Episode 348-Home Accessibility Upgrades and Universal Design for All with Erica Sell

Your house can be beautiful and still be safer, easier, and more supportive for real life. I sit down with Erica Sell, owner of Harmony Home Medical in San Diego, to get practical about home accessibility, assistive technology, and universal design for families raising neurodivergent kids and for anyone planning to help aging parents live well at home.

We start with how Erica built a high-touch, education-first medical equipment showroom after seeing a gap between what people truly need and what third-party payer criteria tends to prioritize. From there, we dig into bedroom solutions like high-low adjustable beds that look like normal furniture, plus enclosure bed options families often search for when safety and nighttime behaviors become a serious concern. We also talk honestly about how coverage and classifications can change, and what it means to plan ahead instead of waiting for a crisis.

Then we go through the home with specific aging-in-place and special needs home modification ideas. In the kitchen: task-height surfaces, safer appliance controls, and layered lighting that improves visibility while respecting sensory needs. In the bathroom: modern grab bars that don’t look institutional, smarter layouts, and transfer systems that reduce lifting and protect caregiver backs as kids grow. We close on community resources, the rapid innovation in lightweight mobility devices, and why remodeling is the perfect time to quietly build in universal design.

If this helped you, subscribe, share with a caregiver or parent, and leave a quick review with the one home upgrade you’re prioritizing next.

Transcript

SPEAKER_01 0:01

Hi, thanks for joining the SG Child show today. I am really excited to have this guest with me today. We're going to explore a really great topic that I think is important to just human beings in general, but you know, we'll make some specifics and give some good advice for our neurodivergent community and for parents and other caregivers and providers and others that are listening. Of course, there's going to be takeaways for you as well. There always is just these wonderful, even if it's anecdotal, you know, ideas that you can take from these discussions and really put them to work and put them in action and see the results for yourself. So, Erica, I'm so excited to have you here today. Thanks for joining me.

SPEAKER_00 0:53

Yeah, absolutely. Excited to be here. Thanks for having me on the show.

SPEAKER_01 0:57

Yeah. Tell us a little bit about yourself. Give us an introduction, and then we'll lead into that discussion.

SPEAKER_00 1:04

Awesome. Yeah. Well, my name is Erica. Erica Sell and I have two medical equipment stores called Harmony Home Medical in San Diego. And I kind of got started in this all by chance, by accident. I grew up working in my mom's medical equipment store, where a large population of hers was the regional center community. So it was developmentally disabled kiddos, and then also the seniors in Medicare recipients. But her business was set up as a warehouse model focused on third-party payer criteria and what they covered. And so there was no retail and no, not no advocacy for the end user, but it was more focused on what's covered. And so I did not want to go into medical equipment when I graduated high school. I came to San Diego to do social work and business. And I actually ended up working for this financial investment firm my first six months out of college. And my mom called me with a crisis in the business, and she had an embezzlement in her company at the same time she was having a cancer scare. And that's how they found out because she was in the hospital, but she was okay, but she had to lay off more than half of her staff. And she was on a shoestring about to lose her business that she'd had for like 15 plus years. And I came back up to help her out. And at this time, I got to do all of the big kid stuff. I got to measure people's homes. I got to measure people's bodies. I got to help figure out what rolling shower and ceiling lift combo or custom shower chair worked for these people's home environment. How are we going to get them to have community access and all these things that I said, you know, why don't why don't you show the public this? Like, why don't you show it in a store format? And she said, well, because Medicare doesn't cover it. It's just regional centers who we who we were doing these things for. And she said, So, you know, no one will pay for it if it's not covered. I said, I don't know. I think, I think you might be wrong. I think someone might want to want to know about this, even if Medicare is not going to cover it. And so that was where the idea was born. And I ended up coming down to San Diego and starting at the Del Mar Fair and then going to a little tiny store and bumping up three three times till we finally found our footprint and our model that we would like to duplicate here of these large showrooms, kind of like the Toys Rest or the Aging Adult. And of course, we still serve our developmentally disabled community as well. But a large part of our demographic is the aging community. And we do it in a in a retail fun way, education, hands-on, a lot of products that you won't see anywhere else in the store to help people understand what's possible for them.

