Have you ever wanted a quick reference for aging-in-place issues? Are you wondering how to incorporate some aesthetically pleasing designs into your projects? If so, the Aging-In-Place Services Design Checklist might be suited to your needs.
The checklist below contains features you may want to consider for your next new construction or renovation project. It also provides a quick reference for various aging-in-place issues.
• Accessible path of travel to the home
• Sensor light at exterior no-step entry focusing on the front-door lock
• There needs to be 32-inches of clear width, which requires a 36-inch door
• Non-slip flooring in foyer
• Entry door sidelight or high/low peep hole viewer; sidelight should provide both privacy and safety
• Doorbell in accessible location
• Surface to place packages on when opening door
• There needs to be 32-inches of clear width, which requires a 36-inch door
• Levered door hardware
• Lever handles or pedal-controlled
• Thermostatic or anti-scald controls
• Pressure balanced faucets
• Wall support and provision for adjustable and/or varied height counters and removable base cabinets
• At least one wheelchair maneuverable bath on main level with 60-inch turning radius or acceptable T-turn space and 36-inch by 36-inch or 30-inch by 48-inch clear space
• Bracing in walls around tub, shower, shower seat, and toilet for installation of grab bars to support 250-300 pounds
• If stand-up shower is used in main bath, it is curbless and minimum of 36-inches wide
• Bathtub - lower for easier access
• Fold down seat in the shower
• Adjustable/handheld showerheads, 6-foot hose
• Tub/shower controls offset from center
• Light in shower stall
• Toilet two and half inches higher than standard toilet (17-19 inches) or height-adjustable
• Design of the toilet paper holder allows rolls to be changed with one hand
• Wall-hung sink with knee space and panel to protect user from pipes
• Slip-resistant flooring in bathroom and shower
Stairways, Lifts, and Elevators
• Adequate hand rails on both sides of stairway, one and a quarter inch diameter
• Increased visibility of stairs through contrast strip on top and bottom stairs, color contrast between treads and risers on stairs and use of lighting
• Slope no greater than one inch rise for each 12-inches in length, adequate handrails
• Five-foot landing provided at entrance
• Two-inch curbs for safety
• Installation of energy efficient windows with Low-E glass
• Flex room that can be used as a nursery or playroom when the children are young and as a home office later; if combined with a full bath, room could also be used for an aging parent/aging in place
Tub to Shower Conversions
• Create a shower that meets the Americans with Disabilities Act (ADA) recommendations to accommodate a person with mobility issues. In addition, check with your local building authority to see if any supplementary codes apply. The ADA suggests a minimum size of 36 inches by 36 inches for a walk-in shower, which features a bench attached to one wall for sitting. Even if you eschew the bench, 36 inches by 36 inches is a good minimum size for ease of showering. If the shower will accommodate a roll-in shower chair, the ADA recommends a minimum size of 30 inches by 60 inches to permit easy in-and-out access.
Grab Bars and Bathroom Safety Measures
• Avoid dangerous falls in the bathtub or shower by installing grab bars and floors with traction.
When you consider all the slippery surfaces, the scalding-hot water, and the hazards related to drowning and electrical shock, the bathroom can be a dangerous room. You can't eliminate the risks completely, but you can make your bathroom much safer. Members of the National Kitchen and Bath Association (NKBA), the National Safety Council, and the Center for Injury Research and Policy suggest the simple steps of choosing floors with traction and installing a grab bar.
Make Your Bathroom Safer
• Taking bathroom safety seriously could prevent a bad fall or injury. Water and slippery surfaces make your bathroom one of the most dangerous rooms in your home. Use these tips to minimize risks and increase bathroom safety.
According to the National Safety Council, more than 200,000 people are injured in their bathroom each year—and those are just the ones who report. When you consider all the slippery surfaces, the scalding water, and the hazards related to drowning and electrical shock, the bathroom is probably the most dangerous room in your house.
You can't eliminate the risks completely, but you can make your bathroom safer. Follow these guidelines from members of the National Kitchen and Bath Association (NKBA), the National Safety Council, and the Center for Injury Research and Policy.
Get a Grip
• In a room with splashing water, good traction underfoot is a must. Don't install slick, glossy tiles on bathroom floors. Grout lines increase traction, so smaller floor tile is usually best, especially inside a shower. There are also larger stone or ceramic floor tiles that are designed with a little extra grit, making them a safe option for bathroom floors.
Outside the shower, any rug you use should have a rubberized, slip-resistant backing.
A fall might still happen, so don't choose shower fixtures with sharp edges or points that would cause a serious gash if you fell against them. Choose rounded corners on countertops and other components. Also look for rounded, oversize hooks designed especially for bathroom use.
