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Aging-in-Place Part 1: Bathroom Safety Modifications

3/1/2011

12 Comments

 
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Aging-in-place is a hot topic these days. As baby boomers enter retirement, the government is bracing itself for the impending “gray wave” of elderly adults who will need access to specialized health care services and accommodation at the same time. Ideally, an individual will stay in their own house or condo as long as possible. There are many modifications – both permanent and temporary – that can be made to a home to achieve this. As there are many different considerations, this topic will be broken down into different parts, the first being dedicated to bathrooms.

Despite everyone's best attempts to age gracefully, the process is often accompanied by slowly diminishing capacities such as vision, hearing, balance, flexibility and strength. Washrooms that were once considered luxurious can become hazardous, but with simple modifications can be made safer and easier to use. A person can spend thousands of dollars retrofitting a washroom with permanent components. However; if on a budget, many temporary items can be rented, or found on Craigslist, Kijiji or other classified ad websites. Below is a list of considerations that incorporates both permanent and temporary measures that can make a bathroom more accommodating.

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Doors: A typical bathroom door is 24” or narrower. Unfortunately this does not allow for a walker, wheelchair or other mobility device to enter the room. The narrow width also complicates assistance by a family member or care-giver. If possible, make the clear doorway opening at least 32” wide. If increasing the width is not possible, consider mounting grab bars adjacent to the door frame to allow for transfer from a mobility device into the washroom. Additionally, door handles should be changed to a lever-style to allow for the best grip. 

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Flooring: Eliminate tripping hazards that occur at flooring changes – often from carpet or hardwood in the hall to tile, vinyl or linoleum in the bathroom. The transition strip should be gradual and not change more than ¼” in height from one room to the next. To select the correct transition strip, look for one that is ADA or barrier-free compliant. To reduce the risk of slipping and falling, a slip-resistant glaze can be added to floor tile to provide more traction.

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Toilets: Bending and sitting can become more difficult as we age. To facilitate their use, toilets can be replaced with a taller models or have a raised seat added. Maneuvering around the toilet can be made easier by adding permanent grab bars – whether along the sides or in a lift-up configuration. A temporary solution is a Versaframe, a curved frame of grab bars that fits over toilet bowl.

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Bathtubs: The ability to maneuver in and out of a bathtub can be improved by adding grab bars. These can be temporary models that fit over the side or permanently installed into the walls. Although wall-mounted models with suction cups are on the market, they do not provide the reliability of a permanently installed grab bar. When installing the grab bars, they must be located so as to have the fasteners penetrate into a wall stud. Regardless of what the person at the hardware store tells you about drywall anchors, grab bars must be securely attached to either a wall stud or in-wall blocking.

The process of bathing – whether standing or sitting can also be more difficult as we age. Luckily, there are several choices for assistance. These include a portable bath seat that comes in different widths, and with or without a back. They are durable and rust resistant and feature adjustable legs allowing for varying heights. There are also rotating bath seats that sit on the edges of the bathtub and allow a person to sit down outside of the tub and then swing themselves into position. There are also lift models that allow people to be fully submerged in the tub. Depending on the model and the features, these range in price starting from $1500 to several thousand.

There are also walk-in bathtubs on the market. However without a full immersion tank that fills first, then allows a person to get in and then have the bathtub fill very quickly, waiting naked inside the tub while it fills from a standard tap can take a long time, and make for a very cold and chilly wait. The same is true when it empties.

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Showers: If a bathtub is no longer practical, it can be removed and a shower can be installed. There are many ready-made shower pans with wheelchair accessible lips or ramps on the market that will fit the size of a typical bathtub. This allows for greater flexibility. Additionally, a bathtub can be cut and retrofit with a new opening that allows for access similar to a shower. However, the bathtub will no longer be usable as a basin. To reduce slipping in the bathtub or shower, non-slip strips can be added to the bottom of the tub, or a standard rubber bathmat can be used.

For ease of mobility, hand held showers allow for greater ability to shower oneself or for assistance when the time comes. These can be added at a relatively low cost to existing shower or bath controls. The head of the wand can be installed within reaching distance of a seated position in the shower or bath. Similarly to a bathtub, a portable shower seat can be used, or a permanent flip-down shower seat can be installed.

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Counters and Sinks: Using a sink can become difficult as we age. To accommodate changing needs, counters can be lowered to work with wheelchairs and have storage relocated. If this configuration is chosen, exposed plumbing and pipes below the sink must be covered with insulative material to avoid scalding the legs. Counter edges should also be rounded, to minimize risk in the event of a fall. Sink controls can also be moved to the side for easier access and shallow sinks (6”) installed to reduce bending and reaching. Taps should have lever-style cold and hot controls. Cabinet handles should be “D” type to allow for easy opening.


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Other: As washrooms are often the location of slips and falls, as a general safety precaution a telephone or security call system can be installed in the room to summon assistance if required. Although not required directly adjacent to the toilet (as shown in the photo), if the phone is located within reach of the toilet and bathtub (or shower) it will provide the greatest safety. For bathroom lighting, the wattage of light bulbs can be increased in order to improve vision within the room.


12 Comments
JH
3/4/2011 02:52:48 am

Very interesting. There are seniors associations, care facilities, etc. that would benefit from this article.

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    Kate Harrison is a licensed architect and is the principal of KHA.

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