Bathrooms
Sinks and Lavatories
Three elements are critical in lavatory design: the clearance underneath the
sink (for those who use wheelchairs), the height of the sink (for those who may
have difficulty bending from the waist or for others who are seated in chairs),
and the faucet hardware (for those who have hand dexterity problems).
People in wheelchairs need approximately 27" to 30" of height underneath the
front of the sink so they can get as close as possible to the basin. Removing
the doors or the entire cabinet below the sink can eliminate access problems. A
decorative curtain below the sink will allow access while providing a concealed
undersink storage area. If you remove your sink cabinet, cover or shield any
sharp edges or hot water supply and waste pipes (if the hot water temperature is
set above 115' Fahrenheit). To cover the pipes, use pipe insulation or build a
box around the pipes to protect you from burns.
Vanity Top
Your sink should be located at a height where you can use it comfortably
whether you're seated in a wheelchair or standing. Generally, a 30" high
lavatory top provides easy access if you're seated; 34" is the maximum
height allowed by barrier-free design standards. If you are very tall and have
difficulty bending, raise the top to 36" or even 40". If there are
others in your household who are short, a compromise height of approximately
30-34" should be acceptable to everyone.
Faucets
If you have limited hand dexterity, adapt your faucets so you can operate
them easily with a single hand. Single lever faucets are best because they
provide a visual indication of water temperature, and don't require fine hand
dexterity to operate. They also provide a mixed water temperature from a single
tap. You can replace existing knob-type hardware by removing the handles and
installing double levers or cross knobs (available at most hardware stores) that
fit the faucet stems. When handles are hard to turn, their washers probably
should be replaced.
Toilets
The optimal toilet seat height varies from one individual to another. It's easy for
most people to sit down or get up from an 18" high seat. However, this seat
height often creates problems with bowel movement. Many older people need to
assume a squat position, with their knees above the level of their buttocks.
Toilets mounted at a low height would resolve this problem, but they create
problems for persons who have difficulty getting up and sitting. A design which
raises the feet slightly helps to resolve the problem.
Rehabilitation hospitals now teach people how to transfer themselves without assistance from
wheelchair to toilet or tub as illustrated here.
Stable support such as grab bars or tub edges is critical to allow
individuals to safely complete this independent transfer. If independent
transfer isn't possible, lifts are available to help people from one place to
another, but they usually require assistance from another person.
Grab Bars
Grab bars surrounding toilets must be located so they are convenient and
strong. Most building codes require that they be capable of withstanding a 250
pound load. To support this weight, the bars should be screwed directly into
wall studs, or installed using one of the blocking techniques illustrated below.
Molly bolts, nails, or screws into sheetrock are not adequate. There are
three basic types of grab bars: wallmounted, sheltering arms, and pivoting.
Consider the needs and capabilities of users in your home before you select a
particular type. Pivoting grab bars can be moved out of the way and yet be close
when they're needed to provide support. Wall-mounted grab bars are the most
stable, and sheltering arms provide the best support for getting up and sitting
down on a toilet from a standing position. Grab bars designed for wheelchair
users aren't always satisfactory for people who use crutches, canes, or walkers
to get around. Many elderly people find getting up from or sitting down on a
toilet difficult because they've lost muscle strength in their legs and knees.
For this reason, sheltering arm grab bars are superior to wall-mounted grab bars.
The sheltering arm grab bar surrounds you, providing support similar to the arm rest
of a standard chair. It allows you to use your arm and leg muscles to lower
yourself onto the toilet and return to a standing position. Sheltering arms also
provide better balance support while you are seated on the toilet. Make sure
that these bars are firmly secured to the toilet to prevent instability or
shifting. Tightly attach the bolts to the toilet and check them every few weeks.
Sheltering arm grab bars which have legs that extend to the floor (see
illustration) are more stable than bars which rest only on the toilet bowl. You
can make perfectly useable wooden or plastic grab bars from common construction
materials. If you make rectangular wooden grab bars, allow closure between the
thumb ad fingers of your hand. This provides the best grip when you close your
hand around the bar. The optimum diameter for grab bars is 1 1/4--1 1/2"
for adults. For a child or person with a very small hand, the ideal diameter is
1-1 1/4". The distance between the wall and the grab bar should be 1
1/2". A wider space can be dangerous if you slip and your elbow lodges
between the wall and the bar. A narrower space is not adequate for fingers and
knuckles.
Tubs and Showers
Transferring someone from a wheelchair to the tub is one of the most
hazardous activities you may ever have to attempt at home. Getting into the tub
is also hazardous for semiambulatory persons. To accommodate these individuals,
your tub area must be carefully designed to provide maximum safety for a minimum
effort. Grab bars should be securely mounted on the walls or on the tub side to
provide support during the transition.
Tub seats allow persons in wheelchairs or others who have poor strength in
their legs to sit in the tub and take a bath or shower without having to lower
themselves to the floor of the tub. A tub seat also works well for those who
tire easily and need to sit while bathing.
