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

RECOMMENDATIONS

Based on the conclusions above, two avenues of attack are recommended. First, research is needed to understand the impact of design on caregivers and care recipients as well to develop design specifications for older adults. The former includes the impact of current guidelines and alternative designs on: safety and injury prevention; proper positioning of care recipients and care providers; stress reduction, especially among dementia patients; and flexibility in accommodating individuals with different abilities. The latter includes studies to determine optimum design specifications, such as: toilet height and location, grab bar height, positioning, and location; clear floor space; and size of fixtures.

Second, in the absence of any better information, it is recommended that a number of immediate changes be implemented to ADAAG to better accommodate assisted transfers in facilities used predominantly by older adults.

• Provide a minimum 24" clearance between any obstruction (e.g., sidewall) and the side of the toilet seat.

• Permit rear or floor mounted swing-away grab bars on both sides of the toilet.

• Accommodate non-standard bathtubs such as the Kohler Precedence tub by permitting a single horizontal grab bar.

• Permit swing away grab bars in and adjacent to tubs and showers to add flexibility.

• Finally, even though orientation of toilet rooms do not directly impact transfer, toilet room designs that minimize turning radii (e.g., doors on 45⁰ angles) should be encouraged to facilitate access.