Show Notes:
Good Fit / Poor Fit: Home Survey
The Residential UD Specifications
Stats:
- The 27% stat mentioned in the episode is actually updated by the CDC to be 28.7%.
- HUD 19% of households include someone with an accessibility need.
- The reference to 1977 is based on the average age of a home which fluctuates by year. Resource.
Transcript:
Sarah: [00:00:00] You’re listening to Good Fit Poor Fit. Our podcast is part of The UD Project, a small business rooted in occupational therapy that looks at how the design of a home environment impacts how well people of different ages and abilities perform everyday activities. We chat about this unique perspective to boost your knowledge and help you consider what can be changed in communities like yours.
Learn more about our work at universaldesign.org.
This episode is part of an ongoing series here on Good Fit Poor Fit. We’re going deep on residential universal design specifications, walking through every major area of the home with an occupational therapy lens. Along the way, you’ll hear stories about real people. Whose lives are shaped by the design choices we discuss.
Whether you are a rehab therapist, a designer, a builder, or someone thinking [00:01:00] ahead about your own home, this series is built for you. Start with episode 107 for the full picture. A good fit doesn’t happen by accident. Let’s get into it.
Sarah: Hi Good Fit Poor Fit listeners, Rebecca and I are back and excited to share about a new direction we’re headed in our conversations on the Good Fit Poor Fit Podcast. Whether you’ve come to tune in on this podcast as an occupational therapist, maybe you work in the home building or design industry, or you’re just someone looking to be wise about the place you live. We are excited you’re here and that you continue to listen when we share new content.
Before Rebecca spills the beans on our announcement, I want to do a brief backstory. If you’ve been following us for a while or our new here.
You may have heard a little bit about some of the resources we’ve created at the UD Project to help people understand the benefits of universal design in our homes and communities. The Residential UD [00:02:00] Specifications, which we previously called the UD Code, The UD Style Guide, The Good Fit Poor Fit Home Survey, or even explored our Learning Community of courses and discussion areas.
While all of those resources are important on their own, we thought it would be super cool to take a deep dive into the home from an OT perspective and reference a lot of that detailed content in a methodical yet fun way. So, Rebecca, can you tell our listeners what they can expect in the episodes ahead?
Rebecca: Yeah, of course. So we’re starting a new series within Good Fit Poor Fit, where we’ll spend time going through every part of the home, from the parking space or garage to the kitchen, to the bathroom, and even to places like bedroom closets. And we’ll be talking about how we can make them more universally designed.
This series will probably end up being like 70 plus episodes. So strap in gang! It will still appear in your normal Good Fit Poor Fit feed, but the episodes will just be [00:03:00] structured a little bit differently. So in this series, we’re gonna get specific, we’ll talk about measurements, products, conversations you might have with a contractor, and clinical rationale behind all of the things that we’re recommending.
All the content in these coming episodes will center around the same idea that we’ve always returned to here at Good Fit Poor Fit that universal design is good design because we don’t know who may use or live in the spaces that we’re designing, redesigning, and adapting today. So putting universal design into practice isn’t a niche commitment because when we build things to be flexible and usable by a broad range of people, it serves us and enables us all to do the things that we want and need to.
And this is the idea that we’ll be bringing into all of these podcasts.
Sarah: Yes, that’s a perfect explanation, and I agree. It is just good design. We’ve done element specific episodes before, but to match up our podcast content with some of our other resources, we thought it would be helpful to shed more light on these details. But before we get into the [00:04:00] specifics, to help introduce everyone to this in-depth series, we wanted to start off with three prep episodes to set the stage. So you are listening to the first prep episode, which will focus on what UD really means. The second episode is going to focus on how OTs typically view the home through the lens of an activity analysis. And number three, we will talk about why most of the current housing tends to fail, and why we have an accessibility housing supply problem.
Rebecca: That’s right. Another fun component of this series is that we’ll actually be weaving in stories about people throughout all of these episodes just to illustrate some of the things that we’re talking about. So as we move through each area of the home, you’ll begin to not only get to know these families and these people that we’re telling stories about, but learn how design can benefit people of all ages, all situations, and all parts of life.
Maybe you’ll even hear something that applies to your life or your work.
Sarah: So there is a question that I’ve been getting from people for [00:05:00] years, and it comes in a lot of different forms. Sometimes it sounds like, “Is my mom’s house okay for her now?” Sometimes it’s like, “We’re building a new home and I keep reading about accessibility features, but we’re not disabled. So how much of this actually applies to us?”
