Bathroom designs for the elderly

The term “ageing in place” or “age in place” is a term we come across in most marketing material for services and or accommodation for the elderly these days. There is a variety of definitions to be found for the meaning of this popular term.

The relevance of this term and its definition within the built environment is to enable an ageing person to remain independent.  With or without support services, within their existing dwelling, enabled through creative design, layout, and functionality, which will enable our ageing population to age and reside within their existing communities, environment, social and support structures.

One of the most common design shortfalls I come across in residential developments in South Africa, is the failure to cater for our ageing and disabled population. In the United Kingdom most local authorities have adopted policies on design criteria for newly built residential developments and require new dwellings to be designed as “life time homes”, where future residents, irrespective of their age group and physical abilities can buy a unit with the knowledge they can grow old and age comfortably whilst staying in their dwelling and existing community.

In South Africa our building regulations and design criteria for general residential units, specifically dwellings within the retirement sector, do not prescribe standards or similar design criteria as we see in the UK with “life time homes”.

The Foundation for Lifetime Homes and Neighbourhoods suggests that, “Lifetime Homes make life as easy as possible for as long as possible because they are thoughtfully designed. They provide accessible and adaptable accommodation for everyone, from young families to older people and individuals with a temporary or permanent physical impairment…..” The literature and information on “lifetime homes” is widely available on the world wide web and a must read for architects and developers involved in the property development sector, especially the retirement sector.

In South Africa, the responsibility is on architects, developers, consultants and even those who decide to renovate their dwellings to try and incorporate these design principles to enable future residents to age in place.

Fall incidents in bathrooms are widely known to account for the majority of fall incidents recorded and deemed as the space within any dwelling that poses the most risk for our ageing population. The bathroom layout, its design, fixtures, and fittings are probably one of the most important spaces within a dwelling where one should maximise access and minimise risks.   

I wish to share some guidance for those designing a bathroom or those buying a home to enable residents to age in place in the comfort of their unit.

Bathroom doors:

Bathroom doors should always open outwards or should have a sliding door with a minimum opening of 900mm after all doors and handles have been fitted to allow clear access for wheelchairs and mobility devices. More important is to consider the impact of forcing a door open inward whilst an elder person is lying on the floor on the other side. Doors opening outward or sliding doors create extra space within the bathroom without physically increasing the floor space of the bathroom.

The size, layout, and servicing of the bathroom:

Even if the elderly person still has the ability to walk, it is important to consider wheelchair use and the possibility of a caregiver when sizing spaces. A well-designed and spacious wheelchair-accessible bathroom also improves circulation, preventing falls and injuries from bumping into something.

• Ensure services such as the drainage of the bath is of such a nature that if a future revamp is required for a level access walk in shower, this can be accomplished. This is essential in especially multi story buildings where services such as drainage is pre- casted in the main structure and concrete slab.
• Ensure there is sufficient space in the bathroom to allow for movement and turning space for a wheelchair, a shower chair or when someone is using assistive walking devices such a walker.
• The location of the toilet, shower and basin should allow for sufficient space between them to be able to provide support to a person using the shower.
• Ensure the toilet is located close enough to a side wall to allow the installation of grab rails if needed.
• Rather install a walk-in shower than a bath if only one of the two can be accommodated.

The Shower:

• Showers should always have level access. A standard shower of 1000cm x 1000cm is recommended to accommodate a shower chair with access from the side for those assisting.
• Shower mixers should never be installed directly underneath the shower head and should be located at the entrance to the shower to pre-set the water temperature and for easy access to those who may provide support and care.
• Ensure the flooring is a non-slip material.
• The shower head should always have the option to be used as a handheld shower.
• Where possible the shower should have a wall on the side with a glass swivel panel above for access.
• Where space allows install a shower chair in case the user has the need to sit in case of feeling dizzy.

Toilets:

• Most standard toilets heights are inadequate for when ageing. Geberitin-wall toilets can quite easily be installed at a slightly higher position than the normal toilet height without impacting on the aesthetics whilst providing a more user-friendly height. They should end up being about 46 cm high.
• Ensure the flush mechanisms are easy to use.

Grab Rails

Install a grab rail where assistance is required at the most critical times, such as when sitting on the toilet or at the shower stall entrance.

Faucets

Rather install faucets with leavers than the conventional taps.

It is important to take note each country and even local authorities have standards and requirements. This article is merely to point out some of the important aspects to consider when buying a dwelling, designing a home or renovating your existing home to enable you to age in place in the comfort of your home and community.

For more information visit www.medwell.co.za

* Compiled by: Gerhard Lombard, Executive Director at Medwell SA.