Home Modifications and Assistive Technology for Disabled Military Veterans
In 2016, 1.3 million men and women served in active duty in the armed forces. Upon separation from active duty service, these men and women face the realities of a significant transition. Most focus on settling down and establishing a rewarding life and a future among family and friends. They seek employment opportunities or continue their education. They date, or marry the partner they found prior to enlisting, or begin family planning. It is a time of new beginnings, continuations, and limitless possibilities. For these service members, there can be no greater joy than coming home to spend time with family and friends after making the ultimate sacrifice of serving one’s country.
For many others, however, the transition back home is not as seamless. For the 48,000 servicemen and women who were injured during recent active duty service, coming home means adapting to physical changes, relearning behaviors and daily tasks, and accepting a new normal that didn’t exist when they first left home. Such changes are the realities that face those servicemen and women who suffered physical and/or emotional traumas during their deployment.
Feel free to jump ahead to the sections that interest you most!
Tinnitus and Hearing Loss Vision Impairments Migraines
PTSD Spinal Cord Injuries Lower and Upper Body Injuries and Amputations
Thanks to advances in body armor and battlefield emergency response training, equipment, and medicine, a greater number of servicemembers are surviving battlefield injuries that would have resulted in casualties only a few generation ago. While such fortunate advancements mean more men and women are being reunited with loved ones after service, it also means more retired servicemembers are returning home with injuries and disabilities that will require physical and emotional rehabilitation.
According to the Wounded Warrior Project, for every one U.S. soldier killed during World Wars I and II, there were 1.7 soldiers wounded. Post 9/11, for every one U.S. solider killed during Operation Iraqi Freedom and Operation Enduring Freedom, seven soldiers are wounded. In the most recent military conflicts, a combined total of over 48,000 servicemembers have been physically injured.
In addition, it’s estimated that as many as 400,000 servicemembers have incurred service-related emotional conditions such as post-traumatic stress disorder (PTSD), while still 320,000 more are believed to have experienced a traumatic brain injury.
Despite their injuries, these former servicemen and women can build for themselves a life that is fulfilling and rewarding, although the idea of transitioning home will take on a very different meaning than for their counterparts who separated from active duty service without significant injuries. One of the first steps to transitioning to life at home with a physical or emotional injury is to adapt the home setting. Feeling comfortable and capable in your own home is a confidence builder, and a necessary step toward reestablishing your place in your family unit, and in your community.
Fortunately, advances in home technology also make it possible for disabled servicemen and women to live comfortably at home, being just as independent and self-sufficient as they were before their deployment. If you or someone you love has suffered an injury or emotional trauma while serving active duty service in the armed forces, know that there are tools and resources available to enable home independence. In addition, know that there are grants and financial aid available to former servicemembers to help pay for necessary home modifications or equipment.
This guide offers a comprehensive overview of the most common disabilities that military personnel acquire, and offers ideas and available resources for modifications and adaptive technology equipment that can help them adjust and reestablish their home life, career, and future. This guide also provides information on available financial assistance, and additional resources for service members and their families.
Common Disabilities Acquired by Military Personnel During Active Duty Service
What follows is a list of some of the most common disabilities that servicemen and women face after active duty separation, and suggestions for assistive technology and home modifications that can make the return home feel more like a return to normal.
Tinnitus is a condition marked by the presence of phantom noises. An individual with tinnitus presumes to hear sound, when in reality, no external sound exists. Such phantom noises may include: ringing, buzzing, roaring, clicking, or hissing. It is caused by inner ear cell damage, something that can occur from exposure to loud noises, such as the explosions or gunfire experienced during combat.
According to a study by the Journal of General Internal Medicine, 16.4 to 26.6 percent of male, and 7.3 to 13.4 percent of female veterans of the Afghanistan War and the Iraq War seeking Veterans Affairs (VA) care suffer from serious hearing loss and tinnitus.
This is a great resource for more information on tinnitus, its causes, and available treatments.
- Visual warning/alert signalers – These devices alert an individual with hearing loss when a visitor is at the door, or when smoke or fire has been detected. Often such devices work to get the attention of an individual with hearing loss by flashing lights, making a very loud sound, or shaking the bed.
- Wide area door peepholes – These modifications assist individuals with hearing loss identify who has arrived at the home or apartment if they are unable to clearly hear the visitor’s voice on the other side.
- Thin carpeting or linoleum floor – Some individuals with hearing loss learn to adapt to interpreting stimuli in their environment by feeling vibrations around them. Installing thin carpeting or linoleum can make it easier for them to identify such vibrations.
