A new tub or towel rack can boost accessibility and value
Whether you see your bathroom as a place for reflection, retreat and renewal, or simply as a necessary facility, you can make it fully functional and absolutely accessible.
Create a lush jungle atmosphere ... or a warm and cozy womb ... or simply a place where toilet, tub and sink are placed with your safety and convenience in mind. The market offers endless choices, limited only by your imagination and your bank account. (See “What’s It Worth?” for some good news about costs.)
|SureHands Lift & Care Systems help users get into a regular bathtub.|
Creating a bathroom to meet all of your expectations and needs is as daunting as it is exciting. If you’re thinking of remodeling your bathroom to make it safe and functional for a family member’s progressive neuromuscular disease, start by asking yourself these questions:
For sources and more suggestions about the bathroom choices mentioned here, see “Bathroom remodeling resources.”
Beginning with the bathtub, what do you want to improve upon?
Questions about size, therapeutic jets, access and design considerations will lead you to more than 400 bathtub styles on the market today. They come in every conceivable size, shape and color. More important, they can come with a door in the side, whirlpool jets, a seat and headrest; or try a state-of-the-art cushioned bathtub made of nonporous polyurethane that conforms to the contours of the body.
This is not your grandma’s bathtub!
Who doesn’t like to soak? But getting in and out of a bathtub can present challenges. Some companies will create a cutout in your existing tub to allow the user to step in.
Or consider electric lifts that can be operated independently or portable manual lifts that require an attendant for operation. Be sure your ceiling reinforcement is adequate for an electric lift, which can run on an embedded track to specified areas.
Free-standing or wall-mounted folding benches enable a person to use a bathtub without sitting on the tub floor. This means less effort to exit the tub since the chair usually sits at the same height as the tub walls.
|The owner of a 100-year-old house retained its clawfoot tub, which he uses with the aid of a lift.|
|Best Bath offers grab bars that are useful for bathers and parents, too.|
|Premier Bathrooms Cambridge model features a cut-out door for easier tub entry.|
|A threshold ramp such as this one from Prairie View Industries can allow you to enter a shower that isnt level with the floor.|
Bath transfer benches and chairs span across the rim of the tub or shower. Some brands feature a seat that slides and/or swivels: The bather sits on the chair on the outside of the tub and then slides the seat into the tub, leaving only the legs to be lifted into the tub. Some models collapse for storage and portability and feature cutouts on the seat for personal hygiene.
Water therapy isn’t just for pro athletes any more. Adding whirlpool jets to your tub experience not only relaxes sore muscles — it’s wonderful as a stress reducer.
Many tubs, including the cushioned or “soft” bathtub, can be factory-equipped with a carefully engineered hydrotherapy system using jets strategically placed for maximum therapeutic effect and comfort. Whether you’re installing a standard-sized tub in a traditional setting or in an alcove, or dropping it into a deck or platform setting, consider the benefits water therapy has to offer.
Show me the shower
Hand-held shower heads, also known as hand showers, can also enhance accessibility in bathtubs or showers. Some come with holders that attach to a vertical bar (which can also serve as a grab bar) so the hand shower’s height can be adjusted to the user.
Showers are easier to get into and inherently less dangerous than bathtubs. There’s also a surprising diversity of styles for showers, reflecting the latest buzz words in accessible designs — “universal,” “curbless,” “roll-in” or “barrier-free.”
Shower construction and installation can be even more intimidating, but not necessarily more expensive, than bathtubs, and showers usually require less space.
Basic new shower options are to:
With any of these options, the roll-in shower is extremely versatile and “universal” for the needs of many. (Always check your local building codes and regulations when installing a shower unit yourself as they vary by community. Recommendations that follow are general guidelines.)
Purchasing just the shower base allows you to select the entry and drainage control, while taking into consideration your foundation construction. It also lets you create shower walls to your own taste and needs (i.e., grab bars and plumbing fixture placements).
Floor entries can vary from a low threshold to a retractable threshold or, if the unit is large enough, a no-threshold or curbless entry, meaning the transition is completely flush between the entry and bathroom floor. Purchasing just the shower base doesn’t offer the wide flexibility of a custom-built shower but it does permit the precision of a manufactured level floor transition.
