7 Types of Home Modifications To Consider When You’re Diagnosed With SPMS

When you’re living with secondary progressive multiple sclerosis (SPMS), your home plays an important role in how safe and comfortable you feel in your everyday life. As your mobility changes, your home may need to change, too, to help make life more accessible.

But figuring out where to start can be overwhelming. Occupational therapy clinical specialist Alyssa DeCarlo, OTR/L, explains when to think about home modifications and what adjustments to consider.

7 types of home modifications to consider

Making changes to your home can help you stay safe and independent for longer, even as your SPMS progresses and your mobility changes.

“When people hear the term ‘home modifications,’ their minds often jump right to renovations,” DeCarlo acknowledges. “But it can also mean changing the positioning of an object or adding a piece of equipment that supports your independence.”

SPMS disease progression can be slow or fast, and it looks different for everyone. So, planning is about options, not predictions. DeCarlo outlines important categories of possible home modifications, including room-by-room breakdowns.

1. Fall-prevention modifications

Even if you’ve been living with MS for a while, it’s worth revisiting foundational safety strategies as your needs evolve. Easy, low- or no-cost swaps can significantly lower your fall risk.

• Remove throw rugs. They’re a tripping hazard even under the best of circumstances.
• Make things reachable. Move heavy and frequently used items to shelves and drawers that are easy for you to access — not too high, not too low.
• Use extra lighting. Illuminate hallways and other dark spaces with nightlights or motion-sensor lights.
• Add visual contrast to steps or thresholds. Colored tape or rubber stair treads offer an extra level of safety if MS-related optic neuritis causes vision changes.

2. Around-the-house mobility supports

Fatigue is one of the most common SPMS symptoms, so saving energy on small movements matters. These mobility supports can help you with basic movements, like standing up and sitting down, allowing you to conserve your energy for other things.

• Grab bars: Installing them near couches and chairs provides support for sitting and standing. Floor-to-ceiling poles are a bigger investment, but they can also be helpful.
• Hands-free tools: “Holding a phone for long periods uses more energy than you might realize,” DeCarlo says. Give yourself a break with tablet stands and hands-free smartphone mounts.
• Lift cushions or lift chairs: Your insurance may cover certain aspects of these installations, like the motor in a lift chair.

3. Smart tech tools

Innovative technological tools can provide significant support to people who need a little extra help at home. Consider options like:

• Smart speakers: Use them to turn lights on and off, adjust the thermostat, set reminders, make phone calls and more.
• Foot-pedal light switches: Reaching up or leaning over to adjust the lighting puts your balance at risk. Foot-powered options can help.
• Electronic locks: These can be a helpful option if you find that tiny knobs or keys become difficult to manage as your hand strength weakens over time.

Explore your phone’s accessibility features, too.

“The settings on your phone can be really helpful,” DeCarlo notes. “You can widen touch targets, ignore double-taps or use voice access.”

4. Bedroom modifications

As your strength or fatigue levels change, bed mobility often becomes more difficult. DeCarlo recommends:

• Bed rails, ladders or rungs: A variety of in-bed and around-the-bed tools can help you roll or reposition more easily.
• Modular wedge pillows: These are a simple, helpful way to customize your bed positioning and raise your trunk.
• Adjustable beds: Just be sure to avoid memory foam. “They cup your body and support your weight,” DeCarlo explains. “But when you have limited mobility, that makes it harder to move.”

Some people, she recommends replacing queen or king-sized beds with separate adjustable twin beds that are pushed together.

“That way, you get the comfort of a regular mattress and you can be close to your loved one in bed,” she points out. “But if a caregiver needs to access both sides of the bed to help you get in or out, they can separate the beds to do that.”

5. Kitchen modifications

From a structural standpoint, kitchens can be especially tough to adapt.

“Most people don’t undertake whole-kitchen modifications,” DeCarlo says. “Instead, we focus on helpful tools and strategies that allow you to do kitchen-related activities.”

• Specialized kitchen tools: Adaptive cutting boards, rocker knives and large-handled utensils can make cooking, eating and other activities more accessible.
• Carrying attachments: If you use a scooter or rollator, look into baskets, pouches and other attachments to carry items from point A to point B.
• Tech gadgets: Automatic can openers and soap dispensers help you conserve your energy for larger tasks.
• Pasta baskets: They’re not just for pasta! Set a strainer in the pot while you’re steaming veggies or eggs. “Then, just lift the basket out instead of handling a heavy pot of boiling water,” DeCarlo suggests. “It’s lighter and much safer.”
• Prep space: Standing at the kitchen counter can be exhausting. Try using your dining room table for seated prep work instead.