And sometimes it sounds like a builder saying, “My clients aren’t asking for any of this, so I don’t really think about it.” The question underneath all of those is the same one. It is, who is this for? And I think the answer most people have in their heads goes something like this. Accessible design is for people in wheelchairs or for older people who are starting to slow down. It’s a specialty, it’s a modification you add when someone needs it. It’s the grab bar in the shower at the hotel that tells you this is an accessible room. The answer is not wrong exactly, but it is not complete that it might as well be wrong. The gap between that answer and what we actually know about how people [00:06:00] move through their homes and use their homes for their daily activities, how homes get used over the decades, and how design decisions play out for every person who ever lives in that space.
That gap is what we will be discussing in our next episodes.
Rebecca: I agree, Sarah. I’ve often had scenarios where it seemed like a good idea at the time is the prevailing sentiment around design decisions, which is something that I think will come across a lot in these conversations. For example, let’s think about a couple who bought their home in the eighties, and they might have loved the look of their tiny kitchen with the bright green paint and open shelving where they can put all of their mismatched mugs and cute glassware.
But by 2026, the husband of the couple has developed dementia, and he is having a hard time figuring out how to make his lunch because the kitchen is overstimulating with dishes everywhere and mugs and the brightly colored paint and everything all open and sitting on the counters. This is a great example of what Sarah [00:07:00] was talking about, where design decisions at one point seem like they’ll be really great, but then that might change over time as our needs and our preferences and our desires and our lives just continue to change.
So I think a good place to start all of these conversations is with a definition. So what do we actually mean when we say universal design? And why does getting this definition right really set an important stage and framing for the rest of these conversations? So let’s start with the definition. I think that a lot of the confusion around universal design honestly starts here.
So the term universal design was actually coined by an architect and designer named Ron Mace. And his definition is, “Design that’s usable by all people to the greatest extent possible without need for adaptation or specialized design.” And there’s a lot of value in this definition, and this is what people were first introduced to when the idea of universal design kind of burst onto the scene in the eighties. I think [00:08:00] now we’ve learned a lot more.
We maybe recognize that nothing can really be universal and work for every single person and without the need for adaptation or specialized design isn’t probably a reasonable expectation because everybody’s different and everybody engages with spaces and products and situations differently.
So I think that there’s more to come from this definition, but this is what we’re working with when we’re talking about universal design.
Sarah: So let’s go through the definition a little bit. I think this definition has flexibility in it, just as universal design is flexible in itself.
The first part is design that’s usable by all people. It is worth pausing on because it is the most ambitious. It means that the design does not start by excluding anyone. The intent is broad inclusion and ensuring it’s functional for people with diverse abilities. Do it well and the results will be usable and marketable to everyone. Universal [00:09:00] design is often misunderstood as it only being for people with disabilities, but disability is part of the human condition. Our bodies don’t always work as they should. And that’s where that flexibility comes in. The second part states to the greatest extent possible, which means the design will work for just as many people as possible, including those with disabilities, not just those with disabilities.
It acknowledges that trade-offs exist and the goal is to push as far as the design can go without becoming too specialized for one type of user that someone else wouldn’t see the need for. That phrase is also what separates universal design from a rigid compliance standard, it is a direction, not really a finish line.
Rebecca: I love that analogy, Sarah, that it’s a direction, not a finish line. I think that that transitions well into the last part of the definition without need for adaptation or specialized design. Because what he was getting [00:10:00] at is a fundamental critique of how we have historically approached accessibility.
We design a standard environment and then we figure out accommodations for people who can’t use it.
Sarah: Right. That is so common, and that’s a great way of saying it, build it and then change it. Can you give a few examples of that for our listeners that maybe they have seen.
Rebecca: Sure. And listeners, once you start thinking about this, I promise you won’t be able to unsee it. You’ve probably seen a ramp that seems to have just been plopped there haphazardly or by chance. Maybe it’s on the total opposite side of the building than the entrance or winds all around a flower bed or a sidewalk.
What about a grab bar that’s added to a bathroom after someone comes home from a hospital? Or do any of you listeners have a plastic shower chair living in the corner of your shower? Because without it, there would be nowhere else to sit or rest your legs while you’re taking a shower or shaving. These are adaptations.
They’re absolutely better than nothing and they’re [00:11:00] what we have to do in a system that is not built excessively at baseline, but they’re not universal design.
