Bathroom Modifications for Seniors and People with Disabilities
An American Association of Retired Persons (AARP) study found that 90 percent of people over the age of 65 would prefer to age in place, that is live in their own homes as they grow older.
Elderly individuals prefer this option over going to a nursing home or an assisted living facility. This brings up many critical bathroom safety concerns for their homes, especially in the bathroom for elderly people.
The CDC describes aging in place as “the ability to live in one’s own home and community safely, independently and comfortably.” Seniors are more accident-prone and/or have limited mobility, making it necessary to consider bathroom renovation and other home modifications to ensure they are safe and comfortable. For example, installing a raised toilet seat or a walk-in tub can significantly improve safety.
One-third of people over the age of 65 will fall at least once every year, says the National Center for Biotechnology Information (NCBI). Of these falls, one in a hundred will result in a hip fracture, and one-fifth will cause a more serious injury. A bathroom for elderly people is one of the places that require careful attention, especially if there are seniors who choose to age in place.
The Centers for Disease Control and Prevention (CDC) reports that an estimated 235,000 people over the age of 15 visit the emergency room because of injuries that they suffered in the bathroom every year. Of this number, 14 percent end up hospitalized. The rate of injury increased with age, especially for injuries that happened while using or being near the toilet. In these cases, bathroom safety features like installing grab bars and ensuring non-slip mats on the bathroom floor can help reduce these risks.
There are about 12.8 percent of persons with disabilities in the United States, with the number steadily rising in the past five years, according to the 2017 Disability Statistics annual report. The 2015 American Community Survey reports that Americans ages 75 and older comprised nearly half of the people with disabilities. Many of these disabilities involve difficulties with walking or independent living, which makes a properly accessible bathroom essential to creating senior-friendly bathrooms.
Bathroom Safety Assessment
Considerations and Contingencies
Around 80 percent of falls occur in the bathroom, according to data from the National Institute of Aging (NIA). A bathroom is considered to be one of the most hazardous locations for persons with disabilities or limited mobility. Adding bathroom safety features such as a walk-in tub, shower wall add-ons, or senior-friendly bathroom furniture that is easily accessible can make the space significantly safer.
Some of the most common problems of living in a non-adapted home is the lack of accessibility to certain places and lack of freedom to move freely and easily within one’s living space. In addition to that, people with different disabilities, like impaired vision or hearing, have their own set of requirements for a safe home.
Common Problems
Some of the major risk factors in the bathroom are the following:
- Bathroom door being too narrow for wheelchair access
- Lack of proper lighting
- Lack of space
- Wet, slippery surfaces on the bathroom floor
- Getting into the tub (which increases the need for a walk-in bathtub)
- Hot exposed pipes
- Hard-to-reach areas
- Non-adapted toilet
When making the bathroom safe for older people or persons with disabilities, one should address the problem areas listed above.
Bathroom Modifications for Bathroom Safety
In the table below are the problem areas in the bathroom for people with limited mobility or disabilities and some recommended modifications to make the space safe.
| Amenities | Challenges | Modifications |
|---|---|---|
| Lighting |
Lack of proper lighting can cause falling, tripping, or other accidents. Also, ample lighting is essential for doing delicate tasks like shaving, applying makeup, and grooming. |
Install additional lighting to improve vision, avoid tripping hazards, help make doing task-oriented work easier and help improve bathroom safety. Motion-activated lights can be added so that older adults and people with limited vision don’t have to navigate through a dark room to find the light switch, reducing the risk of certain accidents. |
| Floor | Slippery and uneven flooring increases the risk of falling. |
Use flooring materials that meet the Americans with Disabilities Act (ADA) standard. One option is a non-slip mat for added safety. Add non-slip accessories, such as anti-fatigue mats, anti-slip strips, or carpet, to minimize slips and falls. Color contrast for floors and walls can also help improve spatial awareness. |
| Threshold |
Thresholds are present in most homes, but they can make it difficult for someone in a wheelchair to cross a room. They are also tripping hazards for people who use crutches or those who have limited mobility. |
Make flooring even and consistent throughout the home for easy access. Removable ramps that are not too steep can provide smoother transitions. |
| Sink |
Standard sinks can be hard-to-reach for people who need wheelchairs. Hot exposed pipes may also burn their knees. Certain types of faucets may be difficult to operate for people with weak grips. |
Install a wall-hung sink with the height adjusted for easy access on a wheelchair. Adjustable sinks can also make it more convenient for people to use. Make sure to cover exposed hot pipes. Use faucets with lever handles that are easy to turn on and off. Or install automatic faucets for more convenience and less contact with germ-ridden surfaces. |
| Bathtub | A bathtub is a particular danger zone for older people. Stepping in and out of it increases their risk of falling. Moreover, tubs are inaccessible to people on wheelchairs without help from another person. | Replace the bathtub with a walk-in shower. If that’s not possible, equip the bathtub with a bench that extends outside of the tub. This makes getting in and out of the tub easier, as well as making baths more comfortable. |
| Shower |
Shower floors and curbs are fall hazards. Certain types of shower handles may be difficult to operate. Shower valve may be out of reach and hard to adjust. |