6. Bathroom modifications

This category is a whopper.

“The bathroom is where we spend the most time talking about home modifications,” DeCarlo says. “It’s the area with the biggest safety concerns and the biggest impact on your independence.”

Tight spaces, slippery surfaces and narrow doorways all mean potential trouble. Plus, bathroom-related issues feel deeply personal. So, it’s worth planning for comfort, privacy and dignity, as well as safety.

To understand which options are right for you, it’s always best to talk to an occupational therapist. But DeCarlo explains the basics, breaking down potential modifications into a few categories.

Bathtub and shower modifications

Having your bathtub removed and turned into a walk-in or roll-in shower is often the safest option for the long term. But it’s not feasible for everyone’s home or budget. And DeCarlo says other modifications bring a variety of pros and cons, from how much support they offer to how much they cost to install.

“What’s best for you will depend on your abilities and what’s possible within the confines of your space,” she says.

• Shower chairs: Options range from simple seats to more supportive roll-in models.
• Sliding tub benches: These devices can help you safely get over the edge of a bathtub. But they’re large, require a lot of space and may not provide enough torso support.
• Threshold ramps: These plastic or rubber devices can help you roll a chair over the lip of a shower stall.
• Grab bars: DeCarlo recommends being present during installation. “You can actually get in the shower and show your contractor exactly where you need them to be installed,” she adds.

More accessible toilets

There are lots of adaptation options for toilets. The right choices for you will depend on your needs, the height of the toilet and the physical space itself. Here are some possibilities:

• Stability supports: Having grab bars or safety frames installed around your toilet can help you steady yourself.
• Bidet toppers: These simple attachments make it easier to clean yourself. “Just be sure the controls work for your hand strength,” DeCarlo advises. “Some people need a dial, while others need a push button.”
• Base risers: These devices go beneath the toilet itself, raising it to a more manageable level. They’re safer than bulky commode seats that sit atop your toilet seat, which can be too tall and leave your feet dangling.
• Advanced combos: Technology-forward options like electric toilets combine power lift and bidet functions. They offer the most independence, but they’re also the most expensive.

Other bathroom considerations

Other aspects of your bathroom deserve attention, too. In particular, DeCarlo points out that bathroom doorways are often the smallest in the house.

“Putting your door on offset hinges — hinges that swing the door outward — can add up to two inches of doorway width,” she shares. “Or you can have sliding doors installed. They’re easier to manage and offer more space than swing-style doors do.”

And don’t forget the sink. Adding space beneath it (called a “sink cutout”) allows you to sit to wash your hands, apply makeup, etc. You’ll want to have the piping insulated, though, to keep you safe from burns.

7. Multistory living modifications

If you live in a multilevel home, planning ahead is especially essential. Though stair lifts might seem like a simple fix, DeCarlo says they’re often not the best long-term solution.

“If you’re eventually in a full-power wheelchair, who will get the 450-pound chair upstairs?” she asks. “And you still have to be able to safely transfer on and off the lift.”

She offers options to consider instead:

• Rework your space. Could you create a functional first-floor bedroom and bathroom?
• Look into short-term solutions. Portable pop-up showers connect to an existing water source, like a sink faucet. This creates a temporary bathing space while you figure out a longer-term solution.
• Consider an elevator. Pantries and half-baths often provide enough space to install a small residential elevator.

How an occupational therapist can help

Occupational therapy can help you navigate home modification options and questions.

This catch-all resource is designed to help you figure out how to work with your abilities, rather than against them. That includes making changes to your home and daily habits, and even pointing you toward grants that can defray the cost of home modifications.

“If your goal is to stay in your house, we’re going to find a way to help you do it,” DeCarlo emphasizes. “And if we can’t, we’re going to be honest and tell you that — but only after we’ve exhausted all the options.”

When to start considering home modifications

It can be hard to accept that your needs are changing. But even if you don’t yet need major home modifications, DeCarlo encourages you to start exploring the options early.

Making changes before you need them can help you:

• Figure out your home’s limitations and potential problem spots.
• Make modifications in phases.
• Spread out costs over time.

“It’s never too early to start talking about what aging in place looks like,” she says. “Being proactive, rather than reactive, gives you more options to stay in your home safely for longer.”

Remember: You don’t have to do everything at once. One small change at a time can help you feel safer, steadier and more at home in your own space.