Designing for the Rollercoaster: Why Dynamic Disabilities Matter in Designing for Accessibility.

What Is a Dynamic Disability?

A dynamic disability (or dynamic health condition) is one where symptoms fluctuate over time. The type and severity of symptoms aren’t consistent, and they rarely follow a predictable pattern.

Imagine an ever-changing rollercoaster that sweeps you up without warning. One moment things feel manageable. The next, you’re plunged into a steep drop you didn’t see coming.

These fluctuations are often referred to as “flares.”A flare might happen within hours of the same day, or it might last for days, weeks, or longer.

Symptoms can vary widely, including:

• Severe fatigue

• Weakness or loss of coordination

• Nausea or shortness of breath

• Cognitive challenges or “brain fog”

• Extreme pain

• Hospitalization in severe cases

  
  

The Invisible Challenge: Stigma and Misunderstanding

Living with a dynamic condition means navigating more than just physical symptoms. Many people also face shame, stigma, and judgment from others—including healthcare providers, employers, and sometimes even family members. Because symptoms fluctuate, someone might appear “fine” one day but be unable to get out of bed the next. Unfortunately, it can lead to assumptions that someone is lazy, exaggerating, or simply needs more motivation.

But what people living with dynamic disabilities actually need is understanding and flexibility.

We need reassurance that when the rollercoaster drops us off somewhere unexpected, someone will still be there waiting at the gate.

Why Dynamic Disabilities Matter in the Home

Dynamic disabilities also raise an important question:

What happens when your ability to move through your home changes from day to day?

Traditional accessible design often focuses on static disabilities. For example, someone who consistently uses a wheelchair or someone with long-term mobility limitations. Those considerations are essential.

But dynamic disabilities challenge us to think differently.

For example, a person might walk independently most days but may occasionally need a mobility aid. This is where thoughtful, flexible design becomes critical.

How BuildAble Thinks About Dynamic Disabilities

At BuildAble, accessibility isn’t just about meeting a checklist or complying with a standard. It’s about designing homes that support people as their needs change. Dynamic disabilities remind us that accessibility must be flexible, anticipatory, and person-centred.

When we design or renovate homes, we often ask:

• What happens on a bad day, not just a good day?

• Could this space still work if someone’s energy suddenly drops?

• Would this layout remain safe if balance or coordination changed?

• Can the home adapt without requiring major renovations later?

Instead of designing only for someone’s current abilities, we try to design for future possibilities.

Designing for Fluctuating Needs

Thoughtful design can make a meaningful difference for people living with dynamic conditions. Some key features include:

Step-Free Access

Eliminating steps at entrances or between key spaces helps ensure mobility changes—or temporary weakness—don’t become barriers.

Accessible Bathrooms

Barrier-Free showers, grab bars, and non-slip flooring provide added safety at a baseline. One important feature to note is the positive impact of a shower bench. Sitting down to shower during periods of fatigue, dizziness, or pain, saves essential energy that can get depleted very quickly. (Some benches can also flip up and out of the way for the 'good' days or if it's a shared shower.

Additionally having a perch seat or roll-under vanity can also help save energy when taking care of our every day needs (teeth brushing, face wash, make-up, shaving).

Main-Floor Living

While we generally advocate for making use of your entire home (with a stairlift or elevator); including a bedroom and bathroom on the main floor can help with independence during more difficult periods.

Wider Doorways and Clear Pathways

Even if someone doesn’t currently use mobility equipment, extra space makes movement easier when energy, balance, or coordination fluctuate.

Adaptable Spaces

Designing with future changes in mind—such as reinforcing walls for potential grab bars (called "blocking") or creating bathrooms that can be modified later—helps homes remain functional over time.

Reducing Physical Strain

Small design choices can have a big impact, including:

• Lever door handles instead of knobs

• Well-planned (or automatic/sensor) lighting

• Choosing large, simple/one colour tiles for bathrooms or kitchen to reduce visual and cognitive strain

• Accessible storage heights

• Easy-to-use fixtures and controls

Accessibility often isn’t about one large intervention—it’s about many small decisions that reduce friction in everyday life.

Designing With Compassion

Dynamic disabilities remind us that health and ability are rarely fixed. Many people will experience periods where their physical capacity changes—whether due to chronic illness, injury, recovery, aging, or stress.

At BuildAble, we believe homes should support people through good days and bad days alike.

Because everyone deserves a space where they feel safe, supported, and able to live with dignity... even when the rollercoaster drops unexpectedly.

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Kyla MacGinnis, BScN, RN, MN

Clinical Nurse Specialist & Co-Founder of BuildABLE

Also living with Rheumatoid Arthritis, Psoriatic Arthritis, Fibromyalgia, Autoimmune Thyroiditis, Degenerative Disc Disease/multiple herniations