Bathrooms can present many physical challenges for all family members, but especially for people with disabilities and older adults who have impaired balance and mobility. For good health and well-being of wheelchair users, good daily hygiene is especially important, and the correct design of this room should help maximize performing daily bathroom hygiene activities. It is also important to design and build the bathroom to reflect the precise needs and preferences of users with disabilities.
The bathroom entry door, as with all other doors in the house, should be a minimum of 34" wide and have lever handles instead of doorknobs. In a remodel project, where practical, the door can out-swing.
Select easy-to-clean, nonslip flooring. Ceramic or porcelain tiles with a narrow grout line look great…but are mold-prone and can be dangerous if a person should fall. Vinyl sheet flooring products are less expensive, warm to the touch, and will better cushion a fall. Both materials are easy to clean and maintain.
Provide a 60"-diameter clear turnaround in bathrooms, kitchen, and laundry. Leave a clear open area under the sink with a removable modesty panel to conceal plumbing lines, or insulate wrap an exposed hot-water line and drain pipe. Allow 29" minimum clear height, 30" clear width, and 19" clear depth for wheelchair access under the sink.
Take into consideration structural framing conditions above the bathroom ceiling if a lift and transfer ceiling track-mounted unit is to be installed. On the ground floor of multistory homes, the track can be securely anchored directly to the structural framing above. If the bathroom is situated on the second floor, keep in mind that existing roof truss chords or ceiling joists may need structural reinforcement. Make certain existing or new light fixtures and ceiling-fan units are installed clear of the ceiling-mounted track.
Bathroom heating and cooling requirements depend on the room size. Mechanical exhaust ventilation should be installed to help eliminate odor and moisture. Operable windows are helpful, but it is best to use an exhaust fan to provide more positive ventilation. Install a quiet, energy-efficient exhaust fan with the correct flow capacity for the room size. Panasonic now offers great “Whisper Green” DC-powered, energy-smart, quiet fans and fan/fluorescent light combination units for use with automatic motion sensing on and timed-delay off switch controls.
Bathroom illumination should be accomplished by the use of energy-efficient fluorescent lighting enhanced by natural day-lighting provided by a window and/or skylight. An operable window providing supplemental natural light and fresh air is invaluable.
When possible, consider a full-length over-vanity mirror installed at 3'4" maximum height from the finished floor, or directly above the vanity counter backsplash. I recommend a 50"-long, electronic ballast, 2-lamp T8, 3500k to 4100k, EnergyStar slim line fixture with a frosted acrylic wraparound diffuser, such as the new Progress Model P7189, or decorative multilamp wall-mount vanity light fixtures with 3500k CFL spiral lamps mounted directly above the mirror top. This will provide good even lighting.
Remember, most wheelchair users can’t get close enough to a wall-mounted mirror for close-up use, so consider a portable self-illuminated mirror set on the vanity counter.
Countertops and Bathing Areas
Consider installing easy-to-maintain, good-looking, and inexpensive laminate countertops or, for a more quality look, quartz. For comfort and convenience, select a large oval or round sink with a high-arc spout and easy-to-use single- or dual-lever faucet with antiscald hot-water valve set at 120° maximum for safety!
The new water-saver Delta TouchH20 pull-out spray faucet unit can help you wash your hair in the sink. Just a light tap on the faucet automatically turns it on, and another tap shuts it off.
Although a 36"x 60" curb-less shower unit will work for some wheelchair users, the ideal shower size is 42"x 60" or 48"x 60" in quality simulated-tile fiberglass, as made by BestBath Systems. Install a single easy-to-grasp lever control with an anti-scald valve set at 120° maximum, mounted offset toward the front of shower and at 33" to valve center height. Complete this great shower with a separate, grab-bar strength, vertical slider bar with adjustable height, hand-held spray unit with a 5-foot hose and on-off switch built into the handle.
Safety bars (grab bars) are for everyone! Securely install them, conveniently located, and able to hold 250 lb. Install support backing in walls during renovation or new construction.
All other accessories should be placed within a reachable area and comfortable height, and securely fastened to the wall. Seriously consider using decorative, securely mounted 250-lb-capacity grab bars as towel bars. For wheelchair users it is important to locate towel hooks or bars near vanity basins and the shower, so they can dry their hands before propelling their chair.
Tubs & Toilets
Bathtubs should have an easy-to-reach single lever control installed close to the entry of the tub, with an anti-scald valve set at 120° maximum. Tub should have a sit-and-transfer platform at end of tub, and nonslip bottom. All towel bars and soap holders should support the full weight of an adult who may accidentally slip and grab them for stability. Avoid having a “slippery” area rug or mat outside the tub and shower.
The toilet alcove should be 36" minimum width, or larger for certain transfer situations. Select a quality, name-brand, elongated, water conserving, comfort height, easy-flush-lever toilet like the great American Standard, Champion 4 model.
Consider installing a custom floor drain unit with water flusher, and with a full-length mirror behind the drain unit to allow easy urine leg-bag emptying.