CAPS Connection

Shoshana Shamberg

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A Quick Guide: Common Bathroom Accessibility Problems and Solutions

The bathroom is one of the most common sites for disabling accidents to occur in the home.  The space is often tight, is slippery when wet, and has many hard surfaces and protrusions. Flimsy and unanchored towel racks are often used for support instead of properly designed and mounted grab bar systems. Bathrooms are also a very personal space and clients may not be as open about their current and future needs and abilities with all members of the project team.

Occupational therapists are uniquely trained to assess a person’s independence and safety challenges, when environmental demand exceeds functional abilities.  Problems with vision, balance, muscle strength and coordination, hand function, joint mobility, and declining health due to aging or a disabling condition can place a person at risk for accidents. However those risks can be minimized or eliminated with collaboration between a trained occupational therapist, the client, and a building professional who will implement suggested modifications, equipment and ergonomically appropriate installation suggestions.

The following is a partial list of common bathroom problems with suggested solutions for environmental modifications. Providing an individual assessment to identify abilities, needs, and problem areas is the first step to identifying appropriate solutions to modify the home.

Problem: Glass shower doors can be hazardous because they limit access in and out of the tub or shower.  With a strong pull or push, the doors can pop out of the track, shatter, or fall on top of a person. Clients may also have difficulty standing in and accessing the tub and shower.

Solution:  Remove the doors and track and replace with a shower curtain or retractable, shatter proof, lightweight door. Create an open space or shower room with floor grading for proper drainage. Install a grab bar system and movable shower bench to increase environmental support and safety. Install a hand held showerhead with a diverter valve and mounting clip that is located within reach when sitting in the shower. Remove the tub and replace with accessible shower.

Problem:  Faucets and door knobs are difficult to grasp, manipulate, and turn. Water temperature is hard to control, resulting in hot water surges.

Solution:  Install levered handles, single mix controls, and anti-scald water controls on faucets to decrease the stress on hands and prevent scalding. Hot water heaters may be turned down to 115 degrees Fahrenheit. Electronically controlled water faucets, hand dryers, and soap dispensers minimize the need for stressful hand movements.

Problem: Toilets are difficult to access and cause challenges when the client moves from sitting to standing.

Solution: Replace the existing toilet with a higher model if the person is 5’5” or taller to minimize movements.  An 18″ high toilet enables a person in a wheelchair to transfer easily. A low cost solution would be to raise the height of the existing toilet with a Toilevator. Install proper grab bar support. Install a bidet with warm water wash and dry and electronic controls, to maximize hygiene and skin care. Install an automatic flushing toilet.

Problem:   Difficulty with mirror visibility during shaving or makeup application. Difficulty accessing controls, switches and plugs.

Solution:  Increase illumination 2-3 times by installing non-glare, dimmer bulbs.  Install a retractable, magnification mirror. Use light switches with rocker, pressure sensitive, or push button controls that illuminate in the dark. Install multi-plug outlet with single on/off control and GFI outlet within easy reach. Use an automatically controlled and wall mounted hair dryer and other appliances.

Problem:  Entry door and closet door are too narrow.

Solution: Widen the doorway to 36″ minimum.  Install a pocket door with a recessed wall cut out for a large C or D shaped handle for easy opening and closing.

Problem: Bathroom safety is an important issue and is often overlooked.

Solution: An emergency call system may be a lifesaver in case of a bathroom accident. Non-skid or cushioned flooring can reduce serious injury from a fall. Motion sensor lighting for nighttime access can increase orientation when drowsy.  Proper training in the use of all bathroom equipment is crucial especially for grab bars. Eliminate clutter with storage systems using easy glide baskets, drawers, and shelving. Eliminate low profile items like a waste paper basket or stool which can be a trip hazard.  If possible change the bathroom door so it swings to the outside in case of a fall against the door. Contrast the color of surfaces so edges are easily distinguished. Eliminate unsecured rugs. Install medicine cabinets that are accessible and can be locked if necessary. Avoid sharp edges on furniture and fixtures.  Install a phone in the bathroom at a height reachable from the floor in case of a fall.

Shoshana Shamberg, president of Abilities OT Services and Seminars, Inc., is an accessibility consultant and independent living specialist.