May 17, 2023

How to make a Philly rowhouse wheelchair accessible

After spending more than two months in hospitals and rehabilitation in Philadelphia, 19-year-old Mia Hope Andrilla was happy to be home after surviving a spinal cord stroke. But the South Philadelphia rowhouse she came back to looked very different from the one she left in August 2021.

"She was essentially paralyzed from the shoulders down with very limited small movements," said her mother, Stephanie. "She was in a wheelchair and wasn't going to be able to make it up the steps."

Their three-story, 2,400-square-foot rowhouse, built around 1920, looks like thousands of other homes in Philadelphia. It has four steps leading up to the house, a staircase between floors, and a narrow front doorframe.

The stairs were too narrow to accommodate a lift, and the doorframe wasn't wide enough to fit a wheelchair. Mia's bedroom was on the third floor, and there was no bathroom that could accommodate her new needs. Her parents needed to make changes to their home — fast.

"After what had just happened, I wasn't going to have her in a hospital bed in the living room with no privacy," said Stephanie. "I wasn't going to bathe her in a basin or toilet her in the living room. She was not going to lose an ounce of dignity."

While their daughter was still in the hospital, Stephanie and her husband, Marc, quickly got to work, making structural changes to accommodate Mia's needs. They bought a portable ramp to lead to the front door, widened that door, and installed an elevator between the first and second floors. They turned the second floor into a space for Mia, with a bedroom with a wider door frame and an accessible bathroom.

The changes were costly and stressful, but it was the only way that Mia and her family could stay in their rowhouse. Many Philadelphians face similar challenges when adapting their homes to accommodate residents with mobility issues, either from disability or simply age.

As people age — or develop mobility issues — they often lose strength and balance. The bathroom is typically the first area where adjustments must be made. Installing grab bars for toilets and tubs or putting in a walk-in tub will alleviate the need to step up into a bathtub or step over the shower threshold. The average cost of a grab bar, including installation, is $150, according to The installation cost per bar decreases as quantity increases. A standard walk-in tub, including installation, starts at about $4,500, according to Kohler.

When the Andrillas created a new bathroom for Mia, they built the shower at floor level, so Mia could enter in a rolling shower chair. These range in cost from about $150 to more than $1,000. For those who may not be wheelchair users but are unable to stand in the shower, shower chairs, which start at about $40, are a good option.

Navigating steps can present another problem in Philadelphia rowhouses, which are often three or four stories.

"As people get older, they may walk around fine, but when they look up 14 or 15 steps, it's a challenge," said Jeff Dubin, president of EJ Medical Supply in Northeast Philadelphia.

A stair lift is a good choice, but your staircase must be wide enough to install one. Dubin sells some stair lifts that take up only 4½ inches of space, but they may not work for a larger person with a narrow staircase.

"In Center City townhouses that are small and narrow, some of the very old staircases are only 26 inches wide," he said. You generally need a minimum of 30 inches in width, but it also depends on the height and weight of the rider.

Stair lifts, vertical wheelchair lifts, and ramps are options to get into the front of the house when there are steps, depending on the orientation of the steps and how close they are to the street. But they can't block the sidewalk or present a trip hazard to someone passing by. Ramps require a lot of space — for every one inch you go in height, you need to go about 12 inches in length, which would be very unlikely on a city street, Dubin said.

The Andrillas were fortunate to have had their renovations complete before Mia came home from the hospital. That is extremely rare, said Katherine Zorn, advanced clinician physical therapist at Magee Rehabilitation Hospital.

"Over the course of the last 10 or 20 years, our length of stay has been greatly reduced, primarily because insurance companies want to see patients get out of the hospital system quicker," she said.

It takes time to figure out what a person might need over time, find a reputable contractor, secure funding, and have the work done.

"You are making all of these decisions and you are not in your right state of mind," said Stephanie, whose family was scammed by the contractor they hired to order and install their elevator. The contractor took their $5,000 deposit and disappeared. Fortunately, the elevator manufacturer covered their financial loss, and they were able to have it installed in time for Mia's return home.

Dealing with a physical disability or changes that come with aging require a huge adjustment.

"There's a period of, ‘Who am I now that I can't do those things I could do before?’" said Zorn. "Their home is a safe space that makes them feel like themselves and to not be able to access that is another level of loss."

Reba Weiner lived in her Fitler Square rowhouse until she died in September 2019, just two weeks shy of her 104th birthday.

"My mother wanted to stay in the house until the day she died," said her daughter, Patty Fox, who lived in the house next door.

To accommodate her wishes, Weiner's family made adjustments to her three-story house, built around 1828. They installed a stair lift to allow Weiner to get up to the second floor, where a four-pronged cane awaited to help her maneuver the additional two steps to the next landing. From there, she used a walker to get into her bedroom.

Though there wasn't a bathroom on that floor, she had a commode and also a safety railing on the side of the bed. On the first floor, they cleared out much of the furniture to provide a safe path between the living room, kitchen, and a powder room they created.

"It was true blessing that I could complete my mother's wishes to remain in her home," Fox said.

In South Philly, Mia's health is improving. She is still going to physical therapy regularly and is now able to use a walker.

"Being able to have my own private space, privacy when my friends would come over, and not having to create a room on the first floor, definitely helped," said Mia.