Sarah: Exactly they’re products added to the environment so that someone can perform those tasks. This is what most people think when they think about universal design and when we talk about it. So since there’s a lot of overlap between the terms and ideas of UD, accessible design, and specialized design, let’s go through them a little since they are all related, but they’re not all the same thing.
So accessible design, you are bound to have heard that before. In the technical sense, it really means design that meets a legal or code standard, usually derived from the Americans with Disabilities Act or building codes. It ensures a minimum level of usability for people with certain types of disabilities. It is compliance oriented. It is better than inaccessible design, but it still often produces environments that are designed for a specific population rather than designed to work for [00:12:00] everyone. And you’ll usually see this in public spaces. There isn’t a lot of people doing ADA design in homes.
They’re not required to do that in single family homes, but in apartment buildings, yes, but not single family. Specialized design goes further in one direction. It is equipment or modification tailored to a person’s specific needs. A custom wheelchair, a home modified for a person who is short in stature, an assistive technology set up built around one person’s situation. It’s often the most precisely functional solution for that person, and it’s not transferrable to a wide range of other individuals. And that’s why when you see a house designed in this way, most people wanna tear it all out because it doesn’t make sense for them.
Rebecca: Right. And just to be clear, listeners though, universal design is different than specialized design or accessible design. It doesn’t mean there’s anything wrong with specialized design or accessible design. [00:13:00] Not throwing any shade at any of those design choices. But universal design is not designing to a minimum compliance standard, like accessible design, and it’s not tailoring to one person like specialized design.
It’s designing environments that work for the widest range of people possible from the start without requiring anybody to identify themselves as needing something special. So this doesn’t necessarily mean that whatever’s designed universally is just gonna at the snap of someone’s fingers, work for everyone, but it means it’s gonna have more capacity to work for everybody when everyone shows up to that space, bringing their own needs, their own experiences, working within that context, within that space to make it work for them. What Ron Mace understood and what we occupational therapists understand intuitively because we spend our professional lives at the intersection of the person and the environment. Is that the range of human function is huge.
It spans [00:14:00] age, body size, strength, endurance, visual capacity, hearing capacity, coordination, cognition. The variability within a single day across a lifetime is huge. So no person is at the same functional point at 30 than they are at 60 or than they were at 10, or that they will be at 80. No person functions identically when they’re recovering from surgery or when they’re really tired or when they’re carrying something heavy or they’re in unfamiliar surroundings.
So when we’re talking about universal design, we’re talking about design that works for the full range of variability, and it’s just good design.
Sarah: I really like that you pointed out it’s variable and it changes. That’s what a home should be for somebody and that it can adjust as different things happen in their lives. And this is really where accessibility starts to affect far more people in situations than most people expect because it’s the population we are talking about [00:15:00] and the population is not small. The CDC tells us that approximately 27% of the US adults have some type of disability. HUD estimates that 19% of households include somebody with an accessibility need, and when you broaden the frame beyond formal disability to include people in recovery from surgery or injury, people experiencing temporary illness, people who are pregnant, people who are older in managing the natural changes that come with aging.
Parents, who have little kids, people who are carrying something heavy. People are just having a hard day. Like you mentioned before, Rebecca, the number of people who benefit from a well-designed environment on any given day is not 27%. It’s a much larger share of everyone.
Rebecca: Absolutely, I love this call out, Sarah. I think it’s easy to overlook the fluctuating nature of access needs and functional capacity. We tend to think about our current situation [00:16:00] when we make design decisions, and this is very human. No one’s doing anything wrong by doing this, but homes last a long time and they’re not something that we replace every few years, like a car or maybe a cell phone.
So the median American home was built in 1977, which means that most of us are living in homes that were designed for a version of the world that existed decades ago by people who had not carefully thought about the range of people who would eventually live in those spaces and who had no conception of what life would be like in 2026.
So every home that gets built today will be occupied by multiple households over the next 30, 40, 50 years or more. And while we can’t foresee what will come in the world over that time, we can make decisions at the design stage that could set those future generations up for more flexible interactions with the same spaces that we’re building.
For example, we can determine the width of doorways, the height of the thresholds, the presence or absence of a step free entrance. And those [00:17:00] decisions can help shape the experience of everyone, whoever lives in or visits that home in the future.
Sarah: Definitely, and it makes it easier for someone to actually find a home that works well from the start without having to change an existing one. This is where the sustainability argument comes into play. Companies and communities have a great responsibility to manage the impact on people and building homes that exclude a significant portion of the population from full use, not through malice, but through default assumptions that do not hold up. It’s an impact. It is just an invisible one.