SPEAKER_01 3:46

And I think that a lot of there's almost like an overlap, if you will, if we look at our the both of those kind of senior and you know, disabled or neurodivergent communities in some of the accommodations that they do need. And some of these equipments are so relative and so um in place for the accommodations that we're also going to be seniors and our children will be them as well. And all of these things will be necessary, and being able to plan something by maybe even just looking at at what you have and seeing, okay, this might be something, you know, for a parent with an older adult. What would I what might I get in now so that when it's time, you're not like, oh, what am I supposed to do? And in this panic mode, where do you even go to find these resources?

SPEAKER_00 4:45

Yeah, absolutely. Planning ahead and looking at life, how you need your spaces for now and forever is kind of the key. And it's what so many of us don't do because we just see ourselves now and we don't like to project ourselves in aging. You know, I I still have clients that are 92 and saying, I'm not old, I don't need that, I'm not old. So it's better to know that we're all going to age, and they call some of these changes in our homes now universal design because it's helpful for everybody. Yeah, it's helpful for a parent taking care of a neurodivergent kiddo, it's helpful for that kiddo as they get a little bit older and can participate in their own self-care, but they need a little bit more safety items in place. It's helpful for all. I did these same practices in the bathroom for my kids because my kids were pulling towel bars off of the wall and you know, being being kids. And so I put everything in there grab bars, weight bearing, non-skid floors, all because we can all fall in the bathroom.

SPEAKER_01 5:48

Yeah, why not? You know, why not plan for safety? You know, I think that's an incredible idea, especially, you know, for me personally, my mom is just on her own, widowed at this time. And so those are some things I'm noticing. Okay, what am I gonna need for my mom, you know, in the future? And I'm an only child, so that that is the on me that you know, I need to start figuring those things out. And this is the perfect place for someone to be able to do that. Is there kind of have you set up an online version as well as the in-person version? Tell us a little bit what that looks like.

SPEAKER_00 6:29

Yeah, so we do have our website and tons of product education on there and all of our favorite products on the page. We can order from kind of any medical manufacturer, so not everything that we can do is on there, but our core product offerings are some really helpful ones, or some of the specialty beds. That's that's a big deal and very helpful for both the neurodivergent community and for an aging population to have uh options that are beyond just the metal hospital bed.

SPEAKER_01 7:00

Yeah.

SPEAKER_00 7:00

You know, be it high, low adjustable beds that are beautiful, but do all the positioning and function of a hospital bed or safety enclosure beds that you know keep kiddos safe if behaviors are falling out of the bed. So, you know, so all that's one category that ends up being very helpful for parents and for aging adults that they could think of sooner. Like you can get that high-low adjustable bed because it looks nice and it doesn't make your home feel hospital at all. You can put that in place when you're having the slightest bit of difficulty getting on a bed and don't wait for it, you know, get it right when you need it and prevent the fall.

SPEAKER_01 7:36

I love that. And there are so many stories I see all the time, especially in my groups and community, of people, parents looking for those enclosure beds. So many of them. I know when we were just, you know, our son is profoundly autistic and he used to take his mattress off of his bed every single day. He we he wouldn't keep the mattress on the bed. And so you're always he got stuck in like the the wood planks one time. He like he, oh man, he put us through it with that bed stuff. And we looked, I mean, it was you know, a decade ago or more, and so of course that was not available then. We had to come up with our own little, you know, get your pup tent and whatever and make it just as fun as possible. Um functional.

SPEAKER_00 8:24

Wow, yeah. No, they have amazing enclosure bed options that you know sew the sew the the bedding, this the sheet covers and the top together too, so you can't get your hands in between the mattress and the frame or the enclosure, and you can't get under anything. And I have now where you can do there's some tech built into it where you can talk to your kiddo or play music. You can even do some chromatherapy with light changing and everything, and then a camera to watch and then make sure everybody's safe. So the the bed options are really amazing and great, and they they've been traditionally covered by a regional center, so Medi-Cal would be the first payer or Medicaid, wherever you're at, and sometimes they will pay, and then if not, then the regional center. However, I just got notice from the the San Diego Regional Center that they're now considering it an entrapment device, and they're not gonna pay for the full over the top. They're paying for this particular client the the sidewalls, but nothing that's fully enclosed that they couldn't get out of. But it kind of defeats the purpose for so many parents and for their safety needs to not have it be fully enclosed. So we're gonna have to see how that how that unfolds and what they'll choose to do. But every state and every area is is different too. Not everywhere has regional center, and then some places don't call it regional center, but they have these third-party payers that are either state funded or grant funded.

Kitchen Accessibility And Better Lighting

SPEAKER_01 9:55

Yeah, and you could usually call your state resource center or dial, I think 211 might be in all states to or 411, something like that, to get all of the information wherever you are if you're in the United States. So I believe that that is something available, and that's a really great place to start. And it kind of got me thinking, well, let's move into kind of the next area, let's just go through the house. So, what kind of accommodations would you guys provide for the kitchen, for example? Let's talk about that type of thing and and what that looks like. I think that's just a great idea to give everybody an idea of all of the different types of areas that they can uh make their home more accommodable.

SPEAKER_00 10:46

Yeah, it it depends on what their scenario is and what their goals are. If we were doing it for wheelchair accessibility, some pointers and some of the pointers would apply for just accessibility period, because one thing I like is task height tables. Sometimes counters are too high, and you can have we've done like an island and then a flip-down that's a little bit lower than the island to do work from, and that can be for the kiddo to do their work and activities. It can be to be able to chop and prep food from a lower height from a wheelchair. Uh, so that's one thing. And then for access, again, whether you're wheelchair bound or limited mobility, we like to have appliances that have a lot of front features. So knobs that are at the front of the stove versus the back of the stove or oven controls that are at the front versus the back. You want to try to stay safe and not be reaching over flame per se to do the back knobs. So you could have limited sensitivity in your skin depending on your diagnosis. Um, so we want to keep those up front. And then we want to have multiple layered lighting. So the task light, it's super easy to do nowadays, too, with even just strip light that you could put under your cabinets. You don't even have to have an electrician install it. We want to have some of that brighter task lighting in combination with the higher ambient light, preferably on a dimmer. So you have those kind of options. And when you're doing things that can be dangerous, like chopping and carrying hot water and stuff, you want to make sure that your highest light, your your task light, and then your upper end of your dimmers are on because that can be a very easy, preventable thing to do is to be able to see everything. Yeah. Have enough light to do your thing.

SPEAKER_01 12:36

That's that's wonderful. And I think that lighting is a really, really important accommodation to give because it affects everyone differently. Everybody has their own, you know, access to natural versus LED or whatever type of lighting. And some people just have different reactions from those things and making that sure those are accessible. That's just brilliant. And I love that like kind of showing that during these types of tasks, you need to use the highest amount of light. I think that that's really smart to remind people.

SPEAKER_00 13:11

Yeah. So that's it's simple, but it applies to all your rooms, you know, your especially your important ones like your bathroom and your kitchen, and then your entryway at your door, like something automatic, something photo sensitive, so it comes on at night, and you don't have to fiddle with switches or anything like that to make those entries easier and smoother. And even I like some of the biometric locks and things to just keep you from being in your purse trying to find your keys, removing of steps and you know, using landscaping to do grading up to your house, ramping, of course. And then in the kitchen again, the the microwaves and ovens that are at that mid height. So, you know, not really high, not really low countertop height. And you can put your microwave on the counter, you can build it into shelving, and then dishwashers that are the drawer that are a little bit higher up, and they're the pull-out drawer dishwashers as opposed to the the big, it's still kind of a drawer, but you know, our big traditional dishwashers where you're bending and get to it.

SPEAKER_01 14:17

Absolutely. I love these ideas too, because I think that we're all looking, or sometimes you know, we're all just in a house that has what it came with, and we just sometimes don't think about you want to hear the worst thing. I I don't think I've ever told this to anyone, and it's pretty off-topic and ridiculous. But when we bought our house, I loved everything, the size, every da da da da da. But there was one thing I didn't look at, and I never will never forgive myself. There's one kitchen drawer, Erica. Like one kitchen drawer. One kitchen drawer. One, one kitchen drawer. Yeah, we had to buy literally like another little cabinets and get and so we could have there was one drawer. I'm like, how did I not notice that? I was worried about a lot of other things, but whoa, right?

SPEAKER_00 15:11

Yeah, yeah, on our kitchen, but yeah, and you can make some cabinets like drawers if you did if you do the rollout shelving that you can install in cabinets, you know, kind of looking for exactly that's interesting, but yeah, it's uh things to look for, right?

SPEAKER_01 15:30

Well, that's a whole nother podcast episode.

SPEAKER_00 15:32

Yeah, easy to access the things that you want your your kiddo to access. I do this for my kids too, from when they're little, you know, their cups and plates were in a lower cabinet with one of the pull-out drawers so they could get it. So there was some autonomy there. It was safe dishware, not our glass dishware, and they can go and and do their own thing to get their own water to learn to you know take care of themselves without always having to depend on me to reach up high where they can't reach to get their glasses and their plates and stuff.

Bathroom Safety Without The Hospital Look

SPEAKER_01 16:01

I love that little things like that. But you want to make it at your excess level, definitely, and that just creates so much um independence and autonomy for them, and and that's that's what you want ultimately. We want to build independent people to leave the house when we can with those that we can, right? That's our goal. So that's great. I think what about uh bathroom accommodations? Let's talk about some bathroom accommodations and maybe yeah, I'm interested to hear what types of of products there we can kind of.

SPEAKER_00 16:38

Yeah, there's a lot you can do in the bathroom. So, you know, for for us, our ideal bathroom is generally one that has a lot of space and a roll-in zero transition shower, but we can't always have that. Sometimes people don't have budgets for it, don't have space for it. But the optimal outcome is to have one of those seamless roll-in showers, and that's that's whether you're gonna roll in or walk in it, just removing any barrier to entry and then making it safe for all. But rolling back to kind of the the first steps that we take in a bathroom is grab bars, and grab bars that we have now are absolutely beautiful, they don't need to make your house look hospital-y or uh medical in any way. We have ones that are two in one towel bars, so you take your existing towel bar and the top piece of it is weight-bearing and sturdy, and then underneath is a little skinnier bar that the towel goes on. And it's important that the towel is under because before they invented those, we would do the grab bars and put our towel on the bar. And if you have a fall, yeah, you're grabbing it and you and the towel are going down.

SPEAKER_01 17:52

Yeah.

SPEAKER_00 17:52

Um, so this keeps them separate, and then we have that for toilet paper holders. They're like circular, really sturdy grab bar with the little piece in the middle where the toilet paper goes. It looks just like a modern fixture, doesn't look like a grab bar. And same in the shower, shower wand, circular thing kind of frames your lever. It's a grab bar, soap shelf grab bar, and then just decorative, pretty finishes for your longer length grab bars that tie into those other ones that look integrated with your shower. So grab bars are like the new safety belt. You know, like we never use seat belts back in the 60s, and now everybody uses seat belts. I feel like that about grab bars.

SPEAKER_01 18:32

That's funny. I love that. Well, and yeah, and I think you make a good point to say that like you can make all of these accommodations without making your house look hospitalized or institutionalized and really just make it accommodal. And really, it's it's about safety and things. So it's great that it can also be aesthetically pleasing.

Transfer Systems That Save Your Back

SPEAKER_00 18:55

Absolutely. Though those changes can be there's some product that you can use. So if you have a kiddo and like the bathroom is a dangerous place to be doing transfers and slippery or wet and going from the commode to the shower. It's not best to be lifting your kiddo. And I come into that situation a lot of parents lifting from the toilet or toilet riser fixture they have to put over into the mesh like Riften shower chair and lifting over the ledge. There's systems that connect all of that. So they have the there's a couple brands, but Rifton is one, shower buddy is one, and new products is another that have systems where you transfer into chairs in the bedroom and then you roll it into the bathroom. And if you are doing any sort of commode or bowel routine, you can roll it over the toilet and then you snap it into a track and slide it over the shower. Oh you're never you're never doing a lift in the bathroom.

