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Bathroom Design & Products
Bathrooms are the most dangerous place in our homes regardless of whether we have a disability or not. Bathrooms also present some of the greatest challenges in the home in terms of access and function for those who are dependent on mobility devices. In the following pages I'll be writing about equipment in the bathroom product pages which will not only make the bathroom more accessible for users of mobility equipment but also safer for everyone. I'm going to write mostly about bathroom design on this page.
Before a person who uses a piece of mobility equipment can even try to use a fixture in the bathroom, they have to be able to get in the bathroom. Many houses and apartments were never designed with a thought given to anyone with mobility issues whether it be a cane, walker or wheelchair. You'll notice, especially in older homes, the the bathroom is accessed through a narrower than normal doorway from an awkward narrow hallway. Because designers didn't expect anyone to try and move any furniture into the room, they wide open access into the bathroom wasn't deemed important. Today, bathrooms tend to be bigger with wider doorways than in the past however they may still be difficult to access by many wheelchair users.
When designing a dwelling for someone who uses a wheelchair, the bathroom should be accessed from the end of a hallway or directly from a room so the user doesn't have to make a turn to enter the bathroom and the door should be at least 36" wide. If the user lives alone or doesn't have a caregiver available all the time, and funds are available, an electric automatic door opener is ideal. Offset hinges can allow for an additional 1" to 2" of clearance when passing through the door. Pocket doors which slide into the wall rather than swinging open can also be used for access to the bathroom but some people may not be able to physically open and close them.
Once inside the bathroom, the more room for maneuvering the better. Not only should user should be able to turn around completely and approach each of the fixtures from different directions there should also be enough room in the bathroom for a caregiver to provide aid as needed. Often, enlarging an existing bathroom is impossible or difficult and sometimes an adjoining room has to be sacrificed to create an accessible bathroom in an existing house. It may actually be more feasible to create a second bathroom, preferably adjoining the user's bedroom, than modifying an existing bathroom.
Although I've seen designs where pedestal sinks are used in bathrooms for the disabled who use wheelchairs but the pedestal still gets in the way of the wheelchair footrests. A conventional sink mounted in a cabinet which is completely open underneath or a wall mounted sink is the best option for wheelchair users. Many people who have mobility issues, and many who don't, may have problems with their hands. Taps which use a single lever to control the water flow and temperature is usually the best bet. If standard two valve taps are desired, there are models which use levers to control the water flow. Often, levers can be purchased to convert standard knob type water valves for those who are trying to adapt an existing bathroom.
Preferably a toilet in a bathroom for mobility impaired users will be accessible from both sides and the front. While a person in a wheelchair may be able to transfer to the toilet from the front now, their condition may deteriorate over time to the point where they need to transfer from the side. The user's prognosis, whether definite or not, must be considered in order to prevent future expensive renovations. Toilets are usually too low for wheelchair users to transfer on and off of easily, but are also often difficult for walking people with diminished abilities to stand up from. Tall toilets are available and should be considered. for easier transfers. When trying to reuse an existing toilet, there are devices available to raise the toilet seat height which I will discuss on the product pages.
There are also options when it come to bath tubs. There are devices which will be described in the product pages which will aid in the use and access of existing and specialty tubs but there are several options when renovating an existing bathroom or designing a new one. The size of the tub is the first consideration. Bath tubs, unknown to many people, come in different sizes and a tub which is too big or too small will not only be non-functional but will be expensive to correct in the future. Many users will benefit from whirlpool tubs which can provide therapy and stress relief. Most bath tubs can be installed on a raised base which will make bathing by a caregiver easier but transfers must usually be done by mechanical means. There are bathtubs which will elevate after the client transfers into the tub but the costs are in the range of $20,000.00 to $30,000.00 dollars (That price is not a mistake. These tubs are usually only used in institutions).
There is a new tub which I've seen advertised recently, which is not a new idea, where there is a door built into the side of a tub which is about 4' tall and has a seat built into the other side. The idea, which seems sound, is the user will be safer if they can enter the bath tub by the doorway and sit in a position similar to sitting in a chair while bathing. While certainly being safer and easier to access than a standard style tub, I do see one draw back to this design. As the door cannot be open when there is water in the tub, the user must enter the tub, fill the tub, have their bath and then wait for all the water to drain before opening the door before exiting. I don't think I'd like to sit, undressed, in a tub waiting for it to fill, nor would I like to sit there while wet waiting for the tub to drain. I can imagine it would take a little while to fill the tub if the house water pressure is not very high and the tub may drain fairly quickly but the speed can also be limited by plumbing in the house.
When renovating or building a new bathroom for someone with mobility issues, an alternative to a bath tub is a roll-in shower stall. Accessing a bath tub is always an issue for people confined to a wheelchair and often an issue for people with other mobility or balance problems. A roll-in shower stall is similar to a conventional shower stall but large enough to accommodate a wheelchair or commode. Roll-in shower stalls have only a small lip over which users can easily negotiate wheelchairs or commodes without too much trouble. Most roll-in showers also benefit from the use of a hand held shower, with an extra long hose, to enable the user to spray the water to where it is needed instead of trying to move their body to where the water sprays as is the case with a conventional shower head. Bath seats and bath benches can be used in a roll-in shower stall as well as a bath tub or users who don't require a wheelchair or a commode.
If the funds are available, a ceiling track lift should be considered to ease the transfering a wheelchair user who is unable to do a standing transfer and finds a sliding board transfer difficult. A ceiling tracklift can be used to transfer a user from wheelchair to toilet, wheelchair to bath tub, wheelchair to commode, toilet to bath tub or just about any other transfer need one can imagine. Ceiling track lifts are fairly small electrical devices which use a sling to lift the user and a track, mounted on the ceiling, to move the user from one location to another.