If there’s any threshold into the shower, you can solve that problem by adding a threshold ramp that will allow you to roll in. Ramps are available from about 6 inches to 34 inches wide, with a rise ranging from less than 1 inch to about 6 inches. Threshold ramps, which are also used to allow a wheelchair to go through a doorway, can be attached to the floor with screws or adhesive.
Prefab or custom?
Shower option 2 is to buy a complete prefabricated shower unit. These are easy to keep clean, less challenging to install than custom units, and come in hundreds of sizes, styles and package options.
In contrast, custom-built units or custom walls on a prefabricated base require close attention to both water-proofing and detailing. The totally prefabricated shower unit eliminates most of the waterproofing issues, leaving mainly the joint between the room floor and the shower floor to be addressed.
|The authors new home has a roll-in shower with hand rails, fold-down seat and lowered shower head.|
|The Easy-Bathe from Premier Bathrooms is a complete prefabricated shower unit.|
The downside of a modular shower unit is that the shower floor must be shallow to achieve a level transition between the shower and the room floor. Most of these units are set on your existing floor and have low thresholds or curbs to retain water.
Additionally, the shallow modular units don’t have the structural integrity of units with large curbs or deep floor basins. Therefore, it’s important to select a prefabricated unit with a reinforced base around the entry and/or a honeycomb cell construction that provides better overall construction.
Custom-built showers are usually lined with tile, and their size is limited only by the available floor space. Select a larger-sized wall tile and colored grout for ease of cleaning and a smaller, abrasive or textured shower floor tile for better traction. With proper ventilation, a good 15-year tile/grout sealant, and a mixture of bleach and water, tile isn’t difficult to keep clean.
A custom-built shower must be recessed into the floor system to create an accessible entry, and the floor structure re-engineered to accommodate the “dropped” floor. In both wood frame and concrete slab floors, a waterproof “membrane” is necessary to form the bottom of the shower pan and extend up into the surrounding walls and out into the floor area adjacent to the shower.
Naturally, a custom shower requires more careful detailing and construction than a prefabricated unit, but custom design offers more options, better water control and greater usability.
Length and depth (from the entry to the back wall) of a shower are critical. The larger the shower, the easier it is to gradually slope the shower floor to the drain and still contain water.
The minimum recommended depth of a no-threshold shower is 36 inches but even at that, careful attention must be paid to the floor transition. A depth of at least 48 inches is recommended with the bathroom floor at least 2 inches higher than the drain flange. With a 60-inch deep shower, you can easily use a no-threshold entry.
In a roll-in shower, curtains become a very big deal for controlling water. When there’s no curb at the shower entry, there must be a seal using a shower door or curtain. Select a curtain large enough (or Velcro two together) so that not only are your entry walls sealed but the curtain is in contact with the shower floor just inside the entry. Weighted curtains work best for this purpose.
Shower doors with a rubber flange at the bottom can provide a better seal than curtains, but they’re more expensive. Their size and rigidity can also restrict maneuverability. Common choices are either pleated or swing-out doors, and both are “trackless” with no frame to be stepped or rolled over.
|The touchless EZ Faucet can be mounted on any standard faucet.|
What's in a faucet?
Accessible hardware or specialized fixtures can transform any shower, sink basin or bathtub, and further enable use by someone with muscle weakness or limited dexterity. Single levers operable with one hand that don’t require twisting the wrist or tightly grasping the control are ideal.
Other options include electronic faucets with sensors that “see” when to turn the water on and off. These fixtures are more expensive, but boast no-hands operation, water-saving efficiency and accessibility.
Faucets can make or break the functionality of your remodeled bathroom and they don’t need to be fancy or expensive to do the job right. Look for lever-handled (L-shaped) fixtures for your sink, bathtub or shower, and even on a hand-held shower fixture for ease of use.
Many showerheads and bath fixtures come with an antiscald valve but it can also be added inexpensively to an existing fixture. Always check your sink’s current faucet spread and placement before purchasing new fixtures (most are center-set with a 4-inch or 8-inch spread).
|A standing walker from Clark Medical makes toilets accessible.|
|A full-size commode chair from R.D. Equipment.|
Existing bathroom sinks can sometimes be made wheelchair-accessible by removing cabinets underneath them. Remember to cover the plumbing with appropriate material to protect against scrapes and burns. Wide but shallow sink basins also enhance accessibility.
A throne of choice
There’s a wide selection of toilets these days, too. Most of the options center on what type of flush you prefer — gravity, pressure-assist or power-assist. We all know the pros and cons of the traditional gravity flush so to rid yourself of the dreaded plunger, try the pressure- or power-assist flush with your next toilet.