Several types of tub seats are available. Refer to the Resources chapter on
page 30 for manufacturers. You can also install a built-in tub seat, which will
be more stable and safer than a removable seat. Be sure to carefully design this
seat for drainage, so that water runs back into the tub and not out the side
when you bathe.
Shower/Tub Controversy
Since many people prefer a bath to a shower, think about your preference
before deciding which is the most appropriate unit to install. If you have poor
circulation in your extremities, you may find that soaking in a warm tub at the
end of the day is an excellent way to relax and get more comfortable.
Shower and Tub Controls and Accessories
As with lavatory faucets, single lever shower and tub controls are the best.
Antiscald temperature controls are available that prevent the water temperature
from exceeding an established limit. If the water temperature in your house is
above 115' Fahrenheit, you should consider installing this feature. Shower
curtains and doors are the two primary means of containing water within showers
or tubs. But sliding doors with tracks can present a formidable barrier if you
are transferring from a wheelchair to a tub seat. The lower tracks often have
sharp edges which can injure persons who try to slide over them. For this
reason, you should try to provide a shower curtain in a tub to be used by a
person transferring from a wheelchair.
Shower Units
Accessibility standards call for two types of showers in accessible
facilities: roll-in showers and transfer showers. Roll-in showers provide a
gentle, easily crossed threshold that keeps water in the shower area. A person
in a wheelchair can easily roll from the shower area to the rest of the
bathroom. In most cases, people who will roll into the shower will use a special
commode chair. Because its small wheels can catch on ridges, thresholds, and
cracks, it's important to have smooth thresholds between the bathroom and theshower.
Roll-in showers normally require a larger space than standard showers,
but they should be equipped with the same hardware and controls as standard
showers.
Transfer showers require that you transfer from your wheelchair to a seat in
the shower compartment. The dimensions of a transfer shower are critical. When
you're seated in the cubicle you should be able to easily reach the surrounding
grab bars and controls. You can probably transform your existing shower into a
transfer shower by simply installing a seat and the appropriate controls. Make
sure that a clear floor area is available for a wheelchair to approach the
shower area and allow an easy transfer to the shower seat. Hand-held shower
heads are a necessity for many people, particularly those who are seated in a
shower or tub. These fixtures often come with adjustable height rods and/or
fixed hooks to allow the shower head to become a fixed level unit.
It's imperative to have at least 5' of hose attached to the shower head so
that it can reach the end of the tub or shower. Many manufacturers provide
special adapters that replace the existing shower head or tub spigot with a
nipple for attaching the shower hose.
Safety Issues
You're more likely to have an accident in your bathroom than in any other
room in your home. Therefore, your bathroom should be designed and equipped to
help you avoid slipping or injury when you use the facility.
Floor Surfaces
Non-skid adhesive strips, flowers, or dots are a low-cost solution to the
problem of slippery walking surfaces, both inside and outside of the bathing
unit. Replacing the existing floor surface with a slip-resistant surface, such
as a non-skid ceramic tile or indoor/outdoor carpeting, is another solution that
is more costly, but may be more aesthetically acceptable.
Grab Bars
Securely mounted grab bars or strong towel bars are necessary at places where
a person may be off balance. They must be capable of supporting at least 250
pounds of force (more if anyone who is a frequent user of the facility weighs
more than 200 pounds). To make sure they are capable of supporting this weight,
ask the dealer or manufacturer, and screw the bars directly into the studs in
the walls or a secure form or blocking that has been applied to the studs [see
the illustration in the Stairs and Ramps section]. Screws fastened into
tile or sheetrock are not adequate anchoring.
Lighting
Make sure you have adequate lighting in your bathroom so you won't trip,
slip, or hurt yourself. It's especially important to light the area around the
lavatory or sink for convenience, personal grooming, and easy reading of
medicine containers and directions. It's also important that your lights shine
on the object being viewed, rather than directly into your eyes. Direct light
sources create special problems for people who wear glasses that refract light,
causing glare problems. Cover bulbs with some kind of shade to create indirect,
soft illumination.
Electrical Shock
If you use any electrical appliances in the bathroom (hair dryers, electric
shavers, electric hair curlers, etc.) their circuits should be Ground Fault
Interrupted (GFI). This type of equipment virtually eliminates the possibility
of electrical shock and is part of the bathroom building code in many states.
Hire a professional electrician to install GFI outlets to make sure they are
properly grounded, and test the circuits regularly to make sure that they are
operational, using the button on the outlet.
Storage
Many older homes don't have adequate storage space for medicine, equipment,
and linens in or near the bathroom. If your space is limited, you may want to
install medicine cabinets or shelves to hold these items. If you or others in
your home have equipment ordered by your doctor or rehabilitation therapist to
assist you with personal hygiene, make sure the items you use frequently are
stored within easy reach.
BACK
