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AT Reports

Bathroom Accommodations

Activities of Daily Living Series
Assistive Technology Quick Reference Guide

Frequently Asked Questions
Other Information Resources
Product Resources

The bathroom can present many challenges for an individual with a disability. Individuals may have difficulty accessing the room, maneuvering inside the room, manipulating the fixtures, transferring to the toilet or bathing area, and/or safely using other bathroom equipment or performing activities of daily living (ADLs). Adaptive equipment and design can make it easier for individuals with disabilities to complete tasks in the bathroom.

FREQUENTLY ASKED QUESTIONS:

Is a larger bathroom better than a smaller one?
Not necessarily. The size of the room is not as important as effectively designing the space for the individual to complete his/her daily activities. Some individuals prefer or need to have smaller spaces to minimize travel or reaching. Other individuals may want or require larger spaces for safety and comfort. It is recommended to have at least a 60" turning radius when an individual uses a walker or wheeled mobility aid. It is helpful to look at the tasks to be completed and at the individual's physical abilities. Having a proper evaluation to determine space design is beneficial. Also keep in mind that more than one person may need to be in the bathroom at the same time.

What kind of door is best?
Individuals can choose between a standard swinging door, a folding door or a pocket door that slides into the wall. The decision depends on the required width of the doorway and the area required for the door to open. Most resources for accessibility state that doorways should provide at least a 32" wide passage, with the door open, to provide clearance for individuals using wheeled mobility aids and walkers. Door hardware (handles, locks, latches, etc) should be easy to manipulate and mounted at an appropriate height (typically no higher than 48" above a finished floor).

Can an individual with a disability use a bathtub safely?
There are ways to make bathtubs safer and more accessible. Generally, it is safer to sit in a bathtub when bathing or showering. Grab bars, hand rails, bathing seats, and non-slip tub mats can make it easier for a person to sit or get into a seated position in the tub. The height of the sidewall can be a significant problem when entering and exiting the tub for many individuals with mobility, balance, or body control issues. If an individual is unable to safely get over the sidewall, a bathing seat with a sliding feature or bench that extends on the outside of the tub can make bathing easier. For individuals who need to sit directly in the bathtub, a lift can be used to raise and lower him/her into the tub.

What kind of accommodations can be made for the shower?
Most showers have low or no edges and have flat floors. These features make it easier for individuals to enter and exit the shower. When transfers are not possible, showers can be built to accommodate rolling a wheelchair directly into the area. The minimum floor clearance for a roll-in shower should be at least 30 inches by 60 inches. Shower or bathing seats can be built into the shower stall, however, it can be hard to keep these surfaces clean if water does not freely drain. Flexible and adjustable showerheads and spray nozzles can be attached installed or attached to existing plumbing to make showering easier. Easy-to-turn water control handles and anti-scald devices can also be installed to make the shower more accessible and safe to use.

What are some types of lifts that assist an individual getting into a tub or shower?

Portable boom lifts are mounted in a floor socket or on a rolling dolly. The boom lift is raised and lowered by another person who operates a lever on a hydraulic pump. Boom lifts can also be battery- powered or electrical.
Overhead track lifts have slings that slide in a track system mounted in the ceiling. They are powered for lifting and lowering, and some systems have power features for traveling along the track. The user or another person can control the track lift via a control box.
Water-powered lifts can raise and lower the user directly into the tub.

Are there seats to provide support for an individual in the shower or tub?

Portable seats can be removed when not in use and can travel with a person. Portable seats can be on wheels, have legs, lay on the tub or shower floor, or lay on the edges of the bathing area. Seats can be benches or chairs and seating surfaces are made of plastic, wood, stainless steel, mesh or fiberglass. They come in a variety of sizes and support a range of weights. Some portable seats are available specifically in left or right versions depending on the direction the tub faces.
Mounted seats can be attached to the walls or floor of the bath or shower. They can be fixed or fold out of the way. They come in a variety of sizes and support a range of weights. They may be chairs or benches and seating surfaces can be made of plastic, wood, mesh, stainless steel, or fiberglass.
Water-powered seats can raise and lower the user directly into the tub.

How can a sink be made accessible?
Wall-mounted, pedestal, and countertop sinks can all be used in accessible bathrooms. An individual should be able to access the sink, as well as the handles on the faucet. Here are some guidelines for accessible sinks.

There should be space under the sink for an individual using a mobility aid or sitting in a chair to get close enough to reach the faucet handles and the sink bowl.
Soap, hand towels, paper towels and electric hand dryers should be within reach and accessible.
Water temperature should be adjusted to ensure that an individual won't scald himself or herself accidentally. An anti-scald device can be installed on faucets or showerheads.
The drain and supply pipes must be covered to protect against accidental burns by skin exposure to the pipe could be installed.
Faucet handles should be operable without having to grasp or pinch (e.g., lever handles) or a motion-sensing faucet.
Mirrors should be mounted at an appropriate height. Generally, a full-length mirror or a mirror mounted 40 inches or less from the floor (measured from the bottom of the mirror) will accommodate most individuals. A tilted mirror can also be installed to accommodate for height issues.
Edges or sharp corners should be minimized on countertops or sink basins.

