Bathrooms are the most dangerous room in a home, according to the U.S. Centers for Disease Control and Prevention. They tell us that of the 235,000 people who go to an emergency room every year because of an injury in the bathroom, more than 80% are from slips and falls. Stepping in or out of a bathtub or shower with wet feet, inadequate area lighting, narrow doors and improper use of color contrast are all causes of falls.
Now add in lighting and vision. About 65% of us wear eyeglasses, but we don’t use them while bathing! Many factors can lead to a fall for anyone, at any age, but falls for elderly people are much more dangerous and can lead to broken bones, neurologic injuries and more. Industry professionals are now learning how to improve designs and recommend products that reduce the chance of a fall. Fewer falls help our clients stay in their homes longer, with independence and dignity.
Our Role in Bathroom Safety
Kitchen and bath designer Julie Schuster, Certified Living In Place Professional, says it well, “When we help a client remodel their bathroom, if they have any physical challenges, we always listen to an occupational or physical therapist. Then, based on the medical professional’s recommendations, we recommend features and products that improve safety. Support bars are one of the most important features to add, but few want to talk about them. But as a trained designer, I always want to make the environment aesthetically pleasing and offer suggestions to make their home more safe – healthy – comfortable.”
Essential Bathroom Features to Minimize Slips and Falls
Here are a few of the features to consider for all bathrooms, regardless of the residents’ ages or abilities:
Towel and Support Bars:
Specify models that can support a person if they start to fall. They should be installed to support 250 pounds force in any direction and have sufficient color contrast to the walls to make them easy to see.
Folding Support Bars:
A medical professional may recommend a support bar near the toilet, either wall or floor mounted.
Choose flooring that has a high Dynamic (moving) Coefficient of Friction (DCOF) rating, a measurement that helps us choose flooring based on safety as well as aesthetics.
Throw them away! Yes, these are nice to step on coming out of a tub or shower, or while standing in front of a sink, but a high difference in DCOF to the floor, plus the difference in floor height that feet may catch the edges, and improper color contrast may cause a fall.
Stepping over a bathtub or shower curb is dangerous. Instead recommend shower entries with a no-step entry.
A Place to Sit:
Many of us would benefit from being able to sit while showering or bathing. Folding wall-mounted seats are often the best solution or a properly installed permanent bench.
One common bathing area feature is the Listello Stripe or what a medical professional would call a horizon line. Besides making a bathroom look great, this feature can help a person stay in balance and provides a depth-perception cue to how far they are from the wall. Typically installed about 60 inches above the floor, with a 20-point minimum light reflectance value (LRV) from the wall.
For many people, heated flooring is a luxurious experience. But this feature is a necessity for someone with peripheral neuropathy—according to the Cleveland Clinic, an estimated 25% to 30% of Americans will be affected by one of over 100 types of neuropathy.
For many, stepping onto a cool floor will create a pins-and-needles or a burning sensation. Plus, heated floors help evaporate water faster, reducing another slip hazard.
There should never be a threshold entering any room. This is especially important for persons who use a wheelchair or walker, or those who have difficulty walking.
Ease of Use and Comfort
There are many other features that make the bathroom experience better for everyone.
Shower and Tub Controls:
Always install controls near the opening, up about 44 inches to the center, with a support bar nearby. To minimize water temperature changes, the best choice is a thermostatically controlled valve.
To allow a person to easily see the door, add an etched line, similar to the horizon Line discussed previously, or use frosted or textured glass. The door handle should be vertical, to help identify the door opening as separate from a horizontal support handle.
Lighting and Controls:
Install switches 44 inches center above the floor (the same for all controls throughout the home). Consider occupancy-sensor devices, illuminated switches and, of course, always use LED lights with adjustable K values.
Drawer and Cabinet Handles:
Always use handles with closed ends to prevent catching clothes or a towel on the handle. These are often called C or D styles. Who has not gotten snagged on a knob or protruding handles?
Wider Doors That do not Swing in:
Doors should be a minimum 36 inches wide to allow access for everyone, whether walking, using crutches or a walker, using a wheelchair or carrying a child. If the door swings inward, a person who falls may be near the door, preventing someone outside the room from opening the door to help. All bathroom doors (as well as other doors) should swing away from the room, or a pocket or lateral sliding door should be installed.
The toilet seat should be about 18 inches above the floor—a standard chair height.
These toilets are installed at any height most comfortable for the user. And because they have no toilet base, there is more floor space and they are much easier to clean.
The comfort of a heated seat is only surpassed by the benefits of a full-functioning personal hygiene toilet seat (similar to a bidet seat). Common in many parts of the world, they reduce the need for a caregiver, can reduce bacterial infections (most often, urinary tract infections) and can minimize or eliminate the need for toilet paper. (Always install a GFCI-controlled outlet behind every toilet; it is also useful to plug in a water-leak sensor.)
A detachable shower head installed on a vertical sliding bar (that can hold minimum 250 pounds weight) helps everyone. They work for persons of different heights, a person sitting and they even help when bathing a child or the family dog.
In the bathroom, we are often not fully dressed and have wet skin. Additional heat adds personal comfort. Common devices include infrared ceiling lights, wall heaters and toe-kick heaters (placed away from feet).
Not only do they play music or your favorite news or radio station, but they can also be invaluable by allowing you to connect outside the bathroom in case of an emergency or just to answer a phone call.
We have come a long way from a pump handle outside the house and a bucket of water inside. Options now range from traditional two handles to lever-style to motion-sensing, touch-activated or voice-controlled. Because of concerns of surface-borne pathogens, these new ones are now even more popular. Look for materials that resist contamination.
Electric Outlets Under Sinks:
Now that we have voice-controlled faucets and water leak sensors, an electrical outlet is needed under every sink. Plus, they allow for rechargeable toothbrushes, shavers, hair dryers and more.
Minimizing moisture in the bathroom helps prevent mold and foggy mirrors. Fans that exhaust the moist air to the outside can be automatically activated, operated by a digital timer or manually operated by a simple wall switch.
Options now include lighted frames; tilting or pivoting mirrors, heated to prevent fogging; and even those with an integrated television or computer screen. These allow everyone to see better, adjust for different person’s heights and check the weather, calendar events and emails.
Home Inspectors’ Important Role in Bathroom Safety
This is only a start for what should be considered essential safety features in every bathroom. Keep in mind that if your client or any of their family or guests has a suspected medical condition, a medical professional such as an occupational or physical therapist should be involved in designs and product choices. Remember everyone’s role, everyone’s responsibility is to learn more and make all homes safe, healthy, comfortable for everyone!
Watch for the virtual Showcase for Living In Place at the upcoming Kitchen & Bath Industry Show,February 9-12, 2021. www.LivingInPlace.Institute.
The opinions expressed in this article are those of the authors only and do not necessarily reflect the opinions or views of ASHI. The information contained in the article is general and readers should always independently verify for accuracy, completeness and reliability.