Bathroom Modifications for Elderly
I recently worked with a client who wanted to make modifications to the bathrooms in her mother’s home. Her mother was up in age and had recently had a fall in the home so weeks prior to our conversation. Her mother was almost done with rehab and physical therapy and was preparing to move back into her home. After a brief initial introduction, one of her first questions was,” How to set up a bathroom for the elderly?’
To set up a bathroom for elderly you can add grab bars, make floors slip resistant, make toilets taller, use shower chairs, change shower and faucet control handles, install a handheld showerhead, make lights brighter and declutter the space. If needed you can take modifications a step further and widen doorways, replace the tub with a shower, or install a walk-in tub. Let’s discuss the purpose and process for completing each of the senior bathroom modifications listed above as well as a few more.
It’s important to evaluate and prioritize the needs of the individual, the budget, as well as any challenges the bathroom space may present before you begin making changes.
Also, consider that some elderly home modifications are inherently more permanent than others. What makes sense for one person’s situation may not make sense or be feasible for another. We have a lot of things to cover so let’s get started.
Shower Grab Bars
Grab bars are the senior home modification that most people think of first when the topic of aging in place comes up. And for good reason, grab bars offer an additional layer of fall safety wherever they are installed.
Wall Grab Bar Shower/Tub Entry
Shower/Tub grab bars can be installed at the entrance to a tub and shower to assist in the user in maintaining their balance as they step in and out of the tub or shower. This grab bar location is particularly helpful in bathrooms that have tubs or showers with thresholds, where the user has to raise their leg and step over the wall of the tub or the curb of the shower. The Grab bars at this location are often installed vertically lengthwise straight up and down.
Grab Bar on Back Wall of Shower
Another excellent location for a shower and tub grab bars is along the back wall. There are lots of different size and shape options that will work for this location. Grab bars installed at this location are usually installed at an angle. The angle installation gives the user the freedom to grasp the bar at different heights.
And because the grab bar can be used from different heights and grip positions, it can easily be used by people of different heights. If you install a straight grab bar in a parallel position along the rear tub wall or shower wall it will provide stability for the person while they are standing. But if the person is showering from a seated position is much easier for them to grasp and pull up on a grab bar that is installed at an angle.
Whenever you are going to be getting in and out of the shower, slippery floors are always going to be a major concern. Additionally, if floors don’t allow for enough traction, it can make it more difficult to stand from a seated position like from a shower chair or from the toilet. Slip-resistant adhesive strips are an easy low-cost way to increase the traction underfoot in the shower or tub as well as on the floor in the central part of the bathroom, or anywhere else you need more traction.
A handheld showerhead gives the user a lot more flexibility in how they direct the flow of water as they shower. This flexibility allows the user to move less and remain in more of a stationary position while still being able to direct water over their whole body.
There are two different styles: One handheld showerhead style is attached to your existing shower head and sits in a cradle below the existing head, and does not affect your ability to shower regularly. The second type replaces the existing shower head and sits in a cradle that allows you to use it in a stationary position like you would a traditional shower head, and when you are ready to use it as a handheld you just take it down from the cradle.
Handheld showerheads work great whether the user is standing or seated. This can further limit the opportunities for falls, and can also help maintain the user’s independence.
When it comes to getting on and off the toilet a taller toilet definitely can make a big difference. The difference between a standard height toilet and a comfort height (aka ADA, which stands for Americans with Disabilities Act) toilet is about 2 inches. This doesn’t sound like much, but it can make a big difference because most people are able to generate more power in their legs the less bent they are.
Changing out the toilet is a pretty straightforward solution. Most brands make a tall toilet, so you take your pick. But before you do, make sure that you actually need one. The reality is that shorter people may not actually find comfort height more comfortable.
And for some, the comfort height toilet still may not be tall enough. If you determine that you need a taller toilet, start by measuring the height of the existing toilet first, and see if it’s close to 17 inches. If it’s in the same height range you may come out better trying a tall toilet seat instead.
Tall Toilet Seats
A tall toilet seat is much less involved than replacing a toilet. It also gives you the opportunity to raise the height of the toilet well above 17 inches. Tall seats come in different heights. Some styles are designed to replace the existing seat, while other styles work with the existing seat and function more as a spacer.
This recommendation should go without saying, but we will cover it anyway. Removing as many unnecessary items from the bathroom area can greatly improve the user’s ability to move around in the space. This improvement can be done at no cost if you do it yourself.
Toilet Grab Bars
Grabs that are specifically designed to be installed on or work with the toilet are another great option for improving the user’s ability to descend and rise from the seated position. Some less expensive toilet seat options are designed to be installed underneath the existing toilet seat. You remove the existing toilet seat bolts and place the support tabs for the toilet grab bar over the holes on the porcelain toilet, place the seat on top, and then reinstall the seat bolts. This design relies on the toilet seat bolts to hold the grab bars in place. It’s important that you ensure that the existing toilet is stable and properly secured to the floor before installing any type of grab bath that will rely on the toilet for support.
There are several different grab bar styles. A freestanding toilet grab bar can be set up without making any changes to the existing toilet seat.
