A ramp that is too steep or sits in front of a door that will not open is worse than no ramp. The install goes wrong most often at the first step, when someone orders a length before measuring the height. This piece walks the process in order, from the first tape reading to the first trip up and down.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Step 1: Measure the rise

The rise is the height from the ground at the bottom of the door to the surface of the threshold or landing. Measure it in inches. If the ground slopes, measure at both corners of the bottom and use the highest reading that will need to be covered. Write the number down before you look at any product.

Step 2: Set the run from the rise

The run is the horizontal length the ramp needs. The accessibility standard in the ADA Standards for Accessible Design, section 405, sets a maximum slope of 1:12 for ramps on accessible routes. That means one inch of rise needs twelve inches of run. A three-inch rise needs about thirty-six inches of ramp. Home ramps are often planned to the same ratio because it is the gentlest slope a wheelchair or walker can climb without strain. Confirm the number with your parent's therapist if one is involved, because the right slope depends on the person and the chair.

Step 3: Check the landing and the door

The top of the ramp needs a flat landing large enough for a chair to stop and turn, and the door needs to open without hitting the chair or the walker. Check which way the door swings. If it swings outward over the landing, the ramp layout has to leave room for the door to clear. Check the bottom too: a ramp that ends on a curb or a lip will catch the front wheels.

Step 4: Check the surface and the edges

Ask the supplier for the surface type in writing and for the rated load and slip resistance the manufacturer gives. Look for a textured surface and raised edges on any open side. Confirm the ramp is set up for the weather it will see, since wet concrete and wet metal behave differently.

Step 5: Decide portable or fixed

A portable ramp rests on the ground or steps and can be moved. A fixed ramp is built into the ground or the porch and usually needs a permit. Ask the city or county building office whether a permit applies before anyone cuts, pours, or bolts into the house. If you are renting a ramp, read the lease for the removal and damage terms before the first delivery.

Medicare generally does not pay for ramps as home modifications, so ask the supplier to show you which parts of the quote are the ramp and which are the install labor. Do not assume a line item is covered because it is in a medical supply catalog.

Step 6: Test it with the person who will use it

Have your parent, or the helper who will be with them, go up and down with the walker or chair. Do not test it by pushing a chair yourself. Check the bottom edge for scraping, the top for door clearance, and the middle for flex or sway. Test it once more after rain. MedlinePlus has general guidance on fall safety at home, and the National Institute on Aging publishes home safety checklists you can use to look at the whole route to the door, not only the ramp.

Step 7: Write the install into the folder

Keep the supplier's manual, the measurements, the permit record if one applies, the warranty, and the signed quote together. If something moves, loosens, or slips, you will know what was installed and what the manufacturer says it should do.

For St. Louis-area offices and phone numbers to call about permits and local help, see Local Help After a Discharge.

Measure the Rise Before You Buy the Ramp: The Install From First Measurement to First Wheel