Design ideas for wheelchair accessible bathroom

[Pathfinder]

A friend's 16 year old son was tragicly paralyzed when a tree overloaded with snow broke off and forever changed his life.  He survived 14 hours of surgery and three weeks in the ICU and has recently regained consciousness and begun his rehabilitation.  In order to help the family I have offered to help convert their home's unfinished daylight basement into a space that Matt can live with a minimum amount of inconvience.

One of the priorities is the installation of the bathroom facilities.   We will locate the bathroom in the same area that the roughed in plumbing exists and expand the space to better suit wheelchairs.

If anyone has some layouts that are suitable I would very much like to see them.  Most of what I have found are conversions of standard sized bathrooms.  Since we are not bound by those size limitations I'm looking for bathrooms designed specifically for wheelchairs.

Thank you in advance for your insights.

[jwv]

Wow, in the blink of an eye, how life can change. What a great friend you are.

Here's a short thread we had not long ago:  http://www.countryplans.com/cgi-bin/yabb2/YaBB.pl?num=1162612753

Good Luck to All,
Judy

And a bit more in this thread  http://www.countryplans.com/cgi-bin/yabb2/YaBB.pl?num=1161798395/17#17

[scottb]

shower with small slope for water. just wheel in and hand held shower head. check out this chair.  http://www.1800wheelchair.com/asp/view-product.asp?product_id=1083
it would be nice to have a low toilet to roll right over. he would still have to get out of regular chair into this open bottom chair. it would be nice to have seperate chair for bathroom use. his rehab will give him arm strength to get in and out of chairs.

[Amanda_931]

This is simple and pretty elegant.  No electricity needed, can be a smallish pop-out/addition to a house.

http://www.turtlehomes.com/

[Amanda_931]

More in this thread--including the first reference to turtle homes--from, say, reply # 13 or 14 on.

http://www.countryplans.com/cgi-bin/yabb2/YaBB.pl?num=1161798395/17#17

[mark_chenail]

Pathfinder asked me to post this design he has done for the accessible bathroom for his friend Matt.  He welcomes any comments and I am also going to post the email exchange we have had about the design.






MARK to Mo:

Mo;

Glad to help.  Suppose you tell me a bit about matt.  How agile will he be?  I assume he has a spinal injury of some sort.  Does he have full feeling or any use of his legs?  Will he have good upper body strength.  Are his hands effected in any way?
.........
Can you send me a rough plan of what you have in mind?  I think you said this was a walkout basement.  Is the plumbing already there stubbed in?  Let me have some details and we can see what we can come up with.   The real issue is to give him plenty of space to turn the chair and approach fixtures without having to fuss about in a small space.    minimum 8 by 10 foot room but 12 would be better for a big rollin shower and stool and sink.   More space if he wants a tub as well.

MO to Mark

Mark,
THANK YOU!!!  Your insights are extremely valuable!

Matt is 16 years old and a two year Cross Country letterman.  Nov 27 2006
he was struck by a tree and his spine injured along with some other injuries
that he will recover from.  He has feeling down to just below his navel.  He
seems to have 100% function above that.  0% below.

Mentally strong and morally straight kind of young man.  He's handling it
amazingly well.  He's physically weak right now.  He was unconscious for 21
days following the accident.

I'll attach a picture of what I'm thinking.  I'm not sure the scan kept the
scale but I will be glad to provide dimentions.

The exisiting space is roughed in for the traditional 60" wide in-line
bathroom.  I widened the space to 96" and changed the layout and passage
ways.

We have just started planning.  With luck ......
we hope to have this phase completed or nearly so by the time Matt comes
home (~5 weeks depending on his progress)

[mark_chenail]

THIS IS A CONTINUATION OF MY DISCUSSION WITH PATHFINDER


Mo:

Lord you dont let any grass grow under your feet. Its barely been a month since the accident, not to mention the holidays and you already have your ducks very much in a row.