- Audio or hearing loops– This type of hearing assistive technology (HAT) works in tandem with an implanted hearing aid or cochlear implant. It is a wire that circles a room and is connected to the sound system. The wire loop transmits the sound directly to the hearing aid for better clarity.
- Infrared system – This type of HAT uses an invisible beam of light to carry sound that is within the individual’s line of sight to a personal receiver, such as a neck loop or a behind-the-ear silhouette inductor.
- FM systems – This type of HAT uses radio signals to transmit amplified sounds to a receiver tuned to a specific frequency or channel, or to a hearing aid or cochlear implant.
- Captioned telephones – To enable individuals with hearing loss to receive telephone calls, these devices display written captions of the caller’s words on a built-in screen.
- Communication access real-time translation (CART)– A verbatim, near instantaneous conversion of spoken language into text that is displayed on a screen or by a projector connected to a notebook computer or computer monitor.
- Hearing aid-compatible landline or cell phones– It may be possible to adapt an existing landline telephone or cell phone for use in tandem with a hearing aid. Click here to find an accessible wireless provider to assist with such modifications from Access Wireless.
- Augmentative and alternative communication (AAC) – This term refers to a wide range of tools that assist hearing impaired individuals with expressing themselves. Options range from a simple picture board to computer software that synthesizes speech from text.
Various HAT devices can be ordered directly from the Hearing Loss Association of America (HLAA) and Harris Communications. In addition, Starkey Technology produces hearing aids designed for individuals with tinnitus.
Additional information and resources on hearing loss and tinnitus home modifications and assistive technology:
Traumatic eye injuries and other visual disorders caused by penetrating wounds are the fourth most common type of injury among active duty personnel. It’s estimated that such vision impairments have impacted 16% of all soldiers evacuated from Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (OND). Individuals with vision impairments may find themselves entirely blind, or they may struggle to identify details, their surroundings may seem blurry, they may be sensitive to glare or bright lights, or unable to see properly at low light.
- Additional lighting or task lighting – Task lighting provides heightened illumination in selected spaces where proper vision is critical, such as the kitchen, reading areas, or staircases. Also, consider installing glow-in-the-dark light switches.
- Hot water adjustments – This home modification technique can help to prevent accidental scalding of the visually impaired. Set hot water temperature to 120 degrees.
- Flooring and carpeting – Remove or replace worn or uneven carpeting and rugs that post a tripping hazard and install non-skid flooring.
- Bathroom safety– Install grab bars in bathrooms and railings that extend beyond the bottoms and tops of stairways.
- Screen-reading software – This technology uses synthetic, digital speech to read the content of a computer screen aloud.
- Magnification software – This software acts like a high-powered magnifying glass for a computer screen. As a cursor or keyboard moves, it magnifies relevant content.
- Larger computer monitors – For some visually impaired individuals, a larger computer monitor makes a significant difference in viewing on-screen content.
- Software that enlarges computer fonts – If not included in a computer’s operating system, additional software can be installed.
- Dictation software – This software is often compatible with braille embossers and braillewriters to allow the visually impaired to create documents in braille.
- Refreshable braille displays – These tools raise and lower combinations of pins to create braille characters for reading and writing.
- Optical character recognition (OCR) systems – These systems allow the visually impaired to read traditionally printed documents. A printed document is scanned into a computer and then the OCR system converts the image of the scan into text characters and words that can be recognized by either a screen reader or a braille embosser.
- Video magnifiers and closed-circuit televisions (CCTVs) – These tools use a stand-mounted or handheld video camera to transfer a magnified image to a monitor screen.
- Portable magnifiers – Portable, video magnifiers with handheld cameras can assist the visually impaired with reading signs and other printed text.
A variety of vision assistive technology products are available from Boundless Assistive Technology.
Additional information and resources on vision loss home modifications and assistive technology:
Migraines and other headache disorders are becoming increasingly common among deployed servicemembers. It’s believed that the stress and physical demands of active duty service can trigger such severe headaches. In addition, servicemembers who suffer traumatic head injuries are also at an increased risk of developing migraines. It’s estimated that 36 percent of soldiers returning from deployment in Operation Iraqi Freedom experience migraine-like headaches.
- To avoid light-triggered migraines:
- Place lights strategically, employing as little light as possible while still effectively illuminating a space. Table and floor lamps might be a good alternative to overhead lamps, as they can provide less intense, more accommodating light.
- Replace or fix any lights that flicker, as flickering can often be a trigger for these migraines. Pay special heed to the ballast; old ballasts are prone to flickering too slowly and are more likely to trigger migraines.
- Consider removing dimmers, which function through rapid flickering that’s not consciously perceived.