The less expensive pressure-assist style advertises its power as “robust” and “plug resistant.” The downside is that this turbo toilet is noisy and splashy, and requires a moderate degree of strength to flush the lever.
On the other hand, the power-assist toilet with a 0.2-horsepower electric pump is quiet, saves water and requires much less strength to flush. Its downside is that it depends upon electricity and is rather pricey.
Whatever your selection, it’s highly recommended you go with the elongated style and the 17-inch tall toilet (plus another inch or two with the seat) for ease of use whether you depend on a wheelchair or not. After all, this is your throne. (A 17-inch toilet is even with a manual wheelchair seat; a 20-inch toilet is the same height as a power chair seat, but remember, you gain additional inches when you add the toilet seat.)
Standard toilets can usually be modified by adding a raised seat or a spacer underneath the base. Rails (toilet safety frames) can be installed on either or both sides for added assistance.
A stream of water provides personal cleansing after toileting. Many bidets can be attached to standard toilet seats, and some models boast remote control, warm water, built-in heaters or natural water features.
Grab bars that grab your attention
Once, grab bars came only as straight silver-colored metal bars. Not so any more. Today they come in a wide array of colors, shapes and sizes to accent your home’s décor while providing safety and independence in your bathroom.
|Grabit offers portable grab bars that can be locked into place without drilling, and then removed.|
Dozens of colors and styles are available when you select a bar with a core of anticorrosive aluminum or galvanized steel covered in a nonporous, nonslip seamless nylon tube (often referred to as HEWI nylon and developed by a European company).
For example, there are corner bars in L-shapes, upside-down T-bars that include a hand-held showerhead holder, and flip-up (or swing-out) double-bar supports that include a toilet paper holder. These types of bars also maintain a mild temperature despite any variation of heat or cold. Some HEWI bars are manufactured for mounting on nonload-bearing walls and still support a weight of 350 pounds. (Any grab bar requires close attention to installation instructions and proper wall reinforcement when indicated.)
All said, this style of bar is naturally more expensive and must be ordered, as opposed to picking up a few horizontal metal bars at your local hardware store. But consider what will work best for you, and don’t forget you have to look at them, too.
While shopping, check out heated towel bars. Or you may find hooks more user-friendly and perfectly suitable when installed at your level.
Experts say bathroom remodeling is a sound investment. The 2003 national average return rate (cost versus value) was 89 percent for a midrange bathroom remodel, as reported in Remodeling Magazine. It’s safe to say your dreams about the therapeutic whirlpool tub, spacious roll-in shower or to-die-for tile floor can come true because you’re likely to recover most of the money you put into a bathroom remodel when you sell your home.
“What’s it going to cost?” (below) gives a cost range for many of the items mentioned here. For savings, you might consider consulting with a certified bathroom designer who’s associated with professional buying groups and dealers, thus offering you competitive pricing and expert guidance.
Web sites also offer computerized design services, innovative ideas and products, and instant quotation tools or estimators for your remodel. (See “Bathroom remodeling resources.”)
And don’t forget that some parts of your bathroom remodel may be tax deductible as a medical or work-related expense.
A major bathroom remodel can cost as much as $20,000 or more, but much of that cost will be added to the eventual resale value of the house. If you’re looking to update one feature at a time, here are some price ranges for products discussed in this story.
Always check a variety of sources, including Quest ads, for competitive prices and sales. The final price also depends on what features you include; labor and installation costs aren’t taken into account here.
A Bathroom Guide
Center for Universal Design
Charles Schwab Architects
Department of Apparel, Textiles and Interior Design
National Association of Remodeling Industry
Whitespa USA Inc.
Horcher Lifting Systems
Prairie View Industries
SureHands Lift & Care Systems
Barrier Free Architecturals
Harbor City Supply
Mobility Transfer Systems
The Accessible Home: Updating Your Home for Changing Physical Needs, by Nancy Baldrica, Creative Publishing International, 2003. (Out of print, but used copies can be found online at retailers such as Amazon.com and Barnesandnoble.com.)
A House for All Children, by Richard V. Olsen, Ph.D., B. Lynn Hutchings, M. Arch., Ezra Ehrenkrantz, F.A.I.A., NJIT Press, 2000, (973) 596-3097, www.cabsr.org