Best Practices in the Design of Toileting and Bathing Facilities for Assisted Transfers

4.21.8 Shower Enclosures.

None of the respondents indicated that there were any variations from ADAAG regarding the shower enclosure.

Alternative Designs. Bathroom as Shower Room.

The bathroom-as-shower-room is a concept adapted from the common European residential model by OWP&P as an alternative for including a shower in every resident bathroom. Due to space constraints at the Oakwood facility (Figure 16), a separate shower stall could not be accommodated in each resident toilet room. Having a shower close to the resident room was particularly important in this dementia facility to allow for impromptu clean-ups in the event of incontinent episodes without the indignity of leading residents down a corridor to a central bathing facility. As a result, each resident bathroom was designed as a shower room that permitted either independent or assisted showering. The latter is facilitated by use of a hand-held shower wand, which can be manipulated by the caregiver standing outside the area enclosed by the shower curtain. Given that this is a dementia care unit, there was a concern that residents might inadvertently douse themselves when left unattended. Thus, care providers can remove shower hoses and wands by a quick-release coupling at the outlet. When this feature was specified, it was expected that it would also cut off the flow of water even if the valve were to be opened. This turned out not to be the case, and a retrofit with an after-market in-line valve installed on the upstream side of the coupling turned out to be impractical due to the danger of backflow.

Figure 16. Shower Configuration at Covenant Oaks at Oakwood Village, Madison, WI (OWP&P)

The bathroom-as-shower design requires more space than a typical toilet room as well as special considerations for drainage, doorway design, and waterproofing of other fixtures in the space. However, it affords an enhanced opportunity for assisted showering without the caregiver getting drenched in the process as well as permitting individuals to shower independently.