Visitability: A way of thinking about aging and design

As people age and more people develop physical disabilities, housing and community development must be reexamined. Inaccessible homes impede the daily lives of people who have mobility impairments due to illness, accident or age. Visitors to inaccessible homes run the risk of falling down the entry steps, worrying about not getting into the bathroom and being embarrassed about walking up the stairs. An affordable, sustainable, and inclusive design approach to incorporating basic accessibility features into all newly built homes is a movement known as visitability.

In 1988, the Fair Housing Amendments Act created accessible units in all new multi-family apartments and condos with four or more units. In 1990, the Americans with Disabilities Act greatly increased the accessibility of all government and public buildings. But single-family detached homes and town homes, where the majority of residents live, are the last part of the built environment not covered by federal law. There are no access codes. Until now, private homes and country houses continue to be built with the same basic access barriers: steps at all entrances and narrow doors to bathrooms.

In an effort to pass accessibility legislation in new single-home construction, Eleanor Smith, founder of Concrete Change, started the Visitation movement in the United States. The movement calls for three basic accessibility needs to be met:

* One zero-step entrance on a road accessible from a public driveway or sidewalk.

* Doorways with a minimum of 32 inches.

* Half bathroom on the main floor that can accommodate a wheelchair.

If these three requirements are met in the construction of each new home, future modifications can occur for specialized needs as needed. Visitation features make it easier for people with mobility impairments to visit friends and family and stay active in their communities..

vision cost

Over the life of the home, 25-60% of all new homes will have a resident with a mobility disability. This may be muscle weakness, imbalance, joint stiffness or wheelchairs. 95% of all new homes are built with steps at each entrance and narrow bathroom doorways. Because of architectural barriers, the risk of falls for the homeowner is greatly increased and the success rate of first responders during medical emergencies may be affected.

In 2005, 1.8 million Americans 65 and older were treated in emergency rooms for injuries from falls, and 460,000 were hospitalized. 60% of all residents of nursing homes enter these facilities directly from hospitals after a fall, stroke or heart attack. Since the majority of homes have steps in all entrances and narrow doors to bathrooms, one can only expect that a large number of people do not return to their homes after accidents due to inaccessibility.

Below is a comparison of the cost of built-in visitation access in a new home versus modified visitation access in an existing home. The cost of a nursing home reflects the exorbitant cost of “doing nothing.” (Maisel, Smith and Steinfeld, 2008, “Increasing Home Access: Designing for Visitation”)

Build a new home visit

* Zero step entrance on concrete slab – add $100

*Entrance above crawl space or basement – add $300-$600

* 34″ door add $2 to the cost of a 32″ door

* Average cost of visit features, depending on region – add $98 to $573

* Average Cost for General Design Features – Add 1% to the total project cost

Retrofitting for visitability of an existing home

* Zero entry – add $3,300

* Interior Doorway Expansion – Add $700 per doorway ($22 for a swinging hinge)

* Home Elevator – Add $15,000 – $25,000

Nursing home costs

Nursing home per person- $85,000 per year

Nursing home for $122 billion in 2005 (60% of the cost is borne by the public through Medicare & Medicaid)

*Cost of falls among the elderly for $19 billion in direct medical costs (Maisel, Smith and Steinfeld, 2008)


Cities and towns across the country are gearing up to help their ever-growing seniors. With affordable senior housing in short supply and most seniors wanting to stay home, home programs are taking the lead: meals on wheels, home health care, home hospices, home physical therapy, and seniors. Transportation from home. But for home programs to be successful, basic access must be provided in the home. Visitation access in private homes is critical to the safety and social sustainability of elderly people with mobility impairments. Without the independence to enter or leave the home or use the bathroom when needed, seniors can become isolated, depressed, and sick. Visitable homes are needed for the safety and independence of everyone: the elderly, the physically challenged, visitors, caregivers, and first responders.

In the late 1980s, Eleanor Smith of Concrete Change began pushing Atlanta homebuilders to incorporate Visible features into their new homes, but it was met with significant opposition. Habitat for Humanity listened and today there are over 800 homes visible in the Atlanta area.

1992- Atlanta Visitor Act

Atlanta became the first city to adopt a visitability ordinance that requires all builders of new single-family homes, duplexes, or triplexes, who receive any financial benefit from or through the city, to meet several basic accessibility requirements, including at least one zero step Entrance and suitable width for interior doors.

2002- Comprehensive Home Design Law in Pima County, Tucson, Arizona

Pima County adopted the first law in the nation requiring zero-step entry to single-family homes with door openings at least 34 inches wide, lever door handles, reinforced walls in bathrooms for grab bars, switches no more than 48 inches wide and hallways 36 inches wide throughout. The main floor.

In 2003, the Southern Arizona Home Builders Association sued Pima County over the legality of the visitation law. In a unanimous decision, an Arizona court laid out an effort by Tucson builders to overturn a Pima County law requiring minimal access to newly built single-family homes. By 2008, Tucson, Arizona had built 15,000 visitable homes.

2004- Visitation Code, Bolingbrook, Illinois

Bolingbrook initially agreed to a voluntary visitation ordinance, which was not successful among homebuilders. In order to bring home builders into compliance, Bolingbrook enforced the ordinance that all new homes should be built to visitation standards:

* At least one entrance with zero step

* 32 inch inlets

* One bathroom on the main floor that can accommodate a wheelchair

Bolingbrook today has 3,600 single-family visitation homes.

The comprehensive home design act of 2009

U.S. Rep. Jan Schakovsky (D-ILL) introduced legislation that would apply visitation standards to all new single-family homes and town homes that receive federal funds. Currently, 95% of single-family homes and townhouses built with federal assistance fail to incorporate accessibility features, making it impossible for many people with disabilities to live in or visit the homes. Representative Schakovsky reintroduced the bill in 2010.

Since the introduction of the 1992 Atlanta City Ordinance, more than 50 orders of varying quality have been issued across the country. The legislation resulted in more than 30,000 visitable homes being created for the open market, regardless of whether or not the first occupant had a disability. States whose cities have adopted visitation laws or volunteer programs are: GA, FL, TX, VA, VT, MN, NM, KN, IL, OR, KY, NJ, MI, PA, OH.

ICC/ANSI A117.1, the accessibility standard referenced in most building codes in the United States, is currently developing a Type C section that includes Technical Design Standards for Visitation. This will provide an accessibility model that can be adopted in new single-family homes and demonstrate zero-step entry design, accessible bathroom and accessible doorways. The standard can be referenced by accessibility laws and programs, thus promoting uniformity in applications and assisting in their interpretation. Please note that an IBC will not require Type C housing units. If a jurisdiction or state chooses to require visitation access in single-family homes, the Type C unit criteria will be available for adoption as a baseline. The 2010 edition of ANSI A117.1 will contain the Type C (visitable) Residential Unit Specification. (Maisel, Smith and Steinfeld, 2008, “Increasing Home Access: Designing for Visitation”)


Jordana Maisel & Edward Steinfeld, Buffalo, NY, IDEA Center and Eleanor Smith, Concrete Change, Atlanta, GA, “Increasing Access to the Home: Designing for Visitation”

Related links

IDeA Centre:

Tangible change: