Accessible Housing by Design — Bathrooms
Universal design is a concept designed to accommodate the functional needs of everyone: children, adults and seniors with or without activity limitations or disabilities.
One of the goals of universal design is to maximize the usability of environments. Everyone appreciates having a well-designed bathroom that is safe, spacious, relaxing and easy to use.
The successful design of a universally accessible bathroom starts with identifying potential users and anticipating the needs of all family members and visitors who will use the bathroom.
One of the latest design trends involves the creation of spacious bathrooms that incorporate a variety of features and flexibility of use. As a result, bathrooms become more adaptable and comfortable for individuals and families. The concept of universal design, whose objective is to meet all users’ needs, is incorporated into many bathroom features such as bathtubs, showers, lighting and flooring.
By providing flexibility in the selection of design features and incorporating adaptability into bathroom design, the life and usability of a bathroom is extended, which promotes the concept of “aging in place.”
This concept is increasingly popular with families and individuals who choose to stay in their homes and neighbourhoods as they grow and age. Planning for individuals’ changing needs and abilities allows for periodic bathroom customization based on changing requirements and reduces the need for future costly renovations.
— Large accessible bathroom
A universally designed bathroom should be comfortable and safe for all family members. Give consideration to all of the design elements associated with the bathroom:
- size and location of the bathroom within the house;
- configuration of the toilet, bathtub and shower within the bathroom;
- type of tub or shower you prefer;
- floor and wall coverings;
- safety issues such as slip resistance of the floor, the presence of grab bars or support rails;
- storage requirements;
- types of lighting; and
- overall use of colour and space.
Planning for future needs is good practice. Principles of universal design and FlexHousing™ also encourage flexibility, adaptability, safety and efficiency.
- How many bathrooms do you have? How many people share the bathroom?
- Do you need to have easy and quick access to a bathroom?
- Do you and your family prefer to use the shower or a bathtub?
- Do you have a disability that has an impact on the way you use the bathroom?
- Do you require assistance using the bath or shower?
- Do you worry about a family member who lives with you or often visits who might fall in the bathroom?
These are important considerations that will help you identify your bathroom design requirements. Your requirements should also address the following factors:
- Efficient design
- Minimal effort
- Ease of cleaning
- Manoeuvring space
Creating a bathroom that maximizes safety and convenience is the cornerstone of good design.
Begin with general planning issues such as the location of the bathroom within the home. Is there an accessible bathroom? Is there a bathroom on each floor? Is there only one bathroom serving a number of people? Is there a bathroom for visitors? Is there an ensuite bathroom?
Traditionally, bathroom designers have focused on the configuration of the bathroom fixtures within a small area. Homeowners are increasingly looking for larger bathrooms, particularly in newer homes with a shower and spa or bathtub, as well as a toilet, one or two vanities and maybe even a urinal or bidet.
— Grab bars beside the toilet
This trend to larger bathrooms allows for easier manoeuvrability for people as they get older and may need to use a mobility device. However, people with very limited mobility may find they need to plan for support as they move around a larger bathroom. If you have limitations in your mobility or balance, it is important to consider additional safety issues such as the placement of controls within easy reach (see Figure 2) and the presence of grab bars beside the toilet and near the bathtub or shower.
Designing a safe bathroom also involves preventing falls. Falls frequently occur in the bathroom but they can be avoided with careful planning and selection of materials. Bathrooms should have a vertical grab bar mounted on the wall for people to hold onto as they get into and out of the bathtub or shower. Tubs and showers should have a non-slip surface and the bathroom should have adequate lighting and ventilation.
Designing for minimal effort is an important principle of the universal design concept. Planning for efficiency considers the location and relationship of the elements within the bathroom. This will result in the placement of related items together within the bathroom. Placing the storage for make-up and medicine near the vanity/sink area is logical. Placing towels and bathing supplies near the bath or shower reduces the need to walk around the bathroom while wet.
Flexibility and efficiency of effort can be achieved through such design considerations as providing storage options at a variety of heights, a range of lighting options, adequate place to sit down in front of the washbasin, and a vanity with room for storing materials where they can be easily seen and reached. Extra storage space may be required by some people for equipment such as shower wheelchairs or bath benchs.
If the bathroom is large enough to include a washer and dryer, please see CMHC’s About Your House fact sheet Accessible Housing by Design — Appliances for additional design suggestions.
An excellent time to think about how to prevent falls is when you are redesigning or renovating your bathroom. Grab bars, non-slip surfaces, adequate lighting and ventilation should be integrated into your plans.
— Grab bars in the shower
Adaptability can be achieved by installing a shower head on a vertical slide bar so that it can be adjusted and set at a variety of heights; by providing a raised seat for the toilet and grab bars that fold down; by using drawers for storage; and even by pre-programming temperatures for the shower.
Consider the manoeuvring space within the bathroom for your current and future needs. If you might require assistance through the use of a ceiling lift, ensure ceilings are reinforced to support its installation. See CMHC’s About Your House fact sheet Accessible Housing by Design — Residential Hoists and Ceiling Lifts for further information.
Ease of Cleaning
Photo by: Norbert Koeck
— Ease of cleaning
When making decisions about the selection of bathtubs, floors, toilets and showers, remember to take into consideration the surface finishes. For example, wall and floor surfaces in the shower should be designed to drain fully to prevent mold from growing. Adequate ventilation in the bathroom is extremely important to eliminate moist air and the potential for mold or mildew growth. Flooring should be slip resistant, yet easy to clean and maintain.
Minimal effort should be required to clean the bathroom. Plan to eliminate the presence of difficult-to-reach areas and select materials that do not need special cleaning supplies (see Figure 4).
Bathroom cleaning products should be stored in easy-to-reach locations, preferably in drawers that slide out so that the products can be easily seen and reached. If family members include children, people with Alzheimer’s, individuals who are very forgetful or have developmental disabilities, careful thought should be given to the storage and security of these products.
— Dual purpose towel rack and grab bar
Safety hazards in the bathroom deserve the highest consideration. The bathroom is the site of many accidents and falls. A non-slip flooring surface is extremely important, especially when wet.
If possible, bath mats on the floor should be avoided because they can be a tripping hazard and an obstacle for many people who use mobility devices such as wheelchairs or walkers. On the other hand, a non-slip mat in the bathtub is an excellent idea to prevent a slip or fall.
Burns can be another safety hazard in the bathroom, particularly for children and people who have reduced sensitivity or ability to feel temperature changes. Mixing valves that limit the water temperature to a maximum of 49ºC (120ºF) can be installed. In order to avoid growth of Legionella bacteria, it is not recommended to lower the hot water tank temperature below 60ºC (140ºF).
Avoid sharp edges on surfaces in the bathroom to prevent injury in case of a fall and consider various lighting options. Installing grab bars is highly recommended.
There are now towel rails that have been designed to also act as grab bars and can provide support in the bathroom. The reverse is also true, grab bars may be installed and can serve the function of a towel rail (see Figure 5).
When designing a bathroom for someone who uses a walker or wheelchair, you should allow a sufficient manoeuvring space of 750 x 1,200 mm (30 x 47 in.) in front of or beside all fixtures including the bathtub, shower and storage spaces. It is especially important to consider the manoeuvring space in front of all of the controls, so that it is not necessary for someone to lean to reach them, which may result in a fall. Don’t forget to provide sufficient manoeuvring space in front of all windows and window controls (see Figures 6 and 7).
A minimum manoeuvring space of 1,500 x 1,500 mm (59 x 59 in.) within the bathroom will allow for turning around and approaching the bathroom elements. For power wheelchair or scooter users the required turning radius is larger, increasing the minimum manoeuvring space to 1,800 x 1,800 mm (71 x 71 in.), depending on the size of the mobility device. Room should also be provided for people who give assistance or care in the bathroom (see Figures 8 and 9).
Figure 9 features a bathroom design that incorporates both a shower and a double bathtub and provides sufficient manoeuvring space for either a side or angled approach to the toilet and access to the tub, shower and vanity. Note the provision of storage space and the location of the controls for both the shower and bath, which are within easy reach.
Providing a large open tiled floor and wall area with drainage not only accommodates more than one person in the shower, but it also allows adequate space for someone using a shower bench or shower wheelchair, and who requires some assistance while bathing.
Other Bathroom Design Components that Increase Usability:
- D-type handles on storage drawers;
- drawers that pull out fully and cupboards with pull-out shelving;
- hands-free faucets;
- reinforced walls that accommodate grab bars in customized positions;
- resilient flooring (rather than hard surfaces);
- lighting activated by motion detectors;
- shower head that can be adjusted to a variety of heights.
Sample Accessible Bathroom Layouts
Diagram by: DesignAble Environments Inc.
Figure 6 — A half-bath which is suitable for use as a visitable washroom
Diagram by: DesignAble Environments Inc.
Figure 7 — A half-bath which is suitable for use as a visitable washroom
Diagram by: DesignAble Environments Inc.
Figure 8 — A small accessible bathroom
Diagram by: DesignAble Environments Inc.
Figure 9 — Bathroom with shower and tub, two washbasins, toilet and storage space
The elements of universal bathroom design are:
- Flooring materials
- Switches and controls
- Vanities, drawers and storage
- Grab bars
A range of different lighting levels constitutes one design element in creating a relaxing spa-like atmosphere in the bathroom. It is also a universal design approach. A night light in the bathroom is an excellent feature.
It is also possible to install a light that gradually adjusts the rate of illumination. When you awake in the middle of the night, a motion detector activates the light, which slowly brightens so you are not overwhelmed.
Adjustable directed or task lighting also allows you to have extra illumination in key areas of the bathroom such as the vanity or shower area.
Ambient lighting should be provided to maintain an even level of illumination throughout the bathroom. (Fluorescent lighting offers the most diffused light and reduces glare.) People with visual impairments may require greater luminance to maximize their vision.
Where possible, take advantage of opportunities to maximize natural lighting, but be careful to avoid glare. Glare-free surface treatments and a soft matte paint finish are preferred by most people, especially persons with visual impairments or dementia. These finishes reduce glare and complement illumination levels, creating a more relaxing atmosphere.
Durability, ease of cleaning, comfort, and a safe non-slip surface, are some of the main considerations when selecting flooring. Slip resistance for floors should be assessed when both dry and wet.
A wide selection of different flooring surfaces exists. Marble floors should be avoided as they are very slippery, especially when wet. Vinyl flooring is available in sheets or tiles and is low-maintenance. However, it must be installed on a plywood surface, and, as a result, there will be some emissions from the glue, vinyl and plywood. A ceramic tile floor is waterproof, easy to clean and easy to wheel on.
Whatever type of flooring material is selected, ensure the flooring is installed so that it is level with adjacent flooring to avoid having a lip or rise where the different flooring materials meet. A heated floor should be considered for added comfort.
Switches and Controls
Switches and controls should all be located within easy reach and be easy to operate.
An electrical outlet should be strategically located within the reach of someone both standing and seated, either near the sink or vanity area. Other controls and switches, including the switch for the ventilation fan should be located at a maximum height of 1,200 mm (47 in.) from the floor.
It is also a good idea to think about the manoeuvring space required for the door. Adequate space should be provided inside the bathroom to allow you to close the door when you are inside. Also, for doors that swing outside the bathroom, consider installing a D-type handle on the door so that you may pull it closed once inside. Likewise, space is required to allow you to easily open the door to exit (see Figures 6 to 9).
All doors should have a minimum clear width of 810 mm (32 in.) and should be designed to maximize manoeuvring space. Pocket doors can be used, particularly in smaller bathrooms, but the hardware to open pocket doors may be difficult to operate for some people with limited dexterity. If you can, it would be best to test any hardware prior to installation.
Vanities, Drawers and Storage
Many bathrooms have two sinks or washbasin areas in the vanity. A universal design approach might be to install them at different heights. When a washbasin will be used from a seated position, a shallow sink with the drain offset to the rear is recommended. This will allow sufficient knee space and will move drainage pipes out of the way, eliminating the possible hazard of leg burns. Alternatively, the drainage pipes can be insulated.
Vanities at a height of 860 mm (34 in.) are more convenient for children, people who are shorter and people who use a wheelchair. If the person who uses the vanity is taller, he or she may appreciate a vanity at a height of 910 mm (36 in.).
Adaptability can also be achieved by installing a vanity with electrically adjustable height counters, which are available from a number of innovative cabinet designers. There should be knee space provided at the vanity for someone who uses a wheelchair, scooter or chair.
Knee space should be at least 800 mm wide x 600 mm deep (31 x 24 in.), at a height of 730 – 860 mm (29 – 34 in.), with a minimum footprint in front of 750 x 1,200 mm (30 x 47 in.).
A FlexHousing™ approach would be to install cupboard doors that swing open and retract back in under the vanity (see Figure 10).
— A FlexHousing™ approach, cupboards with retracting doors
A faucet controlled by a single lever or a motion detector is most convenient. This provides flexibility and ease of use for all family members. It is a good idea to avoid gooseneck faucets as they can splash excessively.
Faucets at the washbasin should clearly indicate the hot and cold controls; this style is particularly useful for people who have cognitive limitations. It is important to provide adequate storage at the vanity. A set of drawers beside the sink is particularly useful.
Storing related things in the same drawer or cupboard where they are easy to find is appreciated by everyone but is especially important for someone with limited mobility or a visual impairment. Some people who use incontinence supplies need to have easy access to storage near the toilet and sink area.
Installing drawers that pull out fully, to display their contents for easy retrieval, is an excellent approach. Cupboards and drawers should have D-type pull handles that are also colour contrasted to their background, which is easier for people with reduced mobility, agility or sight to use. Touch-and-release drawers are universally accessible to everyone, including people with limited hand dexterity. A contrasting colour for the interior of drawers and cupboards may also increase accessibility for people with limited vision.
The medicine cabinet or storage area for pharmaceutical supplies should be installed with the shelves at a maximum height of 1,400 mm (55 in.), if it is to be reached by someone using a wheelchair and within a reach of 500 mm (20 in.). It should also be usable by someone with limited dexterity. If there are children in the home or people who should not have access to the cabinet, it is recommended that a locking device be installed.
A full-length mirror is ideal. If there is a mirror over the vanity, it should be mounted with its lower edge at a maximum height of 1,000 mm (39 in.).
People with reduced vision should avoid bathrooms with busy patterns; many people prefer to have solid colours that provide some contrast. Some people select contrasting edging or a raised edge on the sink to help in identifying margins.
Grab bars should be 30 – 40 mm (1 ¼ – 1 ½ in.) in diameter and should have a non-slip surface. Grab bars must be installed into a wall with sufficient support (into studs or reinforced walls) to carry your weight. A space of 35 – 45 mm (1 3/8 – 1 5/8 in.) is recommended between the grab bar and the wall, with sufficient clearance above the grab bar to allow you to grasp it.
The CSA Standard B651 requires that grab bars be mounted so they provide a minimum support of 133 kg (approximately 290 lbs). An excellent approach during construction is the structural reinforcement of the walls surrounding bathtubs and toilets for grab bar installation, thereby preventing the need to remove the tiling and walls at a later date. This approach also allows for customized location of the grab bars to suit the user. Using 16-mm (½-in.) plywood, reinforce the areas behind and beside the toilet, starting at a height of 450 mm (18 in.). Reinforce the three walls around a bathtub or shower stall up to a height of 1,200 mm (47 in.).
Grab bars near the toilet
Grab bars should be provided beside the toilet for support. Fold-down grab bars are particularly helpful in installations where there is no wall beside the toilet (see Figure 11). Another advantage of fold-down grab bars is that they can be folded up out of the way for use by other family members.
Photo by: Lisa Blanchard
— Fold-down grab bars do not restrict usage of the facilities
Most people prefer a horizontal grab bar on the side and back walls although others might prefer a fold-down grab bar due to space limitations.
Grab bars beside a toilet should be mounted at a height between 750 – 850 mm (30 – 33 in.), depending on individual preference. They should extend at least 450 mm (18 in.) in front of the toilet seat to allow them to be grasped while transferring from a wheelchair.
The grab bar behind the toilet should also extend horizontally at least 600 mm (24 in.) in length.
Grab bars in the shower
A vertical grab bar at the entrance of the shower area should be mounted at least 80 – 120 mm (3 – 5 in.) from the outside edge of the shower enclosure and with its lower end at a height of 600 – 650 mm (24 – 26 in.) from the floor. It should extend at least 1,000 mm (39 in.) in length to ensure it can be easily grasped by everyone. To ensure universal accessibility, the shower controls should be intuitive, easy to operate and be easily reached.
Grab bars near the bathtub
Getting safely into and out of the bathtub, especially for older people and individuals with balance limitations can be a challenge. Bathtubs are one of the most common locations for falls in the home. A vertical grab bar on the wall beside the bathtub is highly recommended for everyone. It should be a minimum of 1,200 mm (47 in.) in length and mounted immediately inside the bathtub enclosure.
Grab bars should be installed to suit the particular user or users. Most people prefer a horizontal grab bar along the side walls although others might prefer two grab bars, one horizontal and one vertical to assist in getting out of the tub, as illustrated in Figure 12. For more information, see CMHC’s Research Highlight: Evaluation of Optimal Bath Grab Bar Placement for Seniors.
Photo by: Betty Dion
— Bathtub with grab bars, adjustable height shower head and a bath bench
A horizontal grab bar installed to meet your needs should be placed at a height between 180 – 280 mm (7 – 11 in.) above the rim of the bathtub. Another common installation is a vertical grab bar in a location that you can reach while seated in the bathtub.
The market offers a wide range of toilets; it is important to select one that meets your needs. A low water volume or dual-flush toilet is an excellent sustainable option.
A back support on the toilet will provide stability and assist those with balance limitations. Some toilets have an automatic flushing feature. Some people who use wheelchairs prefer a wall hung toilet as it provides additional manoeuvring space below the toilet.
Manoeuvring space at a toilet must be carefully considered. If there is someone in the household who needs some assistance or may require it in the future, it is important to provide adequate space for the caregiver, either in front of the toilet or beside the toilet. Additionally, if you approach the toilet while using a wheelchair, you may approach from the side, the front or angled from the side. Consider your personal preference and space requirements (see Figure 13).
Photo by: Betty Dion
— A toilet with back support and sufficient transfer space adjacent
The CSA Standard B651 specifies a range of heights for the toilet seat from 400 – 460 mm (16 – 18 in.). Children and some people who use a wheelchair and transfer independently prefer a lower height as it is easier to use. Alternatively, many older people prefer a toilet that is a little higher as it easier for them to get up and down. Care must be taken not to have a raised toilet seat for someone at a height where their feet do not touch the floor as this may affect their ability to balance.
The toilet should be installed with its centre line between 460 – 480 mm (18 – 19 in.) from the wall. This ensures that grab bars are within reach for those transferred onto the toilet.
The flush control should be located within easy reach, on the open transfer side of the toilet. The placement of the tissue dispenser should also be carefully considered so that it is easy to find and does not interfere with the use of the grab bar. It should also be within easy reach, not requiring that someone lean too far over to the side or reach back. An excellent idea for people who have limited hand function is a toilet that sprays water for cleaning followed by hot air for drying (see Figure 14).
Photo by: Betty Dion
4 — Toilet with built-in water sprayer and dryer
In some tiled bathrooms with a drain in the floor, there is a flexible shower hose located beside the toilet for ease of cleaning.
Some homeowners have chosen to install a urinal in their bathroom to better suit their needs. Grab bars can be installed on the walls to further increase its usability.
The universally designed accessible shower is increasingly appearing in “wet rooms” or “spa bathrooms” in Canadian homes. They are large tiled areas with one or more shower heads and appropriate drainage. These showers accommodate more than one person, children, persons who use a mobility device and even the family dog.
The floor should have positive drainage, and the water should flow to the drain via gravity. The drain should be located to the side where people will not be standing or wheeling on it.
Shower controls should be located so that they are easily reached at a maximum height of 1,200 mm (47 in.). A handheld pliable shower hose increases flexibility and usability. The hose should be a minimum of 1,500 mm (59 in.) long or even longer if it is to be used by someone seated on a shower bench or seat (see Figure 15).
Photo by: Betty Dion
— Accessible shower with fold-up bench, easy-to-reach controls and adjustable shower head height
Shower heads at a variety of different heights and positions are increasingly being installed by builders.
Shower controls should be intuitive and easy to use by everyone. Water temperature can be controlled before it reaches the shower or bathtub and should be set at a maximum temperature of 49°C (120°F). Colour and texture can be used to reinforce information on the controls.
Wheel-in showers are preferred by people who shower from a seated position, on a shower wheelchair or a bath seat. Caregivers also appreciate the increased space. A wheel-in shower should be at least 750 x 1,500 mm (30 x 59 in.) and should be equipped with both a vertical and horizontal grab bar. Care must also be taken to provide adequate clear manoeuvring space of 900 x 1,200 mm (35 x 47 in.) outside of the shower area.
Some people may use a portable shower seat; others may prefer a fold-down bench, which should be firmly anchored. The seat should allow easy access to the controls and be constructed with a non-slip surface, which is particularly important in view of the slippery nature of soaps and shampoos.
Some children and adults with disabilities prefer to have a change table on which they can lie while getting dressed or being assisted in dressing. The table should be a minimum of 1,500 mm (59 in.) in length and 800 mm (31 in.) in width and should be installed to support the weight of the user.