There are also more permanent and grab bar styles that are attached to the wall and can be folded up and out of the way when not in use. These styles are the most sturdy, but also require the most work to install.
Bath Safety Grab Bar
Making modifications to a bathtub can get expensive pretty quick. The biggest safety issue with bathtubs is having to step over the sidewall. A Bath safety bar is an excellent non-permanent solution that can give the user added stability as they step over the sidewall as they enter and exit the tub.
Lighting is another important consideration to address when making bathroom improvements for an elderly person, or someone with mobility issues. The better we can see, the more confidence we have when we move around. This can be an easy fix for both vanity lights and overhead lights. Something as simple as changing out the existing light bulbs for LED bulb can make a world of difference. In some cases, changing the light fixtures may necessary to provide the most ideal lighting.
Many elderly people and others with health complications find standing for long periods of time taxing. This is why the shower chair was created. It is a water-resistant, sturdy seat, that can easily be moved around. This seat allows the user to sit in a position that is most easy for them to bath or be bathed by a caregiver. This also eliminates the need to rush through washing to prevent the person from getting tired of standing.
Tub/Shower Handles and Faucet Handles
Many elderly folks suffer from arthritis. And in many cases, it can be more difficult for them to grab objects tightly in their hands. For this reason, changing the controls for the tub /shower valve as well as the vanity sink can make these bath fixtures much easier to use.
This recommendation applies more to bathrooms that have older fixtures that have knobs that you have to turn to control the water. The easiest way to address this issue with the tub/shower valve is to replace the knobs with lever handles. The lever handles are easier to use for someone with limited hand strength and hand range of motion.
The same is also true for vanity sink faucets. However, vanity faucets are typically a lot easier to change out than a shower valve. And for this reason, it may be easier and faster to just replace the vanity faucet with a level style fixture rather than try to find levers that fit.
Bathroom Door Handles
Replacing traditional door knobs for lever style handles can improve an impaired users ability to open and close the door for the same reasons mentioned above for the shower and faucet handles. Additionally, the locking mechanism is also easier to control because of its push-button function, which is much easier than having to twist the lock control in the center of the knob.
Remove Tub or Shower Glass Door
Removing a glass shower glass can free up more room to maneuver in and out of the tub or shower. Removing the doors is a little more involved from a labor standpoint, but if done carefully it is usually reversible. This modification is for bathtubs and showers that have 3 walls and only have glass on the front. These type of tub shower configurations can easily be served with a shower curtain instead of glass.
When mobility becomes an issue, these types of doors often make it more difficult for the user to get in and out of the tub or shower. These type of doors are typically sold in home improvement stores and are installed by attaching the track to the tile walls with screws and wall anchors.
Whether have a shower door or a sliding glass, door, they are both typically installed the same way. Taking them apart is pretty straight forward. Make sure to inspect the glass panels and the metal frames to ensure that they are in good condition before you begin. You don’t want the unit to unexpectedly fall apart in your hands.
If you have an actual shower enclosure, you need to carefully consider removing the enclosure. These type of installs are typically performed by professionals, so if you decide to remove it, you may want to consult the pros.
Okay, now we are officially getting into senior home remodeling. But sometimes, nothing else will do. Widening doorways is the best way to make narrow doorways accessible for those in wheelchairs. This modification will involve some demotion as well as some structural framing. This is a task best left to the pros.
Add a First-floor Bathroom
Since we’ve already crossed the threshold into remodeling, let’s go all the way. If you are moving back into a home that does not have a full bathroom on the first floor, and you have space, adding a full bath on the first floor can literally be your saving grace. First floor bathrooms and sleeping quarters are two of the main amenities that allow many seniors to remain in their homes and age-in-place.
Bathroom Remodeling for Seniors
If you have a bathroom that has a good location but needs major changes in order to be made suitable for the senior, a bathroom remodel is an option.
Whether you are remodeling or building a new bathroom, there are a few design considerations to keep in mind.
Slip Resistant Flooring
The first consideration is the flooring. Slip-resistant flooring should be installed on the floors, preferably tile. Not all tile is the same, so you need to pay close attention to the slip coefficient of the tile.
Change Tub SHower Combo to Shower-Only
If you are doing a remodel in a bathroom that currently has a tub, consider doing away with the tub and going back with a shower-only setup. If possible a curbless shower will provide the user even more ease of use.
If it’s more practical for the elderly person to use a tub, consider a walk-in tub. This style of bathtub has a built-in seat and a watertight door. The user gets into the tub and closes the door before the water is turned on and the tub is filled. This gives the user the full bathing experience while eliminating a lot of the fall risk associated with being able to sit down and stand up from the bottom of the tub floor.
If the budget will not allow you to replace the tub with a shower consider a tub cut. This is a procedure where a door is cut into the wall of the tub allowing the user to make a small step to get in the tub instead of having them raise their leg over the standard height tub wall.
As part of a bathroom remodel, also consider installing a vanity that is optimal height and accessible by wheelchair
Wheelchair Accessible Bathroom
Also when designing a bathroom for an elderly person, try to plan a space that is wide enough to turn around a wheelchair.