- Add fluorescent diffusers to existing fluorescent lights. Dulling the brightness of a light and mimicking natural light as much as possible can mitigate the chances of a migraine.
- If the diffuser is not sufficient, consider installing a filter that excludes certain elements of light that tend to trigger migraines. Blue filters are traditionally acknowledged as most likely to benefit migraine sufferers.
- Provide an anti-glare filter for computer monitors, or choose a liquid crystal display monitor with a high refresh rate.
- Wear anti-glare glasses, especially when working on a computer.
- To avoid noise-triggered migraines:
- Consider noise when positioning furniture. Keep seating and, most importantly, the bed of the migraine sufferer away from loud noises, including reverberations through the walls.
- Provide an environmental sound machine to mask distracting sounds.
- Install sound absorbing wall paneling in the home.
- Use sound absorbing materials throughout the house, particularly cloth and fabric textiles including: carpets and rugs, table cloths, window drapes, upholstered furniture, and pillows in order to help attenuate the impact of sound
- To avoid fragrance-triggered migraines:
- Place an air purification system in the home.
- Use fragrance-free chemicals throughout the house.
- When buying new furniture, painting the house, etc. beware of the fumes that may be released. Ensure that proper ventilation is provided.
- Electrical stimulation devices – These relatively new products aim to ease migraine pain by stimulating nerves in the cranium using electric current. Click here to learn about the Cefaly headband, a stimulation device that has proven to ease migraine symptoms for many patients.
- Motion sensing lights with dimmers can help control the amount of light a migraine sufferer is exposed to during an episode, while also reducing likelihood of injury. These newer dimmers flicker faster and are less likely to trigger a migraine than older ones.
Additional information and resources on migraine home modifications and assistive technology:
PTSD is an emotional disorder with physical symptoms that impacts a significant number of servicemen and women. PTSD can be triggered after traumatic experiences in active combat, such as a life-threatening incident, or witnessing a devastating event that caused death or severe destruction. It’s estimated that 11 to 20 percent of soldiers who served Operation Iraqi Freedom and Operation Enduring Freedom have PTSD. In addition, it’s estimated that 12 percent of veterans who served in the Gulf War, and 15 percent of veterans who served in the Vietnam War have PTSD.
Veterans who suffer from PTSD may experience flashbacks, nightmares, anxiety, and depression in a variety of settings, including the home. There are home modifications that can help mitigate the presence of triggers of PTSD-related incidents. In addition, there are technology tools available to help veterans perform their coping strategies if they feel an incident coming on. In addition, PTSD suffers may consider acquiring and training a support animal, a commonly accepted strategy for coping with PTSD.
- To avoid noise-triggered episodes:
- Install sound absorbing wall paneling to muffle sounds and prevent the type of sudden sounds that can trigger an episode.
- Similarly, use a white noise or environmental sound machine to mitigate loud, unexpected noises that may trigger a flashback.
- Use soft flooring such as carpets to help muffle sounds, cushion falls, and smoothen out transit at home so that movement is more fluid and less disruptive.
- Make sure surfaces are level and any items affixed to the wall are properly mounted and secured. This will help prevent anything from suddenly falling and triggering a flashback.
- To avoid light-triggered episodes:
- Place blackout curtains over the windows to prevent sudden flashes of light.
- Install blinds or shutters to block out light. Plantations shutters can also offer an added layer of security, which can help soothe a flashback.
- Use central heating and not ceiling fans. The movement of the ceiling fan can catch one’s eye and, like a flash of light, trigger a flashback.
- Avoid hanging mirrors in the house. If a mirror is required, be sure to cover any windows nearby, and refrain from placing televisions, monitors, or other sources of moving light
- Mobile applications – Developed by the National Center for PSTSD, PTSD Coach is a mobile app that helps PTSD sufferers cope with triggers and symptoms. In addition, the mobile app CPT Coach uses cognitive processing therapy to help veteran PTSD suffers decrease feelings of distress.
Additional information and resources on PTSD home modifications and assistive technology:
Preparation for People with Disabilities
Similarly, people with disabilities should be taught emergency preparedness strategies and practice “storm drills” on a regular basis. If people with disabilities understand the routine for staying safe during storms, they will be more likely to remain calm and take effective action when lightning begins to strike.