• Installing grab bars in the shower and next to the bathtub is a good idea for everyone, but it's especially important for adults 65 and older. A bar by the toilet helps anyone who has difficulty standing. Grab bars no longer have to look institutional. "They come in every possible finish and look, from chrome to oil-rubbed bronze. Not convinced you need grab bars? If you're remodeling and plan to stay in your home for a number of years, consider installing the necessary blocking in the wall, and keep a record of the location, so it's easy to add the bars later.
Don't Get Burned
• Many water heaters are set to 140 degrees, a temperature that can burn delicate skin in seconds. You can reduce the risk of burns by setting the water heater to 120 degrees. If you're building or remodeling, the NKBA suggests installing an antiscald valve for your tub and shower. The valves come in two types: thermostatic (which sense temperature) and pressure-balanced (which sense pressure changes).
• Thermostatic valves tend to be pricey, but they're required for many high-volume luxury shower systems. If you can't open the wall to change the valve, consider an antiscald device that can be inserted between your showerhead and the pipe neck behind it. A pressure-balancing valve will improve matters further by preventing sudden fluctuations in water temperature when someone turns on the dishwasher or flushes a toilet.
• Lavatory faucets with a motion sensor can prevent scalding because the water temperature is preset to a safe level. This convenient fixture keeps you and your family from spreading germs when washing hands because the water can be turned on without touching anything.
• A bonus with motion-sensing faucets is that there is little risk of an overflow. You'll never have to worry about your 5-year-old (or forgetful spouse) leaving the faucet running all day and flooding the bathroom.
• If you're planning a new shower, make sure the controls are easy to reach, from both inside and outside the water stream. You should be able to adjust the temperature before you get drenched.
Include a shower bench—not just so users can sit, but so they won't teeter while shaving a leg.
Minimizing the threshold into the shower is an important part of creating a barrier-free bathroom. You don't have to have a large, walk-in shower to get one with a low curb. Look for a shower pan that sits flush with the floor, making it easy to step inside.
If there is glass enclosing the shower, it must be tempered glass and the door should open outward, so if you slip or faint, your limp or injured body won't be an obstacle that prevents help from reaching you.
• Considering a new tub? A platform design is safer than traditional step-over designs. You can enter the tub by sitting on the platform, swinging your legs over, and slowly lowering yourself—instead of hurdling the edge. Although steps leading to a whirlpool tub or sunken shower look dramatic, they can cause a fall. If steps are necessary, equip them with handrails and a slip-resistant surface.
For additional safety with a whirlpool tub, the NKBA recommends installing an emergency shutoff. It should be easy to reach from inside and outside the tub.
• If you have small children (or if they visit), lock away medications and cleaning supplies, and install safety devices, such as toilet locks and tub-spout pads. Above all, never leave a small child unattended in the bath or shower. Injury experts recommend that you not use a baby bath seat, because they don't prevent drowning. Children can drown within minutes in even 1-2 inches of water. Their skin is more sensitive to burns than an adults' skin, and their center of gravity is higher, so they topple easily, and their faces or heads usually take the brunt of impact.
Add a Separate Shower
• Most accidents occur when people are climbing in and out of a bathtub. If you can do with a shower instead of a tub (or if you have enough room for a separate tub and shower), a walk-in shower without a threshold will reduce the risk of falling. To make your shower safer, equip it with grab bars, a bench, and storage alcoves that eliminate the need to reach far or stoop. Shower doors should be made of laminated glass with a plastic interlayer; tempered glass; or an approved, shatter-resistant plastic. No lighting fixtures, electrical outlets, or switches should be within reach of a person in a tub or shower.
Add Universal Comfort
• Many universal design features that make a bath wheelchair-accessible can also make it safer and more comfortable for everyone.
A toilet with an 18-inch seat height matches the height of an average dining chair, so many adults prefer it. A handheld shower with an adjustable height makes it easier to shower if you're on crutches or seated. It's also a nice feature if you're short or just want to keep your hair dry.
• Wheelchair accessibility also means the bathroom won't be cramped. Doorways must be at least 32 inches wide, although the NKBA recommends they be 36 inches wide. Including a pocket door instead of a standard swinging door is a space-saver and makes a bathroom safer. Swinging a door open can be difficult for individuals with mobility challenges. Pocket doors also reduce the risk of accidents—including head injuries, stubbed toes, and pinched fingers—from frequent opening and closing in a high-traffic bathroom.
Roomy aisles and the 60-inch-diameter space necessary for turning a wheelchair around offer a welcoming expanse of open floor space that anyone would enjoy.
Take Simple Measures Some of the easiest safety measures are related to simple practices and your behavior.
• Wipe up puddles or splashes promptly.
• Don't leave electrical appliances plugged in next to water sources.
• To prevent electrical shock, install ground fault circuit interrupters (GFCIs) on all outlets, switches, and light fixtures. And plug in a night-light to guide sleepy wanderers.
• Add traction mats to slippery bathtubs and remove any rug with a tendency to slip or bunch up—use rubber-backed bath mats instead.
• Door hardware that can be unlocked from both sides is the safest for bathrooms. With this kind of lock, you can rescue an incapacitated person or a child who gets locked in.