Rebecca: Yeah, this idea of invisibility reminds me of a client that I worked with who lived in an apartment in Philadelphia where there was a giant step to get into the home. Until my clients started to use a wheelchair, that giant step was nothing to speak of. They didn’t really even notice it. But once my client started using his wheelchair, that giant step became giant.
It was a huge [00:18:00] inconvenience. Now before we get into talking about the details of what better design might look like and how we can create spaces where people don’t encounter challenges, like I mentioned above with my client.
Let’s talk about a moment. Most people listening have probably had in some form. ’cause it’s the moment this whole conversation tends to begin.
Sarah: Yes. Throughout this series, like Rebecca mentioned earlier, we’re going to be dropping in on people and visiting them . Real life situations, real homes, real moments where the design of a space either works for someone or makes things harder than they need to be. We want you to come along with us not as observers looking at someone else’s problem, but as people who might recognize something in what they’re dealing with. We’re not going to meet everyone specifically today. There’s a lot of people on our list. Instead, we want to describe a moment. Because we think most people listening have had some version of it in their lives. Picture someone in their mid fifties, they have been in the same house for about 20 years. [00:19:00] They know every corner of it. The house is not accessible in any formal sense. It was not designed with any particular attention to these questions, but they have managed it fine because fine was never really tested. And then something happens. Maybe they have surgery after a sports injury. Maybe a parent moves in, maybe a close friend visit to uses a wheelchair, and they realize for the first time watching that friend navigate from the driveway to the front door, that what they had always experienced as welcoming in their home, for this person is an obstacle course, and the question they ask after this visit is twofold. How do I make my house accessible and how did I never notice this before?
Rebecca: That question reflects that accessibility is invisible when you don’t need it. The step at the front door is just a step. The round doorknob is just a doorknob. The narrow bathroom is just a bathroom until one of those things stops working for [00:20:00] you, or someone you love, or someone who’s visiting the house starts throwing different error codes your way as something to consider.
And then visibility is not a personal failure. It’s by design. It’s not intentional design, but the design of what air quotes, heavy air quotes here, normal, has been assumed to be. What we do as occupational therapists is make that invisible stuff visible, not to alarm people, not to shame people because it’s not already working for them, but because once you see it, you can do something about it, and the earlier you can see it, the more options you have to make decisions that will serve you better.
Sarah: Yeah, and what I find interesting about that mid fifties homeowner is that they’re not a client in any clinical sense. They have not been referred to anyone. They’re not in any formal rehabilitation process. They’re just a person who had their assumptions disrupted by that situation. An aging parent, an unexpected sports injury, you name it, and now they’re paying attention in a way that they didn’t really [00:21:00] have to before. While we’re not exclusively making these episodes for the 50 somethings, they are on the cusp of needing to know more. The OTs and the builders and all the people who are actively navigating a disability or diagnosis are all here too. But the person who is newly paying attention, who is starting to see what was always there, that person has a lot of decisions ahead of them, and we want those decisions to go well.
Rebecca: Yes, and as OTs, this is our jam. We are trained for years to understand how people and environments interact to see environmental barriers and brainstorm ways that we can remove those barriers so that everyone can do what they want and need to in any given space.
Sarah: So what does that look like actually in practice? What is the difference between a home that works and a home that just happens to not have yet caused a problem? I’m super excited to talk through this in our series one feature at a time, because when you really start to [00:22:00] look at this in depth. You realize that each element in the home has the possibility to work well until it doesn’t. But for now, we want to give you a few places to start in thinking about ways to go about working towards a solution.
Rebecca: So we think about getting started with this in three tiers, and I wanna name all three ’cause they apply differently depending on where you are right now. So the first tier is a shift in how you look at your home. That costs nothing. It just requires deciding to look. Most of us move through our homes on autopilot.
We have routes and habits, and we stop perceiving the environment unless something goes wrong. What we’re asking you to do is look at your home as if you’re arriving at it for the first time, not because something has gone wrong, but because something might, or because someone else maybe needs it to work a little bit differently for them, or because you wanna understand what you’re actually living in before circumstances force you to figure it out.
Specifically, we would ask you to notice three things. Where does the house start [00:23:00] making demands? Where do you have to do something, some physical tasks, some adjustment, some workaround that you’ve stopped noticing because you’ve done it so many times. And if you imagine walking through your front door with a walker or using a wheelchair or with both hands full or at 80 years old, where does the experience change?
