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

Height. Only two firms, OWP&P and Nelson Tremain Partnership specifically addressed the issue of height. OWP&P used the high end of ADAAG (33") whereas Nelson Tremain used 10" above the seat height. Although OWP&P did not deviate from ADAAG, the intent was to account for the reduced stature of many older adults as well as to optimize their potential leverage. The maximum height in ADAAG was used because there was no other objective information available upon which to base a decision on effective height for assisted transfers.

In contrast, Nelson Tremain, in the absence of objective data, rationalized that height of toilet grab bars be based on the distance between the seat and arms of a chair. Thus, they decided to locate the bars 10" above the height of the toilet seat, whereas ADAAG permits grab bars 14"-19" above the seat. Although there is no evidence to support this rationale, common sense suggests that lower grab bars would enable caregivers to lean over the bars to provide assistance as well as permit individuals to be able to push up more effectively from the toilet.