Matt sounds like a great guy and from what you say about his injuries and his previous athleticism, I imagine he will be pretty agile once he recovers and gets his strength back.

Frankly your design is very good and just needs a little tweaking.

1)  The door is plenty wide but it swings into the room. If Matt pulls straight in to the stool and trys to close the door its probably going to hit the back wheels of the chair, depending on the size of his chair and how close he can get to the stool.  If its a wall mounted stool, his footpedals will go under the stool but if its a standard floor mount it might be a problem.  The simplest solution is to make the door swing out into the bedroom or you might consider a really good pocket door, which would eliminate the swing problem completely.  You might also consider a sliding door on a track like a barn door mounted on the bedroom side.
2)  The sink is fine as long as its just a counter with a basin set in it.  DO NOT use a standard vanity cabinet unless its made like a kneehole desk. Matt will want to face the sink and get his legs under it so he can shave. Theres nothing more aggravating then to have to sit sidesaddle to the sink to wash or shave.  If he wants bathroom storage it should be drawers or a cupboard set into the wall at his height.  A standard medicine chest isnt very useful mounted over the sink.  And give him a good BIG wall mounted mirror over the sink, so he can see all of his upper body from the sink top up.  You might consider including part of the small alcove in the walkin closet as part of the bathroom and use it to make a linen/ medicine cabinet in the bathroom, say 3 stacked drawers with shelfs above for towels washcloths etc.
3) The stool location is great. Make sure the toilet seat is as close to wheelchair seat level as possible.  The really important thing is that you do NOT jam the stool up against the wall to the side.  As its just us two guys I will be blunt to make my point.  Im assuming that Matt is right handed like the majority of the world.  Now when an ablebodied person is done on the toilet, he stands up or squats a bit off the seat to wipe his butt using his right hand.  A disabled person cant stand or hover over the seat so he will lean to the left a bit so that he can reach down and under and take care of business.
To do this he needs a bit of extra room on the left to lean over and not crack his head or his shoulder on the wall.  If I had a nickel for every public bathroom stall that crammed the stool against the wall and made this a painful and acrobatic procedure, I could retire.  If Matt is left handed, he will of course reverse this process and you need to shift the stool to the the other side of the alcove if possible.  Depending on his balance, its a good idea that the side wall is on the side he leans toward but not so far away that he cant touch it to steady himself if necessary.  Try this out yourself and you will see what I mean if its not clear.  Remember no fair standing up...
4)Toilet paper holders are of course the single source of divorce in the United States.  Frankly I dont care whether you advocate front or back loading but placement of the fixture for Matt will be an issue.  It should be close enough to be handy but it should not be down low where most people put it.
As Matt probably wont have use of his legs, he will drag them along as he slides off the toilet and gets back into his wheelchair.  The standard low placement of the toilet paper holder will be a sure source of banged knees and barked shins.
Trust me I know.  I once managed to get my trouser leg engtangled in a low lurking toilet paper box in Chicago's Union Station and spent a good ten minutes trying to convince someone to come into the stall and help me get disentangled.
Put that paper holder up nice and high on the side wall where its out of the way but handy to reach. If you can make it inset in the wall so it doesnt protrude even better. Actually the best solution is a little alcove where Matt can keep a couple of rolls of paper handy.   There is nothing worse than getting on the stool and discovering that empty roll.  The able bodied person with this problem merely gets up with his skivvies round his angles and shuffles over to the paper storage area.  This method is obviously NOT an option for the disabled for obvious reasons. You know this problem will arise. Its a given in even the best regulated household.

CONTINUED

[mark_chenail]

THE LAST OF THE DISCUSSION:

MO:

5)The shower.  You seem to have gone with a fold down seat in a nice big shower stall.  The only thing you need to be careful about is that the seat is mounted on the side that is most convenient for Matt to make the transfer from chair to seat.  If you can, avoid a curb on the floor. It will allow Matt to get the chair up nice and close so that he can transfer.  This is particularly important when he is wet and getting out of the shower.
I STRONGLY SUGGEST THAT YOU JUST PUT IN A FLOOR DRAIN AND TILE ALL THE FLOOR AND WALLS SO THAT THE ROOM CAN BE AS WET AS POSSIBLE.  DON'T EVEN THINK ABOUT A SHOWER DOOR AND UNLESS MATT IS VERY VERY MODEST, ELIMINATE THE SHOWER CURTAIN AS WELL.  JUST LET THE WATER GO WHERE IT WILL AND LET THE TILE AND FLOOR DRAIN HANDLE IT.
Give him a standard shower head with a hand attachment. You might also want to consider one of those overhead rain showerheads.  Water from above will make it easier for him to rinse his back and head.  Definitely put in an overhead rain shower if you decide to do a roll in shower instead of the transfer seat.  The roll-in is really a simpler and easier solution all around and eliminates the need to transfer and the danger or slipping and falling.  You can pick up a cheap wheelchair that is just for use in the shower.  It really is a JOY to just roll in and out of the shower without any fuss.

That pretty much covers the bathroom.  Just a few more observations if you dont mind my putting in another oar.  The walk in closet will be virtually useless to Matt even if its double barred with high and low bars.  I think Matt would find a bank of drawers, rolling trays and shelves far more useful.
I'd suggest putting them on the long wall of the closet. Reaching up even when you are still young and agile is a pain in the neck when your in the chair.  Give him lots of low down storage that pulls out. You can give him some hanging space on the short side for the few formal clothes he may have that need to hang up.
Kudos on the laminate flooring.  Eliminate carpet in his environment as much as possible.  Its hard to push a chair on carpet. Even flat weave industrial is no fun. And its a maintenance nightmare. Wheelchairs are dirty muddy things but unlike shoes, Matt cant ditch it when he comes into the house.
Make everyones life easier with easy to care for flooring.
You dont give a room size on the bedroom. Make sure its big enough that there is at least 4-5 feet on all three sides of his bed. That way he can maneuver around it with ease, get in from either side or the end as long as there isnt a footboard and it will allow him to make his own bed.   yeah I know what 16yo boy makes his bed, but its one more thing he COULD do if he has the space and things he CAN do are going to be important in his new world.
If you can manage to give him more desk space I would do it.
Wheelchair bound folks like to have everything they need down low and handy so that you arent constantly wheeling back and forth.  Give him plenty of flat work space. Some near the bed too for all the things he will want handy to his bedside without having a cluttered mess.
Okay  Ive nattered on enough for now.  Write back if I havent been clear on anything.   I know you want to have this ready for Matts return, but let me suggest you ACTIVELY involve him in the planning. I know hes recuperating but maybe sit down and watch him do simple things like get in and out of bed or on or off a chair or toilet.  Watch the mechanics of how he approaches these tasks and use them to design the bathroom

Hope Ive been of help.  Take care.

Mark

[Pathfinder]

Thank you again Mark!  Your help is GREATLY appreciated

I ran the preliminary plan by Matt & family and I believe we have a starting point.  They really appreciated your insights.   I will make the revisions and copy you in for further refinement and perspective.  We feel blessed that you have taken the time to help us.

Mo

"What we do in life echos through eternity." -Maximus

[mark_chenail]

HERES the revised plan and some more of our discussion:


Hi Mark,  (Marshall, Blake and Robert CC'd)
Here is a revised plan.  I've tried to incorporate your suggestions.

A few questions:
1- How far should the drain be centered from the (close) wall to allow for
enough manueverabiltiy ?

2-In this layout where would you recommend we locate the drain?

3-Do you have experience with Stair lifts?

Once Matt is able to get around on his own we want him to have a method to
reach the upper floor

Not shown but will probably be added is a rainhead showerhead or
traditionally placed showerhead to augment the handset as per your
recommendation.