This is not a home evaluation, it’s just a perceptual exercise, but it is where it is where useful attention begins.
Sarah: I really like this exercise. We’re also used to moving around our home without thinking, but it’s good to slow our roll a little and realize that gigantic sliding glass doors that have a threshold from the living room out to the back porch isn’t as easy for everyone to just step over, or maybe you have prided yourself in knowing exactly where that light switch is as you go out into the garage in the dark, and not everyone knows that they have to take a few steps to the right and reach up to [00:24:00] turn it on.
Rebecca: Absolutely. I think everybody has these things in your home that when someone comes to visit, you have to explain it to them, but it’s just become so mundane and day to day for you. So the second tier is a more structured look at where your home stands. We’ve built a home survey for exactly this. It’s not a deep dive, it’s just a starting point to gather information.
It asks questions across all the major areas of your home and helps you see where to focus your attention. If you’re an occupational therapist, this is something you can go through with your clients before they are discharged to go home or on a home visit, if you’re lucky enough to have time for that.
If you’re a homeowner, it gives you a place to start that’s more useful than a vague sense that you should probably be doing something. The survey is at universaldesign.org/survey and we’ll link it in the show notes. And if you wanna go deeper on any area that that comes up, we have courses that go into additional elements in detail, room by room, feature by feature.
The survey points you toward where to [00:25:00] focus and the courses are where you go when you’re ready to understand the why behind it.
Sarah: Yes, exactly. They both serve a really good purpose in learning more.
Rebecca: So the third tier is for anyone who’s at the beginning of a new build or a significant renovation. One of the most important things to understand here is that it is dramatically cheaper to add these design elements in at the beginning of the design phase than at the end of the build realizing that you’ve missed something important.
Sarah: Yeah, the blocking in the wall that allows a grab bar to be installed later costs almost nothing during construction. Retrofitting it after the wall is closed requires opening the wall. A wider doorway is a specification change at the design phase. After the house is built, it’s a structural project. Preparing the land to create a no step entry will make it much easier to pull off if it’s done right from the start. The decisions made during the design determine what is possible for [00:26:00] every person who will ever live in that space. And the window for making those decisions easily is open for a limited time.
Rebecca: That’s right. The specifications at universaldesign.org/specifications, which again will be in the show notes, are a vetted set of design standards for residential universal design. They’re specific, they include measurements, they include exceptions where exceptions apply, and they’re what we draw from and will draw from in every episode of this series.
Sarah: We mean each part of the home. We’ll be chatting through every room, every system, every outdoor space, one feature at a time, and I’m sure you’ll find something that applies to your life personally or professionally, even if you don’t do each and every element, something that you will learn can apply to you.
So. Everyone. We’re almost done with prep episode one. Here’s what I want to leave you with today. There are two things. First is a reframe. Universal design is not a category of features for a category of people. [00:27:00] It’s a design that works for a full range of human function across the full arc of life without requiring anyone to declare themselves as needing something special. That reframe matters because it changes who you think this conversation is for. It’s not for someone else. It’s for your home, the people in it now, and the people who will live in it later. The second is a challenge, and it’s the most low stakes challenge we’re going to issue in this whole series. This week walk through your home as if it were unfamiliar to you. Not with a clipboard, not with a checklist. Just look. Pay attention to where your home makes demands, where it requires workarounds you have stopped noticing. Notice the door that sticks, the hallway that feels tight when you’re carrying something, the light switch you have to search for in the dark. You’re not looking for problems to fix immediately. You’re just looking, observing., That attention that willingness to see what’s actually there is where everything else begins.
Rebecca: I love this [00:28:00] idea and this activity, Sarah. Just looking, no pressure, no judgment, just noticing what’s around you.
We’re so glad you’re here and we can’t wait to see you in our next prep episode in which we’ll jump into the brain of an occupational therapist and how the practice of doing an activity analysis of the home is just as important as picking out the beautiful bathroom finishes.
Thanks, listeners. We’ll see you soon.
Sarah: Thanks for listening to Good Fit Poor Fit. If you want to learn more… first, find more episodes with transcripts and show notes at goodfitpoorfit.com. Don’t forget to subscribe! Second, check out our courses at universaldesign.org.
We cover housing topics like advocacy, collaboration, home modification, universal design and task adaptations. Lastly, if you have questions or topics you’d like us to discuss, email us at [email protected]. Thanks for fitting us into your day. [00:29:00]
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