By Shoshana Shamberg OTR/L, MS, President of Abilities OT Services and Seminars, Inc.
#1 PROBLEM: Glass shower doors can be hazardous because they limit the access space in and out of the tub or shower. Often they are used for stability, which with a strong pull or push may pop out of their track, shatter, or become a heavy load on top of a person who has fallen.
#SOLUTION: Replace with lighter, shatter-proof, Plexiglas doors on a sturdy track system or remove completely and use a shower curtain or folding plastic doors. Create a shower room with an open space for the shower and graded floor for drainage.
#2 PROBLEM: Faucets and doorknobs are difficult to turn, and water temperature is hard to control. Light switches are difficult to see and use.
SOLUTION: Install levered handles, single mix controls, and a water temperature control device to prevent scalding and to maintain constant water temperature. Water Heaters may be turned down to 115 degrees Fahrenheit to avoid scalding throughout the house. Automatically controlled faucets may be useful for a person with limited upper body strength and movement. Install lighted toggle switches with color contrasting covers at heights to meet the needs of your customer.
#3 PROBLEM: It’s difficult to get up and down from the toilet: sometimes I lose my balance.
SOLUTION: An 18″ high toilet enables a person in a wheelchair to transfer easily or a normal to tall person to get up and down easily. An elevated toilet seat or commode can be placed over the existing toilet (most are 15″ high). Toilet support rails or grab bars can be easily installed to assist with support when transferring or sitting. Proper bathroom layout to maximize ease in transferring and safety is crucial and should be implemented when building a new bathroom or major modification. A bidet can be installed easily to a standard or high-rise toilet to assist in hygiene. Most have a warm water wash and air dry control.
#4 PROBLEM: Dizziness or weakness when standing in the shower or difficulty getting up and down in the tub or toilet. Lack of adequate support to maintain balance and stability.
SOLUTION: A tub seat or retractable shower chair can provide crucial stability, while using a hand held shower for thorough cleaning. A transfer bench can assist in transfers when extra support is needed. Attractive grab bars may be installed next to sink, tub and toilet at heights and orientation according to the specific needs of the individual. Attractive showers and bathtub units can be installed which are designed to maximize independence.
#5 PROBLEM: The bathroom floors are slippery.
SOLUTION: A padded linoleum floor or matt finished tiles can be a safer assist. If using bathroom rugs-they should be low tight piled glued to the floor. All bathroom rugs should be secure to the floor and removed when not in use. Be careful of curled edges.
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All your suggestions to the Concerned Daughter in the August ’09 AIP Newsletter are good, except the pedestal sink. My understanding is that pedestal sinks are not accessible for someone in a wheelchair. A wall mounted vanity/sink is a good option.
Yes a wall mounted sink is ideal but a pedestal sink can work as well for some people. Evaluating which option works is the key, as well as, what options are cost effective for the client’s budget and their design needs.
Thanks for pointing this out.
I’m really enjoying the AIP newsletter each month and the tips that you give. It’s great for me to see the viewpoint of an OT. Having done many remodels, my concerns on converting a powder room into a full bath would be the size of the door opening, the open space available for a wheel chair or walker, and the building codes.
I’m sure you’ve seen more of the details than were given in the newsletter. I just wanted to point out, from a design standpoint, that simply wanting a powder room to convert won’t always work.
A shower room can be as small as a powder room. Of course space must be considered. as well, as whether the door opening can be widened. Some doors are just removed and replaced with an exterior pocketdoor, bifold doors and retractable doors. Even a curtain when space constraints are very limited. Widening the door frame and changing a door swing to go out of the powder room can also increase clearance. I have even seen the toilet act as a shower seat and the shower head on the side wall. The floor drainage is located so that the water does not drain out the doorway or near the sink. That is a very tight space. Some one told me boats are sometimes designed with bathrooms that are dual spaces and very tight. Locating a sink outside the powder room space can also increase useable space inside. Combining a closet and powder room space when possible can increase usable space in the powder room/ shower room, but would eliminate the closet use. There are many ways to look creatively at small spaces and a careful evaluation while providing many options to choose from is optimal when possible.
As a kitchen and bath designer with 39 years’ experience under my belt, I was anxious to read Shoshanna’s articles. I’m constantly looking for new ideas, and new ways to tackle the same old problems, etc.
The problem I found throughout Shoshanna’s suggestions was that they take a huge amount of space. In an older home, a typical bathroom is 60” x 90” to 108” with a 32” x 32” shower . It is well-documented that people want to age-in-place, in their older homes. Your website is a testament to that fact.
A roll-in shower with a 5-foot turning radius is 60” x 60”. That is almost 4 times the size of the typical shower, and takes up 2/3 of the space of a typical bathroom. People who NEED a roll-in shower are often way past their income-earning days, and can ill-afford an addition to their house. Here in California, many homes are built on a concrete slab, so moving drains and re-configuring the slope toward a drain are very expensive propositions.
I think more people would benefit if Shoshanna kept most of her suggestions to those that would fit in the typical 5 x 7 ½-foot to 5 x 9-foot bathrooms. There are a lot of products out there now that make that easier: wall-hung toilets can be set at various heights, including 18”. They stick out from the wall as much as 9” less than a standard toilet, so make it easier to move and turn in the room. The latest “spa inspired vanities” float off the wall, so that a footrest can swing beneath them. This gives you counter space and drawer space, which the pedestal sinks lack. There are more motion-sensor faucets now than ever, so you don’t need to reach to turn the water on and off. A light ABOVE the mirror accentuates your wrinkles, and is too high for someone in a chair. So change to wall-sconce lights mounted at face level of the user. It is much more flattering, and the wattage doesn’t need to be as high. We all need to keep our electric bills down! Use compact fluorescents in the shower and over the toilet. And add an outlet near the floor by the toilet for an LED night light that is only on at night.
You suggestions add to the wide array of ideas that are possible. I could only provide a small sampling of ideas in this blog and as we progress we can all share our ideas and learn from one another. I have been consulting to designers, builders and consumers since 1990 and have been involved in many creative solutions formulated by a team approach and problem solving that both meets the space and financial constraints of the client and space. Fluorescent lighting is great for saving energy but may enhance visual perceptual problems and increase visual stress and headaches/migraines and other cognitive problems so careful evaluation of lighting is recommended, especially with clients with TBI, Visual Problems, and other signs of stress related to glare and use of fluorescent lighting. An interesting website on this issue is http://www.Irlen.com which teaches about Irlen Syndrome or Scotopic Senstivity Syndrome. A simple solutions to faucet controls and very inexpensive is the EZ Flo Faucet adapter which is around $20 and first sold to dentist offices to eliminate hygiene issues when handing faucet controls in high volume. Wall hung toilets and sinks are great where possible and add turning radius space under the fixtures to add manuverability within small spaces.
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