9 'Must Ask' Questions Before Installing an Accessible Bath

“Design is not just what it looks like and feels like. Design is how it works.” - Steve Jobs

Designing a bathroom that does not feel institutional is a goal shared by many. But accessible bath design should delve deeper than the look and feel of the space. It must immediately and adequately address the functional needs of its inhabitants -- particularly those who are disabled.  

The typical accessible bathroom has a 30-in. by 48-in space for mobility devices in front of each plumbing fixture and room to turn around in a wheelchair. It has handrails for security, unless sturdy cabinets or fixtures can be located in a way that allows a person to “furniture-walk” (hold onto objects in the environment, much like a toddler “cruises”). Items needed for each functional area are stored near places of use. 

These are the functional aspects of an accessible bathroom that represent key building blocks for a safe and comfortable space. 

Everyone has a unique way of managing personal hygiene and each person will have a different set of physical limitations. Optimal design for one household may not be the same for another. That’s why the smartest approach to design planning begins with asking the right questions.

Here are nine ‘must ask’ questions before installing an accessible bathroom: 

What bathroom activities, if any, require assistance? You may need to size the room for several people.

What specific medical needs are there? Catheterization supplies, for example, may need to be stored near the toilet.

How predictable are bodily elimination functions? Install a bidet or shower near the toilet, or make sure there is space for cleanup and sanitary supplies. A larger shower drain may be appropriate.

Are tubs or curbless showers preferred? You may have space for one or the other, but not both.

Which muscle groups are reliable? Strong biceps favor grab-bars located for a pull-up motion such as leaning on a low wall.

What are the user’s manual skills? Consider no-touch controls for the sink and toilet. Left- or right-handedness guides, placement of accessories and transfer logistics.

What side of the toilet is farthest from the wall? Make sure the flush valve is on that side.

Can the body self-regulate temperatures? Activities take longer with a disability, and some conditions (such as spinal-cord injury) disrupt the body’s ability to adapt to changes in heat and cooling. Environmental controls are especially important.

What is the prognosis? If the condition will deteriorate over time, you will need to make space for both the user and the caregiver.

Bathrooms can be dangerous places. More than two-thirds of emergency room visits are due to bathroom falls. For young adults, the tub and shower areas are most hazardous. For the elderly, most falls occur near the toilet. As you look at creating an accessible bathroom, keep in mind the paramount goal should be to make this space safer for everyone. 

The nine questions above will help get the ball rolling!