Eliminate curbs in the shower area, and ensure that flooring is even and consistent. Also, add a grab bar in the shower for support when standing or sitting. Use a lever shower for easy access. Install a thermostatic shower valve to eliminate temperature shifts and prevent accidental burns in the shower. Add a shower chair that can swivel around in the shower area for more comfortable baths. |
| Toilet |
Standard toilets can be hard to access for people in wheelchairs. Getting on and off the toilet can be challenging for some with limited mobility. |
Higher or comfort-height toilets can increase safety and accessibility and make side transfer from a wheelchair easier. Installing grab bars near the toilet to provide support when sitting and standing when using the toilet. A built-in or separate bidet can make cleansing easier for people with limited mobility. |
| Storage |
Accessing cabinets, countertops, and cupboards is one of the common challenges of living in a non-adjusted home. High cupboards and countertops are difficult to reach for people with limited mobility. Low cabinets are no different. |
Build storage spaces no more than 34 inches above the floor or between the nose and knees so that older adults or persons with disabilities don’t have to stretch far and stoop low to reach items. Pull-out drawers for low cabinets can also contribute to improving accessibility. |
| Others | Using bathroom amenities can be more challenging on a wheelchair. | Seats specially designed for transferring onto or off of can enhance accessibility and safety when using certain amenities. |
Hiring an Accessibility Contractor
Modifying a bathroom for an aging person or a person with a disability is very different from remodeling to increase home value or aesthetics. Bathroom renovation for senior-friendly bathrooms focuses on adding safety features such as grab bars, raised toilet seats, and shower chairs.
There are plenty of considerations to keep in mind, including the challenges listed above, and ADA standards to follow. That said, is it better or hire an accessibility contractor for the modification? Or is it possible to do-it-yourself (DIY) the job?
DIY Versus Contractor
As with any other remodeling project, there are some jobs one can DIY and others that need the expert touch of professionals. Designing a safe home for older adults and persons with disabilities should be left to a live-in-place or accessibility designer. They know best what someone with limited mobility needs to make living in place more convenient and comfortable.
Simple jobs, like installing grab bars, replacing faucets, repainting, and accessorizing can be done by the homeowner or their family member. However, major projects, like installing a new toilet, lighting fixtures, shower temperature control, even and consistent flooring, and more must be left to accessibility contractors.
Major modifications like installing walk-in tubs, shower walls, or a weighted shower curtain must be done properly to avoid potential safety hazards.
These are areas that have no room for mistakes, lest they lead to accidents. Ideally, they are jobs that should be done by highly skilled professionals to reduce risk factors and increase the safety.
Paying for Your Home Modification
Home modifications for seniors and persons with disabilities cost money, and they can amount to tens of thousands of dollars. Many people don’t have the finances to afford these modifications. That is why there are grants to help seniors and persons with disabilities fund their accessibility projects.
Here are a few ways to get funding for a home modification:
- Your Medicare Plan B benefits can help with procuring durable medical equipment, such as commode chairs, wheelchairs, and patient lifts. However, Plan B doesn't cover costs for large home modifications.
- State governments have their own programs to help seniors and persons with disabilities to get funding for home modifications.
- Your Medicaid Waiver (also known as HCBS Waiver) program may offer funding for certain modifications, such as assistive devices, adaptive equipment, and structural alterations. Check your eligibility and assistance level by looking into your HCBS Waiver.
- Social workers can help you access resources and assist you with your home modification. Seniors can contact the local Area Agency on Aging for specialized assistance.
- Ask your insurance provider if your policy covers home modifications for accessibility.
- Public and private organizations and grants, like the Joni and Friends Christian Fund for the Disabled, The Specially Adapted Housing Grant (SAH), and The Special Housing Adaptation Grant (SHA), may aid certain groups with housing and housing adaptations.
Tapping into your local resources is the best step to finding financial support for accessibility or live-in-place home modifications. Your local authorities can help you apply for public grants and assistance and find private organizations that can help.
Federal Resources
- Centers for Disease Control and Prevention (CDC)
- National Center for Biotechnology Information (NCBI)
- Americans with Disabilities Act (ADA)
- National Institute on Aging (NIA)
References
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https://agesafeamerica.com/home-safety-seniors-statistics-solutions/
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https://www.basementguides.com/home-safety-for-people-with-disabilities/
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https://www.pewresearch.org/fact-tank/2017/07/27/7-facts-about-americans-with-disabilities/
Khalfani-Cox, Lynette. (February 14, 2017). Can You Afford to Age in Place? AARP.org.
https://www.aarp.org/money/budgeting-saving/info-2017/costs-of-aging-in-place.html
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281399/
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https://www.reviews.com/insurance/homeowners/home-modifications/
Stevens, J. A., Haas, E. N., Haileyesus, T. (2011). Morbidity and Mortality Weekly Report (Report no. 60). Centers for Disease Control and Prevention.
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm
United States Access Board. (n.d.). Guide to the ADA Standards. Chapter 3: Floor and Ground Surface. Access-Board.gov.
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