rugs

Loose rugs are one of the leading causes of falls at home. Remove them entirely, or use double-sided non-slip tape and non-slip rug pads to secure all edges firmly to the floor. This applies to all rooms, not just the bedroom.

Nightlight or motion-sensor lighting

Nighttime bathroom trips in the dark significantly increase fall risk — especially with impaired balance or sensation. Place nightlights or motion-activated lights along the path from the bed to the bathroom. This simple change has a meaningful impact on nighttime safety.

Keep essentials within reach of the bed

Phone, medications, water, and a call device should all be accessible without requiring the patient to stand or reach. A bedside caddy or small table at the right height prevents unnecessary and risky nighttime movements.

Clear an unobstructed path to the bathroom

Remove furniture, cords, clothing, and any other objects from the path between the bed and bathroom. If a mobility aid such as a walker or wheelchair is used, ensure there is adequate space to navigate the route safely, especially in the dark.

Hallways & Entrances

5 recommendations

Improve lighting throughout all hallways

Every hallway and transition area should be well lit. Add motion-sensor lights at the top and bottom of staircases and in hallways traveled at night. Poor lighting is a modifiable risk factor that is frequently overlooked.

Install a ramp at any door with a step

Even a single step is a significant barrier for patients using walkers, wheelchairs, or with foot drop. A ramp with a 1:12 slope ratio — one inch of rise for every 12 inches of length — is the standard for safe, manageable access. Portable ramps are available for rentals or temporary use.

Handrails on both sides of all staircases

After stroke, patients often have significantly more strength on one side than the other. A single handrail only assists descent or ascent in one direction. Bilateral handrails allow patients to use their stronger side in either direction and provide critical support if balance is lost.

Widen doorways if wheelchair access is needed

Standard doorways are often 28–30 inches — too narrow for most wheelchairs, which require at least 32 inches and ideally 36 inches of clear width. Offset hinges can add 2 inches of clearance without structural work. Full widening may require a contractor but is often covered under disability modification programs.

Replace round door knobs with lever handles

Lever-style door handles require significantly less grip strength and fine motor control than round knobs — an important consideration for patients with hand weakness or spasticity following stroke or cervical spinal cord injury. This is a low-cost, high-impact change.

Kitchen Modifications

4 recommendations

Store frequently used items at counter height

Reaching overhead while standing is one of the more destabilizing movements in daily life, particularly for patients with balance impairments. Reorganize so that everyday dishes, glasses, food, and appliances are stored between waist and shoulder height — no reaching up or bending low required.

Add pull-out shelves or a lazy Susan to lower cabinets

Deep lower cabinets require awkward bending and reaching that challenges balance. Pull-out shelves bring items to the front; a lazy Susan allows rotation so nothing is stored out of easy reach. Both are inexpensive modifications available at most hardware stores.

Replace faucets and cabinet hardware with lever styles

Lever-style faucets require only a downward push rather than a grip-and-twist motion. Loop or D-ring cabinet pulls are easier than standard knobs for patients with limited hand strength or coordination. These changes are particularly helpful for patients with hemiplegia or cervical SCI.

Place a non-slip mat in front of the sink

Standing at the sink for tasks like washing dishes or brushing teeth can be fatiguing and destabilizing. A non-slip mat provides both traction underfoot and a tactile cue about position — helpful for patients with proprioceptive deficits following neurological injury.

A note from STRIVE Physical Therapy — This guide covers the most common and impactful home modifications for stroke and spinal cord injury recovery. Every patient's home and functional level is different. Our therapists provide individualized home safety evaluations as part of our in-home PT services throughout the Las Vegas valley — including Skye Canyon, Centennial Hills, and Summerlin. Contact us to learn more.