Design a Wheelchair-Accessible Bathroom
• Tips for designing a bathroom to make it more accessible for those with limited mobility.
Bathrooms designed for universal access present both design challenges and opportunities. Take careful inventory early in the planning process of all intended users' capabilities, preferences, and tastes. While universal design better accommodates users in wheelchairs, it can make a bath more comfortable for all users without sacrificing style.
The first priority in bathrooms designed for people who use wheelchairs is plenty of room for access and maneuvering. Barrier-free bathrooms are usually larger than average. Provide for an open area within the bathroom that's at least 5 feet in diameter to allow for easy turning. Also provide 4 feet of clear space in front of each fixture, as well as between the sink and the toilet, if both fixtures share the same wall. These spaces also will allow room for a caregiver, if needed.
Make doorways 3 feet wide so a wheelchair can pass through. The bathroom door must swing outward rather than inward and should be fitted with a lever-type handle, not a knob. In small spaces, a pocket door may also be a good option.
Specify a vanity designed for use from a wheelchair. Plan for a sit-down dressing table with enough clear knee space underneath so a chair can pull in close.
• The shower stall should have no threshold that would impede the entrance and exit of a wheelchair. Install the control valves and showerheads at two different heights, or include a handheld nozzle that can be used from a seated position. A built-in seat in the shower, along with a sturdy grab bar, can provide extra comfort and utility.
• Other features of an accessible bath include grab rails mounted on reinforced walls beside the tub and toilet (and bidet, if there is one), faucets designed to reduce the risk of scalding, a telephone, and lower light switches.
• A walk-in tub is a bathtub with a watertight door that allows the bather to step into the tub over a low threshold to increase safety while getting into the bath. The door closes, the tub fills with water and after draining the bath, the person opens the door and steps out safely.
While many models are taller than they are wide, there are many different models and configurations available to meet the needs of almost every customer and housing situation. For example, there are walk-in tubs available for easy transfer from a wheelchair to the tub seat; often called slide through tubs, nearly the entire front of the tub opens to give the necessary width.
Walk-in Tub Comfort
• Water Depth
Because there is no need to step over a tall wall, walk-in tubs provide a deeper water depth when compared to traditional tubs. A standard bathtub has a depth of 13 to 14 inches, while walk-in tubs can provide up to nearly four feet of water depth for a comfortable immersion experience while seated securely.
Seats are generally placed at 17 inches high, leaving almost 20 inches of depth to immerse the torso, well within the average torso length of an adult. Many walk-in tub models also have hydrotherapy jets available and other luxury features such as chromotherapy lighting and heated seating.
Walk-in Tub Safety
• Safety Features
Much of the remodeling suggested for aging in place revolves around safety, specifically preventing falls. Over one-third of adults over age 65 fall each year and over 80 percent of those falls are in the bathroom. Walk-in tubs generally provide an array of features designed to reduce falls. These often include built-in handrails, an ADA compliant overall design, anti-slip flooring, contoured built-in seating, and a low step height for entry.
Some models also include wide doors designed to allow those in wheelchairs to transfer easily to the tub seat without assistance. Another safety feature, although not related to falls, is a scald prevention valve, designed to prevent hot water burns.
• Combined Features
Certain walk-in tub models offer a lot of features in a single tub. Rather than purchasing modifications such as over tub seats, add-on handrails, anti-scald valves, and non-slip flooring, a walk-in tub combines all of these features and more in one package. This can reduce the amount of construction needed in your bathroom for remodeling as well as reducing the time required to make the modifications.
Health Effects of Bathing
The benefits of warm water for seniors in reducing certain aches and pains, along with speeding the healing of certain injuries such as burns or ulcers is well known. Hydrotherapy can also help patients recovering from amputations or dealing with conditions such as arthritis. In addition to simply being able to soak in deeper warm water, many step-in tubs have hydrotherapy jets similar to what you would find in an outdoor hot tub. Several jets of heated water and air agitate the water and provide massage to relax muscles further.
Water Usage in a Walk-in Tub
• Pro: Comparable Water Usage
With the deeper size of walk-in tubs, there is understandably the idea that a walk-in tub would hold more water than a standard tub or a shower. However, this is not always the case. Many walk-in tubs are much narrower than standard tubs, so it isn’t much larger than it appears visually when dealing with gallons held.
• Standard Tubs/showers vs. Walk-in Tubs
• Standard Tub Standard Shower Walk-in Tub
42-80 gallons 25-40 gallons 50 gallons
• An average standard bathtub holds around 42 gallons, with garden tubs holding about double that. An average shower uses between 25 and 40 gallons (depending on the flow of your shower head).
• Walk-in tubs do not use significantly more water, with many averaging around 50 gallons of water per filled tub. Many walk-in tubs also offer heating systems that circulate water to keep it warm rather than needing to be refilled turning the bath.