After the kitchen, the bathroom retrofit is probably the most important and challenging modification you can make for safe aging in place.
The potential for water on the floor, combined with the need to maneuover into and out of a shower or tub or onto a toilet, raises the risk of a serious fall among people with mobility or vision problems.
Because of the fall risk and the frequency with which we need to use the bathroom, any bathroom retrofit should focus on two things: fall prevention and ease of use.
Locate a Full Bath on the Main Floor
Assuming you don’t want to retrofit all your bathrooms at the same time, the first consideration is which to modify first.
Ideally, there will be at least one accessible bathroom on the main living level of the home so those with mobility challenges don’t have to navigate a stairway every time they want to use the bathroom.
Of course, a wheelchair-accessible toilet and sink are the bare minimum, but you may want to consider including a full bath (with accessible shower or tub), even if you currently use a bathroom on another level (such as a master suite) for bathing. The ability to move the essential activities of daily living to the main floor of your home gives you maximum flexibility as your or your loved ones’ needs change.
Bathroom Layout
You’ll want to ensure your bathroom retrofit creates adequate space for maneuvering a wheelchair, walker or other mobility aid.
Americans with Disabilities Act (ADA) standards require 60 inches of clearance in each direction to allow a wheelchair-user enough room to turn and move freely. The pathways within and leading to the bathroom should be clear of obstacles, including rugs and bathmats.
Doorways should be at least 36 inches wide and should open outwards to maximize room within the bathroom and to prevent anything from blocking responders from entering the bathroom in case of emergency. Sliding pocket doors are another good option. There should be no barriers at the threshold that could trip a user or prevent wheelchair entry.
Countertops & Sinks
As with the kitchen retrofit, bathroom counters should meet ADA standards for accessible design, at a maximum of 34 inches above the floor. If there is room, having counters and sinks at different heights is ideal, providing maximum convenience for all users.
Countertops should be easy to clean, without highly polished surfaces that could create excess glare. Laminate, stone, stainless steel and solid-surface materials are good choices. Avoid sharp edges that can pose a hazard for those with low vision or during a fall. Some advocates also recommend adding a contrasting color to the counter edge to help those with low vision determine where the countertop ends.
In addition to complying with ADA height requirements, your sink should have at least 27 inches of knee clearance underneath, 30 inches wide and at least 8 inches deep. Make sure to include space for under-sink pipes, which must be insulated to prevent burns. A wall-mounted sink cabinet is usually the best choice, but a pedestal sink can also work.
The sink should be no deeper than 6.5 inches, to allow someone who is seated to reach the back. Faucets should be easy to operate – lever pulls, pedal-operated faucets or touchless models are better choices than knobs for those with arthritis in the hands.
Bathroom Cabinets
With cabinetry, as with the sink and countertop, you can follow the recommendations from the kitchen retrofit. Consider under-counter storage or upper cabinets that are mounted lower than standard, or even pulldown cabinets, depending on your bathroom storage needs. Easy-open latches, such as Seismolatches, are a good choice for securing cabinet doors.
Toilets
The toilet requires serious consideration when you’re doing a bathroom retrofit. This humble appliance gets more use than almost any other in your home, and as we age, we may find ourselves using it more often, so it can make sense to pay a little extra for comfort and convenience.
Toilet Height
You’ll want to get an ADA-compliant toilet with a seat height of 17 to 19 inches (standard is 15 inches).
Placement & Grab Bars
If possible, the toilet should be installed with grab bars mounted to rear and side walls, with the toilet’s centerline 18 inches from the side grab bar. Grab bars should be able to support 250 pounds.
If grab bars aren’t an option, toilet safety rails can be installed around the toilet for security.
Wall-mounted toilets are a good choice, providing for easy transfers for wheelchair- or walker-users. There should be at least 30 inches of clearance directly in front of any toilet to allow users enough room to approach and maneuver.
Flush Controls
Automatic flushes are a convenient option; otherwise, the flush control should be mounted a maximum of 44 inches above the floor.
Toilet Paper Dispenser
The toilet paper dispenser must be easy to reach from the toilet, so that it doesn’t require a seated user to twist or reach too far, posing an injury or fall hazard.
According to ADA guidelines, the dispenser should be mounted between 7 and 9 inches in front of the toilet (to the midline of the dispenser) with the paper outlet a minimum of 15 and a maximum of 48 inches above the floor.
The toilet roll should be easy to change with one hand, with additional rolls stored within easy reach (multiple-roll dispensers can be handy).
Don’t use a moveable dispenser – it’s too easy for these to be moved out of position, setting up a situation where a user can be injured reaching for it.
Toilet Extras
Consider a model with a built-in bidet, or with an optional bidet seat, to make hygiene easier for those with limited mobility or vision. A heated seat can also be a nice addition for seniors who live in cold climates and need frequent trips to the toilet.
Next week, we’ll talk more about the bathroom retrofit, including tubs and showers, lighting and flooring.