A Home Can Be Accessible and Still Leave Someone Dependent

A person can move through every doorway in a home and still spend the day waiting for permission. They can reach the bathroom, get into the kitchen, and have a bedroom of their own, while someone else decides when they eat, who comes over, or whether they can go outside. We can remove physical barriers and leave an entire arrangement of dependence untouched.

That is what I want us to look at when we talk about the future of housing.

After nearly four decades in intellectual and developmental disability services, I bring a different set of questions to a conversation about a home. I want to know what a person values there, how they want to live, and what keeps getting in their way. The answer may involve construction. It may involve technology. Sometimes it begins with noticing that everything a person wants to control has been placed on the side they cannot reach.

Needing assistance is part of being human. A person can need substantial daily support and still direct their own life. The dependence I am concerned about is the kind we create when the environment makes someone wait for help with something they could do, or choose, under different conditions. The home should rise to meet the person.

Start with the life someone wants to live

When I first walk into a home, I look at what matters to the person. I notice the pictures, the things they have kept around them, and what they want to continue doing. Before I start thinking about a device or a modification, I want to understand what makes this home theirs.

Then I look for what is getting in the way. Where are the lights? Where are the controls? How much effort does an ordinary task take? I ask, “What gets you frustrated?” and “What would bring you more joy?” A person may stop doing something because the hassle has become exhausting. If we only look at what they no longer do, we can miss the friction that made them give it up.

With a remodel or a builder working directly with one person, this is where the assessment belongs. I want to hear their dreams, wants, wishes, and desires for that home. What should it make possible? What did they struggle with in a previous home that they never want to deal with again? Those answers give the team something meaningful to work toward. They also give us a way to come back later and ask whether the work accomplished what the person wanted.

There are practical limits to work through. A budget or the building itself may put access to every floor out of reach. Then I ask what matters on those other floors and what we can make available on the floor the person can navigate. Where the circumstances allow, a lift or an elevator may be something to explore with the appropriate professionals. I am looking at what is possible, and I am asking the team, “How can we make this happen?”

That approach is consistent with what the Administration for Community Living describes as person-centered planning: a process directed by the person receiving support and shaped around their goals and preferences.¹ In a home, those preferences need to show up in the decisions we actually make.

What moving a control can change

I remember working with a woman who had limited use of her right side. The things she needed to control in her bedroom were on that side, often too high or too far away. The arrangement left her without a useful chance to try them for herself.

We moved the light switches to her left and put them at a level she could control. We placed remotes within reach and attached them to the bed so they would not fall away and leave her waiting for someone to retrieve them. We made other things accessible from her left side, including the door opener and her favorite pots and pans. We were looking at the things she wanted to use, one by one, and making them available to her.

There was also an Alexa device she had barely interacted with. It had been high and to her right. I moved it lower and to her left, where she could see it from the side of the bed. She looked at the messages on the screen. She engaged with it. I could see her attention change, and to me it looked as though she recognized that this thing was for her, too.

I remember the smiling when she could reach something or control something in her own home. That matters. We can count the switches moved and the remotes installed, but the outcome I was looking at was her access to her own life. Something that had been present in the room was now within her ability to use.

That experience stays with me because it is easy to miss a problem like that when we are concentrating on the feature itself. A control can be in the room and still be out of someone's world.

Technology has to answer to the person

This is where my work in enabling technology meets housing. Enabling technology means using tools to support what someone wants to do in daily life. An accessible door control or a way to reach a trusted support person remotely has value when it serves a purpose that person recognizes as their own.

An installation can work exactly as intended and still be wrong for the household. Someone may not understand the controls, may not be able to afford the connection, or may not want a device in their bedroom. They need to understand what information it collects and who can see it. Privacy cannot become the price of getting help.

Somebody also has to answer the practical questions before making promises. Who teaches the person at their pace, and who fixes the equipment? What happens when the power or internet goes out? If an alert goes to a support service, who responds? Human support remains essential wherever the person's needs and choices call for it. Technology needs to fit into that support arrangement in a way the person can understand and use.

Build for people whose lives will change

For a developer planning homes for many people, the question becomes broader. You may not know every future resident, but you can expect that the people who live there will have different needs and that some of those needs will change. Enabling technology is for all. Anyone, from any background, can enter a period of life when accessibility matters in a new way.

We are all getting older from the day we are born. We are all trying to age well. Nobody is trying to age badly. I want builders to think about whether wellness has a place in their design and whether the spaces they are creating have room to evolve.

The 2026 U.S. Houzz Bathroom Trends Study gives us a useful planning signal. In its survey of 1,619 U.S. homeowners on Houzz about recent, current, or planned bathroom renovations, 71 percent addressed what the study calls current or future “special needs.” Among those addressing future needs, 55 percent expected them to arise five or more years ahead. These are renovating homeowners on Houzz, not a survey of every household.² Even within that defined group, people are making decisions now about a future they can already imagine.

What will happen when a resident needs to reach a control from a different position, use a mobility device, or bring more support into the home? Can the space accommodate those changes? What would be difficult or expensive to alter later? Those questions belong in the conversation while the design can still change. I want us to ask whether we are building places people can grow into or places they will grow out of.

The same attention needs to extend beyond the apartment. Can someone get to work, visit a friend, or take part in something they enjoy? A beautiful common room does not tell us whether people have relationships they chose. In Medicaid home and community-based services, the federal settings framework explicitly addresses autonomy and participation in community life.³ An address alone cannot tell us how freely someone gets to live.

Bringing this knowledge together is serious work. The person living in the home knows what they want from it. A builder knows the construction constraints. A support professional may see where a daily routine breaks down, while someone with technology experience can help the team understand the available options. We need those conversations to connect early enough to influence the decisions.

We need to unhinge the assumption that needing support gives everybody else the right to design a person's whole life. Ask what they want from their home. Work through what is frustrating them. Come back and find out whether they can do more of what matters to them, with the support they choose. The home should keep making room for the person they are becoming.

About the author

Precious “Preciosa” Myers-Brown holds the Certified Aging-in-Place Specialist (CAPS) credential from the National Association of Home Builders. An enabling technology innovator and author of Tech Equity: Freedom Through Enabling Technology, she brings nearly four decades of experience in intellectual and developmental disability services.

Sources

[1] Administration for Community Living, Person-Centered Planning. Read source

[2] Houzz, 2026 U.S. Houzz Bathroom Trends Study, pp. 18 and 62. The 55 percent figure applies to respondents addressing future needs; it does not apply to the full sample. Read source

[3] Centers for Medicare & Medicaid Services, HCB Settings Compliance Post-March 2023, p. 4. Read source