What accommodations are recommended for toilets?
The height of a seat can affect the use of the toilet. For an average height adult, it can be easier to sit down and stand up from an elevated toilet that is approximately 18 inches tall (the standard toilet is 14 inches tall). However, children or individuals who are of small stature find it easier to use toilets that are lower than the standard height. An elongated seat can make it easier for a person to transfer to and from the toilet. Attachable elevated or raised toilet seats can be added to existing toilets to make them accessible. Grab bars, toilet safety frames (an aluminum or plastic frame that attaches to the toilet to assist in stability, transfers, and sitting/standing), and seats that assist with lifting to a standing position and lowering to a seated position can also be mounted for individuals who have difficulties with standard toilets. There should be ample floor space in front and to the side of the toilet for transfers and ease of maneuvering. For a side transfer, a minimum of 42 inches on one side of the toilet is needed. For a stand and pivot transfer at the front of the toilet, a minimum of 18 inches is needed for an individual in a wheelchair to approach and transfer to and from the toilet.

What other devices can make bathroom tasks easier?
It is best to make a list of the activities or tasks the individual performs in the bathroom to determine what additional equipment or strategies might be beneficial. Other devices to help make the bathroom more accessible include:

Appliance holders (e.g., hair dryer)
Reachers
Suction base brushes (e.g., fingernail brushes)
Soap holders
Adjustable height steps or stools
Adapted sponges or bathing mitts
Velcro hand straps (e.g., on brushes)
Toothpaste dispensers
Adapted nail clippers
Medicine dispensers

What kind of flooring is best to have in the bathroom?
The flooring in the bathroom should be non-slip and easy to clean. Common types of bathroom flooring include ceramic tiles, carpet, rubber tiles, and slip-resistant mats. Light colored flooring that has low reflectance properties (less shine) and/or high contrast against other objects in the bathroom will provide better accessibility to individuals with vision impairments. Throw rugs or edging that is not flush with the main surface can create trip hazards for individuals with mobility and/or balance issues.

OTHER INFORMATION RESOURCES:

ADA Accessibility Guidelines:
Information on the Americans with Disabilities Act
http://www.access-board.gov/adaag/html/adaag.htm

Assistivetech.net:
Searchable online database for AT
http://www.assistivetech.net

Bob Vila Ultimate Home Site:
Information on bathroom modifications
http://www.bobvila.com

C.R.S., Inc and asktooltalk.com:
Resource for accessible bathrooms
http://www.asktooltalk.ca/home/articles/construction/accessibility/accessiblebathrooms.htm

Friedreichs Ataxia Association of New South Wales:
Information on accessible bathrooms
http://www.faa.org.au/pdf/accessible.pdf

Jim Lubin's disABILITY Information and Resources:
Accessible and universal design resources
http://www.makoa.org/accessable-design.htm

MSN House and Home:
Information on accessible bathrooms
http://houseandhome.msn.com/Improve/PlanaSafeandAccessibleBathroom0.aspx

National Association of Home Builders:
Directory of accessible building products for the bathroom
http://www.toolbase.org/tertiaryT.asp?TrackID=0&CategoryID=308&DocumentID=964

National Kitchen and Bath Association:
Information on accessible bathrooms
http://www.nkba.org

New Horizons Un-Limited, Inc.:
Accessible homes and housing modifications
http://www.new-horizons.org/gdbhac.html

UD Homes:
Universal design principles for home modifications
http://www.universaldesignhomes.com

Veteran's Home Accessibility Grants:
VA adapted housing grant programs
http://www.housingall.com/Home/VA.htm

Wheelchair.net:
Home modification resources
http://www.wheelchairnet.org/WCN_Living/homemod.html#anchor11054006

Wright State University:
PowerPoint presentation on accessible bathrooms
http://www.cs.wright.edu/bie/rehabengr/bathrooms/start.htm

PRODUCT RESOURCES:

AD-AS
Specialty fixtures
http://www.ad-as.com/kb/

AliMed
http://www.alimed.com

Columbia Medical Manufacturing Corporation
http://www.columbiamedical.com

Disability Products
http://www.disabilityproducts.com

Flaghouse Inc.
http://www.flaghouse.com

Graham-Field Health Products, Inc.
http://www.grahamfield.com

Jacoby Healthcare Products Supply
http://www.ipuproducts.com

Lasco Bathware
http://www.lascobath.com

Maxi-Aids
http://www.maxiaids.com

Rehab Designs Inc.
http://www.rehabdesigns.com

Sammons Preston Rolyan
http://www.sammonspreston.com

Sears Health and Wellness
http://www.sears.com

Shower Anywhere:
Portable bathrooms and shower stalls
http://www.shower-anywhere.com

The Adaptive Design Shop
http://www.adaptivedesignshop.com

Updated 6/2003.

Tech Connections does not prescribe or recommend specific products. Instead, we hope to provide you with information about what products are available, and what features you may want to look for based on your particular needs.

Tech Connections is a collaborative project of the United Cerebral Palsy Associations, the Center for Assistive Technology and Environmental Access at Georgia Tech., and the Southeast Disability and Business Technical Assistance Center. Tech Connections is funded by a grant from the National Institute on Disability and Rehabilitation Research of the Department of Education under award # H133A980052. Content and opinions expressed in these materials do not necessarily reflect those of the NIDRR, UCP or other entities.

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