The ramp is not ready because someone agreed to install it. It is ready when the correct wheelchair or walker can travel from the vehicle to the closed front door, through that door, and back out again.

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.

Start with the discharge method. Ask the hospital therapist or nurse to write down what your parent will use at the entrance: a walker, a manual wheelchair, a transport chair, or a power wheelchair. Ask whether another person must push, steady, or guide the device. Medicare requires a wheelchair ordered as durable medical equipment to be usable in the home, but that approval does not tell you whether the entrance route works (Medicare, Durable Medical Equipment Coverage; CMS, DME and Supplies Used With DME; 42 CFR 414.202).

Day 0, still in the bed: walk the whole route

Go to the discharge address with the actual mobility device if you can. Start where the vehicle will stop. Follow the route to the door. Measure the narrowest point, every change in level, the total rise, the available run, and the clear space where the route turns.

Open the storm door and entry door while you measure. Record which way each door swings. Check whether a person standing behind the chair can reach the handle without letting go. Look for a threshold, loose brick, gravel, a gutter, or a step between the ramp and the vehicle.

Take photographs from the bottom, the top, and the doorway. Put a tape measure in each photograph. Send the measurements and photographs to the installer. Do not accept an estimate based only on the number of porch steps.

The National Institute on Aging recommends a ramp with handrails at the entrance and asks families to check lighting, exterior trip hazards, and whether stairs are manageable (NIA, Home Safety Tips for Older Adults; NIA, Home Safety Checklist). Treat those as separate checks. A ramp does not correct a dark walkway or an uneven path leading to it.

Before installation: approve the written layout

Ask the installer to mark the proposed top landing, bottom landing, ramp runs, turns, handrails, and edges on a sketch. The sketch should show the measured rise and the length of each run. It should also show where the helper will stand while opening the door.

Ask which building rules and permit requirements apply at this address. A federal accessibility standard can be a useful design reference, but it does not automatically govern every private home. Ask the installer to identify the rule or manufacturer instruction being used for slope, landing size, handrails, edge protection, anchoring, and load capacity.

Do not let the door swing become an afterthought. Stand on the proposed top landing with the chair. Pretend the door is closed. There must be enough usable space to stop, reach the handle, move the door, and enter without putting a wheel or walker leg onto the sloped run.

If the home is rented, get the owner's written permission before drilling, anchoring, or changing the entrance. The Missouri Department of Health and Senior Services also directs renters seeking certain home-modification assistance to request landlord work or permission first (Missouri DHSS, Independent Living Waiver, Environmental Accessibility Adaptations).

Day 1, the car pulls in: inspect before anyone uses it

Do the inspection before your parent arrives. Confirm that every section shown on the sketch is installed. Check each connection, support, handrail, edge, and transition. Nothing should rock, lift, slide, or leave a wheel-catching gap when you press on it.

Walk the ramp in both directions. Then roll the empty wheelchair or walker over the entire route. Stop at the top, bottom, and every turn. Open and close the door. Check that handrails, posts, and door hardware do not narrow the path needed by the device or the person assisting.

Look under the ramp. Ask what prevents the supports from sinking, shifting, or being displaced. Ask how rain leaves the landings and where ice or leaves will collect. Get the installer to correct loose surfaces, sharp edges, abrupt lips, blocked drainage, and unstable transitions before the first loaded trip.

Read the manufacturer's label or installation instructions for a modular or portable system. Match the model and configuration to the paperwork. Record the load limit. Include the person, mobility device, carried equipment, and any helper whose weight the system is designed to bear. Do not guess about this number.

Make the first loaded run controlled

Use the mobility device named in the discharge instructions. Follow the transfer and assistance method taught by the hospital team. Do not improvise a wheelchair technique from a general article.

Keep the route clear. One person should manage the device if that is the plan. Another person can watch the wheels, door clearance, and transitions without pulling from the side. Stop if a caster catches, a walker leg lands near an edge, the helper cannot keep a stable position, or the person in the chair cannot remain positioned as instructed.

If the first run cannot be completed as planned, do not solve it by adding more people to push. Call the installer and the hospital discharge contact. Ask for a different entrance or discharge arrangement until the route is usable.

Day 2 to Day 3, the first full days: close the installation file

Collect the final sketch, permit or inspection record if one applies, product instructions, installer contact, warranty terms, and photographs of the completed supports and anchors. Write down whether the ramp is owned, rented, or loaned. Record who may move or alter it.

Ask the installer to show you the inspection points. These may include fasteners, joints, feet, anchors, handrails, edge barriers, and surface panels. Write down what movement or damage requires the ramp to be taken out of use and who handles an urgent repair.

Keep snow tools, lighting controls, and a phone accessible without using the ramp first. Decide who clears water, leaves, ice, packages, and trash from the route. The person assigned should check both landings and the path to the vehicle, not only the sloped surface.

Day 3 to Day 7, the week: test the route you actually use

Repeat the trip at the time of day when appointments are likely. Check lighting from the vehicle to the doorway. Try the route after ordinary rain if conditions allow. Watch for water, mud, soft ground, or a moving support.

Check whether the actual vehicle can stop where you planned without blocking the bottom landing. Open its door fully. Make sure the person can transfer or be positioned before anyone starts up the ramp.

If the device changes, measure again. A transport chair, manual wheelchair, power wheelchair, and walker do not use the same turning space. Medicare's wheelchair guidance tells suppliers to verify that covered equipment can be used in the home, including through its doorways, but you still need to test the exterior route and entrance (Medicare, Medicare Coverage of Wheelchairs and Scooters).

The week: keep a backup entrance plan

Write down what happens if the ramp becomes wet, loose, blocked, or unusable. Name the person who calls the installer. Name the entrance that can be used instead, if one has been checked. Do not designate stairs as the backup unless the hospital team has said how your parent can use them and who must assist.

If cost or access is stopping the installation, Missouri DHSS says local Area Agencies on Aging may have limited home-modification funding or connections to other resources. Start with Local Help After a Discharge. Funding has its own eligibility and approval process, so do not count it as complete until you have a written authorization and installation date.

The finish line is simple. The ramp is installed. The doorway works. The actual device makes the full trip. The helper can perform the assigned task. You have the repair contact and a written backup plan.

A Wheelchair Ramp Is Planned. Carry the Installation From the Doorway Measure to the First Loaded Run.