The Universal Design Bathroom: Where Independence is Preserved
By Gunnar Baldwin
Older people or those whose mobility is impaired by birth defect, injury or illness, face
serious challenges in the bathroom that cause embarrassment, loss of dignity, and
lower self-esteem. When they become dependent on assistance for bathing or personal
cleansing post toileting, it is often the last straw. Rather than inflict the role of caregiver
on a loved one, too many of the elderly or disabled choose to give up their
independence. Whether this means a visiting nurse or moving to a nursing home, their
new dependent status is expensive, demoralizing, and can result in depression and a
loss of the will to live. However, the architect or bathroom designer trained in the
principles of universal design can help avoid this scenario, enabling the mobilityimpaired to live longer at home with dignity, good health, and better spirit.
Architects and certified bathroom designers reading this article are familiar with the ADA
requirements, so they will not be repeated here. In general, however, the universal
design bathroom should not only comply with ADA provisions, but also offer important
features that help a person perform all of the tasks needed to use the toilet, take a
shower, brush their teeth, and groom themselves independently.
Unlike ADA-compliant institutional bathrooms, the universal-design bathroom is visually
appealing. It does not look as if it had been laid out specifically for elderly or disabled
users. In fact, visitors to a home with a universal design bathroom may not notice
anything out of the ordinary, except that the bathroom is attractive, convenient, and
comfortable. In fact, they may want to spend more time there because it feels like a spalike retreat.
The following list highlights of some features that give the universal design bathroom
the feeling of a well-designed place, which almost anyone across the life cycle can use
independently.
Grab Bars
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Grab bars are available that have the decorative appearance of towel bars and
blend seamlessly in the overall aesthetic of the room, while providing more
places for stability.
If waist high towel bars are installed as grab bars, they should meet the
standards for grab bars.
A vertical grab bar should be installed on one side of the toilet, which can be
used to pull oneself up.
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An armrest height, weight-bearing shelf may be helpful to push up on when rising
from the toilet.
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Fold down grab bars are available, so a bar can be installed on either side of the
toilet if needed.
All grab bars require walls that will support them. Therefore, ¾” plywood should
be used behind all of the finished walls, so, if another grab bar is needed
anywhere in the bathroom, it can be installed easily.
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Toilets
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Universal height toilets should be installed, which are at least 17” high at the top
of the seat.
A toilet seat with bidet features, drier, deodorizer, and heated seat will make it
possible for mobility-impaired individuals to cleanse themselves post toileting,
without the need for assistance. The features should be operated by remote
control within easy of reach the unit.
 These units’ warm water washing cycle and warm seat help relax the
individual, which has been frequently reported to relieve constipation, a
common affliction of the elderly and post-operative patients.
 Some of these products also have the ability to sense a person
approaching and will lift the toilet’s lid, close it again, and flush the toilet
after the person leaves, which can be especially useful for individuals with
memory loss.
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A GFCI electrical outlet, preferably on a separate circuit, installed near the toilet
is essential and should be standard in all bathrooms.
Infection Risk
Infections from bacteria or viruses brought into the bathroom are an increasing concern
as people age or develop immune deficiencies.
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Installing floor tiles and wall coverings that reduce the ability of such pathogens
to grow on their surfaces can help mitigate this risk. This information is based on
third party testing per ISO standard. Test lab reports from Georgia Tech are
available. Any implication of antibacterial and antiviral performance is not
intended and is not reviewed or approved by EPA.
Recent advances in vitreous china glazing, using nanotechnology, make the
glaze used in some toilet bowls much smoother, which enables the smaller
volumes of water in today’s highly water efficient toilets to thoroughly rinse the
bowl with lower water consumption.
 Antimicrobial metals are used in these glazes.
 A recent innovation found in some bidet type seats moistens the bowl’s
surface just before use to prevent waste from sticking to the surface, then
uses electrolyzed water to mist the bowl after each use and every eight
hours when not in use.
 The chemicals normally found in tap water are treated with
electricity to give the mist properties similar to NaOCl, or common
household bleach, which lasts for approximately two hours.
Tubs
Many modern bathrooms in North America omit a tub, which is difficult to enter,
consumes a great deal of water, and still requires the addition of shower unit to the
bathroom.
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Where tubs are installed, radiant heat panels are a good way to prevent chilling
as the tub empties and individual leaves the tub, before drying off.
A seat should also be installed on the tub that enables the individual’s legs to be
“swung over” the wall of the tub after transferring to it.
Showers
Showers are often the only option for many elderly or disabled people who can no
longer get in and out of the bath. The following universal design elements make
showering easier for the mobility-impaired individual.
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A waterproof, permanent, folding or removable seat provides comfort and ease of
use. It should be positioned so the shower controls can be reached easily, and
the bather can turn the water on and adjust the temperature while seated and
before getting wet.
The shower valve should not be located directly under the showerhead.
Offsetting the valve toward the entrance to the shower, or locating this control on
a side wall, meets this need.
Floors in the shower should have nonskid type surfaces to prevent slipping.
Linear floor drains help reduce slopes and eliminate curbs which can be
confusing and cause falls.
 A channel drain with a cover that is flush with the tile’s surface allows the
entire floor surface to pitch almost imperceptibly to the back wall. This
saves labor when laying the tile as well.
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Grab bars should be within reach from all locations within the shower enclosure.
Their color should contrast with the surrounding walls, making them easy to see.
Hand showers should be mounted on vertical rods, which double as grab bars.
The hose should be long enough to reach anywhere within the shower enclosure.
Lavatories and Faucets
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Lavatories that project toward a person seated in a wheelchair, a person
of short stature, or a child standing in front of them make tooth brushing
easier.
A faucet mounted on the side of the sink is easier to reach and reduces
the lavatory’s protrusion into the room.
Remote control devices can be installed to make the faucet’s operation
much easier. A simple push of a button mounted on the front or side of the
lavatory, or the floor for foot operation, turns the faucet on and off without
the need to readjust the temperature. This device also saves water
because it is easier to limit the time the water is running.
Today, many homeowners would rank the bathroom as second to the kitchen in
importance to their lifestyle. However, older people and those with disabilities, who are
trying to maintain their independence, dignity, and self-esteem, will say that the most
important room in the house to their quality of life is the universal design bathroom.