In general, it’s important for people with disabilities to establish a supportive network of friends and family to assist them in times of disaster. Be patient with people that have disabilities and explain storm preparedness procedures in terms that can be understood. Write lists and post-it notes to remind them about the precautions they should take when a storm hits, including the following items:
- Necessary medications
- Bottled water
- Non-perishable foods
- Basic first aid supplies
- Fully-charged cell phone
For Caretakers of Disabled People
Caretakers of the disabled should remain calm and ensure that the disabled person stays indoors and away from windows and doors. Ensure that disabled people stay indoors for at least 30 minutes after the last boom of thunder before resuming normal outdoor activities. Books, games, and craft activities can keep everyone occupied and entertained while a storm is happening. These guidelines apply for caretakers who are responsible for people with physical disabilities, mobility issues, Downs Syndrome, Alzheimer’s, autism, and other mental disorders.
If you work in an environment that cares for multiple people with disabilities, employ the “buddy system” and have residents pair up to assist each other. It can also be helpful for people with disabilities to wear a medical alert tag or bracelet that identifies their disability and vital medical information in case they become lost or separated.
A spinal cord injury may be one of the most devastating that occurs during active duty, and one that requires the most involved home adaptation. According to Paralyzed Veterans of America, more than 5 million Americans are living with paralysis, and one in four is the result of a spinal cord injury. Spinal cord injuries can result in functional impairment of the arms, trunk, legs, and/or pelvic organs. With limited mobility comes the need to adapt one’s home environment to make daily tasks and access safe and convenient.
- Entryways and Exteriors:
- Lifts – Install an elevator, wheelchair lift, ramp, and/or stair lift to enable home entrance.
- Widen doors and hallways – Doorways should be at least 36-inches wide to accommodate wheel chair access, and doors should include lever-style handles for easy opening.
- Door locks – Replace door locks with easy-open versions such as keyless locks with remote or keypad codes.
- Lighting – Ensure indoor hallways and outdoor pathways are well-lit at all times to reduce the changes of a slip and fall.
- Living Rooms:
- Flooring – Install non-skid surface materials on floors. Also, ensure carpeting is not worn, frayed, ripped, or buckled.
- Light switches – Change the height and style of wall light switches. Consider easy-touch, rocker-style light switches placed 42 inches above the floor.
- Electrical outlets – Place electrical outlets 18-inches above floor level for easier access from a wheelchair.
- Counters and shelves – Change the heights of shelves and counters. Seats should be 18 inches off the floor and countertops should be rounded and placed no more than 34 inches above floor with knee space below for use while seated.
- Storage – Install easy-access storage. Consider a pull-out pantry or adjustable-height shelving units.
- Shower – Install grab bars or shower assists to prevent slips and falls. For easier entry into the shower the structure may need to be modified to create a threshold, roll-in shower. Minimum shower dimensions should be 5 feet by 3 feet (ideally 4 feet). The shower should include a hand-held, adjustable-height showerhead for convenience.
- Faucets – Install lever handle, anti-scald faucets on sinks, bathtubs, and showers.
- Toilet – Center toilet 18 inches from any side wall, tub, or cabinet to ensure enough room for a wheelchair or walker.
- Sink – Ensure there is enough knee space under sink for seated users.
- Hoyer Lifts – Install grab poles and hoyer lifts for assistance getting into bed. These devices allow individuals with limited mobility to be safely lifted and transported into bed.
Additional information and resources on spinal cord Injuries, disorders, and paralysis and home modifications:
A Lift for a Vet – An organization dedicated to helping physically disabled veterans.
– A trade group of companies that make elevators, lifts, stairway chairlifts, etc.
– A resource for accessibility home remodeling ideas.
– A resource offering products and consultation services for accessibility accommodations.
– A resource offering modular, reusable, easy-to-build wheelchair ramp designs.
Losing a limb can feel like losing a part of one’s identity. Aside from the physical limitations that occur after such a severe injury, amputees often experience emotional stress and insecurities surrounding their new appearance. A recent study identified that from 2001 to 2015, over 1600 soldiers who served in Operation Freedom’s Sentinel, Operation Inherent Resolve, Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom have experienced a major limb amputation. Feeling comfortable and capable in one’s home is critical to adapting to life as an amputee.
Home Modifications and Assistive Technology for Lower Body Injuries and Amputations
For those amputees who utilize wheelchairs, many of the previously described accommodations described relative to cases of spinal cord injury and paralysis are viable home modification solutions. In addition, consider the following:
- Door hinges – Adjust doors to hinge on the opposite side. This creates more space for individuals with a lower body impairment.
- Shower safety:
- Prosthetics for shower use – Consider a prosthetic shower or swim limbs such as Aqualeg for shower use.
- Shower seating – Install a bath chair or bench and a non-slip shower mat.
Home Modifications for Upper Body Injuries and Amputations:
- Doorknobs – Replace rounded doorknobs. Instead, install a doorknob extender or doorknob with a lever for easy one-handed use.