SPEAKER_01 19:53

Yeah. And these are things that families, I'm sure, like you had mentioned before with several palsy and things where they're wheelchair wheelchair bound, you know, these are lifelong uh things you're going to need to set up for your child or adults.

SPEAKER_00 20:09

Absolutely. And a lot of parents get them fairly set up out the gate, like they'll get their recumbent bath chair and and everything, but they have the a little baby that they're lifting over, and time goes on, and all of a sudden their kid is 90 pounds and they're still doing it, but they just don't realize like that it's gotten dangerous, that this is hard on my back. It's just what they've always done. And so they don't often not not often, but yeah, most a lot of times we do an assessment where we're called into the home and they haven't started to look for those solutions or know about them because they just do the way they do it, because they're super parents, and that's right.

SPEAKER_01 20:47

That's the truth, yeah. I and it's it's for them, it's just like it's their life, right? I just I totally get that.

SPEAKER_00 20:56

That is yeah, so we use ways to make transfers be easier or less. So we we want safe, easy, minimal transferring. So we try to do bedroom transfers into wheeled devices versus using transfer systems to go all throughout the home. Then we try to use products that mitigate the number of transfers we have to do, that sort of stuff.

SPEAKER_01 21:20

What type of like toilet accommodations are there like certain seats or things like that families might not know about that might help?

SPEAKER_00 21:30

It's kind of everything. So, yes, we we often do the seat that you can take into the bedroom and transfer onto, and we can have lateral supports to help with seated posture, chest harnesses. We can do some tilt to help the child stay back in the chair. So we we usually look to do one that we can perform the transfer outside the bathroom, but then sometimes kiddos can get into the bathroom a bit safely, or they're doing a little bit more on their own, or the parent. It's still just lifting in there, but there's systems that set up onto the toilet from simple risers, you know, just making a little taller with some handles on the side to full sit on tops that again have some lateral support built in and they're kind of this customized commode seat. Um, that's something that I don't see it as often because again, I try to make the transfers happen outside the bathroom. But if a kiddo is walking in but they need some support or they have seizures or something and they're gonna get to the commode, but we want to make sure they're safe, then that's an option that we can do as well.

Lighter Mobility Tech And Where To Start

SPEAKER_01 22:33

That's wonderful. Yeah, those are great, great ideas and great products available. I'm excited to share this.

SPEAKER_00 22:40

So yeah, there's a lot of stuff available, and it's it's it's really great on the transportation side or on the lightweight power side lately, because uh there's there's not been a ton of innovation in our space over the years I've been in the business. I've been around the business since 1998, and I've owned my business since 2008. So I've been around it for a while, and it was only been about the last six years where a lot of innovation for portability has come on. And that's because we have what they're calling the silver tsunami, you know, of baby wombs coming into the market. So the number of buyers for these products is it has increased a lot. So it incentivizes manufacturers to research and develop these kinds of products.

SPEAKER_01 23:25

Yeah.

SPEAKER_00 23:25

And we've watched the portable power chair go from 99 pounds about six years ago, now to the lightest weight one is 26 pounds.

SPEAKER_01 23:34

Wonderful. Wow. Yeah, wonderful for families so much, and caretakers and all of the people, medical providers, and everything.

SPEAKER_00 23:45

What tell me the name of the company that's doing the lightweight power your company? Oh, Harmony Home Medical. Yeah, so Harmony Home Medical is my company.

SPEAKER_01 23:56

And where can we find it? Do you have website and pages and things like that?

SPEAKER_00 24:02

Yeah, our website is screen so harmonyhomedical.com. And then also if you go to YouTube and it's just backslash harmony home medical or search our name up and you can find us there. And we have videos from years ago. I had I need to start doing more again, but a lot of like what is the difference between a traditional lift and a standing lift? What is the difference between a long-term care bed and a hospital bed? To try to get a little education on what the different equipment is and how to use it out there. And then we are a great wealth of knowledge. So just pick up the phone and call us with questions. And you can do that from anywhere. And we do ship and service product nationwide. But if it's a customized product and it's something that I feel and believe is better serviced with hands-on, I help people right on the phone, Google and try to find a dealer that's like Harmony, that has people who measure you, that look at your home, that don't just drop ship you an insurance-issue chair, you know, that that do the customization that I think is really necessary for so many of our products.