Mo



MARK TO MO

Morning Mo:

1) I assume you mean the toilet drain flange.  Its just a matter of a few inches really. Say 3-4 inches more than the spacing recommended by the manufacturer.  It depends a bit on Matt. If hes tall and slender, he wont need much space.  If hes built like a truck, not likely for a long distance runner, he will need a bit more space.  Once again, Id suggest you try it out yourself.  Set a kitchen chair in the space and experiment with leaning and performing the necessary task.

2) I would put the floor drain in the shower area or perhaps just along the line where the shower alcove joins the main room. Its just a question of a slight pitch to the tile floor so that the water goes to the drain. Most commercial kitchens and baths have a floor drain and when they clean the floors they just spray cleaner on the tile and then hose it all down toward the drain and use a long handled window washers squeegy to push the water.

3)I have no personal knowledge of stair lifts but Im sure any reputable company will supply you with all the info you need.
Im sure Matt wont want to be isolated in the basement but going outside and uphill and down is not a practical solution in any kind of weather.  Its probably the simplest and least expensive solution, unless you have excess to cheap elevator equipment.  I once took a look at an underground house that the owner had built himself.  The place was built like an underground garage and he had gotten a real deal on an old hydraulic car/garage lift which he had installed as a sort of elevator into the house.

The new plan certainly has given Matt plenty of work space but Im sure he will appreciate it and losing the extra door into the bedroom shouldnt be a problem. Still plenty of room for the bed. I see you have eliminated the door to the closet. Makes it easier to get in and out. I'd hesitate to do it with an able-bodied teenager who are not always the tidiest of people, but one of the perks of wheelchair life is that it forces you to pick up after yourself.  The floor is no longer the repository of all things as they become hazards to navigation. So a relatively clean teenage son's room is a small silver lining......
I dont know what the rest of this level of the house is like, but might I suggest a little kitchenette or at least a small dorm fridge and a microwave and a little storage space for basic snacks and things like breakfast cereal, coffee etc. Even the most loving mother is going to get sick of going up and down stairs with snacks if Matt eats like most teenage boys.  And once again, its one more thing Matt can do for himself.

Otherwise it looks as if you got it all in order.  Drop me a line if I can answer any other questions.

Mark

MO TO MARK:

Mark,
We will most likely be using a wall mount toilet and his chair height is 18"
with a 2" pad.  Should we set the stool at 18" or ?

Good idea on the Kitchenette.  I think we can put on on the far side of the
Powder Bathroom.

Mo

MARK TO MO:

MO:

I would set the seat a bit higher than 18 inches but not at 20".
Once he gets used to wheelchair life he may get rid of the pad seat.  They are standard issue nowadays because folks worry about pressure sores.   I dont use one and never have but of course after 50 years of sitting down my butt is like shoe leather.

Sounds like you are ready to start.  make sure to take pics as you work and post them on the Forum.

Mark



ANY COMMENTS FROM THE FORUM WOULD BE APPRECIATED.

[glenn-k]

I can't think of anyone more qualified and knowledgeable in this field than you, Mark.  Many of us are just following along and trying to learn from your experience and wisdom.  Great job.  They couldn't get better advice anywhere that I could think of.

Penny may have some other ideas if she drops by.  We don't see her real often.

We have a chair lift at the local theater.  It runs from the bottom of a steep stair to the top and a transfer is necessary top and bottom.  I understand that this is one of the cheaper methods of getting from one floor to the other though.

[glenn-k]

Here is one similar to the theater one for $1799

http://www.ameriglide.com/Electric-Powered-Stairlift.htm

Here is one from $1595 used.  If no stairs this probably doesn't matter but may be of use to someone.



http://www.accessibility4less.com/Summit_StairLift.htm?crtag=cr

I have no idea about the above dealers.  Just info from a search.