- Placemats – Place gel pads under plates and bowls to prevent sliding during meals when only one hand or arm is available.
- Cleaning Items – Use a backpack vacuum and long-handed cleaning aid.
- Bidets – Installing a bidet in the bathroom can eliminate the need for toilet paper management and ensure proper sanitation and hygiene while maintaining independence.
- Gooseneck clamps or suction cups – When installed in the bathroom, these convenient tools can hold personal grooming items.
- Computer technology – One handed keyboards, speech recognition software, large-key keyboards, foot mouse and touch pad, trackballs, and head pointing systems are all alternatives to traditional computer hardware to assist individuals with a single or double upper body amputation.
- Speaker phone telephones – These tools enable convenient telephone use. Choose one with programmable number storage for speed of use.
- Gripping tools – Grasping cuffs and grasping orthoses can make daily tasks possible in a comfortable and safe manner.
- Lifting items – To assist with lifting heavy items in and around the home, utilize portable material lift equipment, a tailgate lift, hoist, or lift table.
- Universal cuff – This convenient wearable item slips around a residual limb to hold a utensil, allowing for independence during meals.
- Utensils – Specially designed utensils are available that swivel and can be held to achieve necessary angles for eating.
- Dressing tree – This household item uses a system of hooks on a stand to make dressing easier when unassisted.
- A mouth stick – This convenient tool assists with flipping switches and pressing buttons or keyboard keys.
Additional information and resources on upper and lower body injuries and amputations, home modifications, and assistive technology:
The VA offers three primary grant programs to assist disabled veterans and servicemembers to make the home modifications needed for a comfortable and safe return home.
Specially Adapted Housing (SAH) Grant
The SAH Grant helps veterans achieve a barrier-free living environment. Veterans and servicemembers with specific service-connected disabilities may be entitled to a grant to be used to build or modify a home environment to meet adaptive needs. Grants may be awarded up to approximately $63,000. SAH grants may be used to:
- Construct a specially adapted home on land that is to be acquired.
- Build a home on land that is already owned if it is suitable for specially adapted housing.
- Remodel an existing home if it can be made suitable for specially adapted housing.
Grant money may also be applied against the unpaid principal mortgage balance of an adapted home acquired without the assistance of a VA grant.
Special Home Adaptation (SHA) Grant
The SHA grant allows veterans and servicemembers to modify an existing home to meet adaptive needs. Up to approximately $12,700 may be obtained in grant funding. SHA grants may be used to:
- Adapt the existing home in which a veteran that is owned by the veteran or a family member.
- Adapt a home a veteran or family member intends to purchase in which the veteran plans to live.
- Provide assistance for a veteran to purchase a home that has already been adapted in which the Veteran plans to live.
Click here for more information on SAH and SHA grants and to determine your eligibility.
Home Improvements and Structural Alterations (HISA) Grant
HISA allows veterans to receive financial assistance for any home improvement project that is necessary for the continuation of treatment, or for disability access to the home and essential lavatory and sanitary facilities. HISA provides home improvement benefits up to $4,100 to service-connected veterans. Individuals may be eligible for HISA as well as an SHA or an SAH grant.
In addition to grants available from the VA, servicemembers and veterans may be eligible for the following adaptive grants:
The Think Alive Achievement Grant - Designed for individuals 21 and under, the grant can be used for minor home modifications up to $500.
Rebuilding Together - A program made available by AmeriCorps to help groups of people build new homes or modify existing ones.
The American Red Cross - Provides financial assistance for eligible active servicemembers and veterans to modify a home to accommodate a disability that was obtained during active duty service.
The Individual Adaptive Equipment Grant from the Travis Roy Foundation - Available for those who have suffered a spinal cord injury. Funds may be used for home modifications.
The Gary Sinise Foundation’s Restoring Independence Supporting Empowerment (RISE) Program - Provides veterans with grants for modifying existing living spaces or constructing new Smart Home.
Additional Resources for Disabled Veterans and Service Members
Information on Disability Compensation from the Office of Public and Intergovernmental Affairs
Information on Service-Disabled Veterans Insurance from the U.S. Department of Veterans Affairs
After years of service, dedicated to fighting for your country and our nation’s freedom, you deserve to come home again and to live a life of independence and confidence. Even if active duty service changes how you experience the world around you, it doesn’t have to change your enjoyment of your home. With simple modifications and the use of adaptive technology, servicemen and women can return home to live fulfilling and comfortable lives. With organizations dedicated to helping servicemembers and veterans adapt to their disabilities and modify their homes in comfortable and comforting ways, you’ll always have a resource available to assist you in your transition to civilian life.