Community Resources And Expanding The Model

SPEAKER_01 25:05

I love that. No, I agree completely. When you can really personalize the experience to how much easier and maybe they will recommend to other families because kind of once you're in the community, you're looking for other community members to to know and and be a part of, and having resources to share with those community members is is just so valuable. So wonderful. Do you do you go to a lot of fairs and medical things down there?

SPEAKER_00 25:38

Yeah, I was just gonna say the family resource fair that family and magazine here in San Diego. It's a special needs magazine group, and they're connected with regional too. They do just an amazing annual resource fair, and we are always ho we always host the Mario Kart booth. Oh, that's where we have an obstacle course for wheelchairs and it's an inclusion event. So kiddos who are not in chairs, we bring a bunch of wheelchairs so kids who are not in chairs can experience what it's like to navigate these like foams and paper and little cardboard, and then the kiddos who are in chairs come and do it. Last year we had this kid, he was probably nine. Oh my gosh, he was just smoking the course. He because he's in his regular ultra-lightweight chair every day. He was having fun with it. We had like a teacher meeting, and it's great.

SPEAKER_01 26:27

Oh, that's wonderful. Yeah, it's so much fun when you can get into the community and really know that the especially the products that you're providing are helping and and making it so much easier for these families because let's just be honest, life family life isn't easy. And when you have a special uh need for anything, whether it be child, adult, senior, yourself, it's so nice that there are resources available. And now you know you can just go to harmonyhomemedical.com. That's what it is, right? I typed that all out correctly. And also call and and talk to Erica and have any questions answered that you might have about other accommodations that we didn't go over today. Please reach out by email or send the show a message any way that's easiest for you. What do you have coming up, up and coming? Anything exciting?

SPEAKER_00 27:33

And first well, we are looking and exploring to opening another location outside of San Diego and really try to experiment with our model as something that we can like either franchise or have other people do in other areas because we get that question a lot. There's not a lot of retailers and high-touch service uh stores like ours in our space, and people do need it more and more, uh, but we can only be so there's so many of us here in San Diego, or so many of me and these stores. So we're trying to figure out a way to have this business model be able to be carried out to other states.

SPEAKER_01 28:12

I love that. And I hope that maybe some of our city government and other leaders could could help, you know, get give you those whatever you might need in assistance to those things.

SPEAKER_00 28:25

That would be amazing. If anybody listening has a any desire to do a refurbished business, equipment business. That's something that I think government needs to get involved in. I I started it once myself at 501c3 to do recycled equipment. We recycle a lot of equipment here, buy it, buy it back from people, take donations, but it's not the core of our business. And there's so much medical equipment that goes into a landfill. And there's a lot of secondary markets that could use it in other countries, and even right here in the US, just cleaned up and to you know, worked on by experts like us and put back out. So that's something in my next life I would like to do.

SPEAKER_01 29:05

Great message. Yeah. Well, hopefully somebody listening can really take that and get back to us and let us know in two years what how it's gone. We'll be waiting. It's so nice to have you on today. Thank you so much for your time. And I'm I'm really excited about kind of looking to what do I need to do in my own home to be, you know, make some more accommodations. And I think it like I said, make them for my mom. And now I have kind of an idea of where I can send her to say, what kind of things do you think you might need? Here are some things that look at this inventory, you know, treat it as like a shopping trip or something. I love it.

SPEAKER_00 29:50

Yeah, absolutely. We we historically remodel our homes every seven to ten years, is what they say. One one room or another in our homes. Uh, when we do it, we should look for the universal design aspects that we can integrate seamlessly, you know, that look wonderful, but also help us live a little safer.

SPEAKER_01 30:09

Love that. What a great passion, what a great product and community. And I wish you the best of luck in getting it franchised. And I I don't see how it why it wouldn't be amazing for every state. It's especially like you said, with the silver tsunami, it's not gonna only be in San Diego, folks. So that's great. It's so nice to have you on today, and I look forward to staying in touch, Erica. Absolutely, it's been my pleasure. Thank you. Thank you for being a resource. Thank you.