How the bathroom has become less challenging for the physically disabled

Recently, during a conversation with some friends, the subject of my work in health care came up and after a while my friends started asking me questions of how most of my clients handled their daily activities that occurred in the bathroom. I entertained their questions to the best of my ability, choosing to give them a more basic or general idea of what is involved for a disabled individual making their way about the bathroom in their home and including descriptions of the various mobility aids that are available to assist them making sure that I did  not get too bogged down with specifics of such things as brand names of the manufacturers of these bathroom-based aids or the variations in each type (or class) of assistive device.

  In no particular order, I would like to review here the things that I covered during that conversation. One of the more obvious needs of the disabled individual in the bathroom is the need to have unfettered access to the commode; being able to maintain an effective and regular bowel routine is obviously of the utmost importance and naturally there are mobility aids designed to facilitate this need.

  If someone who is physically disabled is not on a colostomy pouch system and still needs to use a toilet for their bowel routines then an obvious concern is how to use a toilet efficiently. A popular way of doing this is to use a commode chair.  The commode chair is basically a metallic skeletal chair frame (at least I think that they are mostly designed with a metallic frame by most manufacturers for increased durability) on wheels which the individual sits upon over the toilet. The chair allows for the user to either perform their routine directly into the toilet or to have a collection bucket hooked up underneath the seat. An added benefit of the chair's design is that it is effectively waterproof and can also be used in the shower as a shower chair, so that you can go directly from the toilet to the shower without the need for any transfers. Soap scum and the eventual build up of rust need not be a problem provided the chair recieves an occasional wipe down after use.

  The commode chair will often include some kind recline function that allows the user to adjust the incline of the chair to better suit their preferred angle of recline, movable arms that can be raised and lowered as needed to allow for easier transfers to and from the chair, as well as removable safety belt that can be used to help keep the occupant safely in the chair.  It is important that when the owner of the chair first receives it, that they take the time to make sure that it is a proper fit over their own toilet bowl - when the chair is first delivered.

  Another empowering device in the bathroom is the familiar and increasingly popular walk-in bathtub.  you may have also heard this kind of tub referred to as a kind of handicap bath tub, however I prefer to avoid references to  handicap bathtubs as being a somewhat pejorative label in its nature.  As many have seen in commercials on television, this is basically a bath tub that is equipped with a hinged door for easy access as well as a shower nosel and controls that are easily accessed from inside the tub by the user. These tubs are also designed to fill and drain  efficiently to reduce the amount of time spent in the tub.

 One form of shower that I have become familiar with through my work is the walk-in shower.  This is basically a shower that is at an even level with the bathroom floor to make it possible for someone in a commode chair to easily be rolled into the shower area. The floor of the shower will have a drain and a minor depression in the center to keep the water collecting towards the middle instead of spreading out towards the rest of the bathroom.  This concept of floor drainage behind the shower is why it is very important that the floor tile is properly laid out at the time that the bathroom is first constructed, or at a later date if the walk-in shower is instead a modification to the original bathroom layout.

  When a physically challenged person is still able to use a standard style bathtub in their home, one safety feature that is often found installed alongside the tub are steel safety rails that are usually located horizontally along the front of the inner wall of the tub and vertically along the wall next to the front of the tub where it opens out towards the rest of the bathroom.

  Other areas of the bathroom which you might find supportive safety bars are on the walls adjacent to the toilet, in both vertical and horizontal alignment. Sometimes my clients have even had supportive standing poles installed near their toilet to help them more safely sit on and get off of the toilet.

  In many apartments, I have noticed clients have had a ceiling lift system installed which allows them to be easily transferred both on and off their toilet, as well as on and off of a standard shower chair. The great thing about the ceiling based lift system is that it is an unobtrusive method of transfer: there are no space or maneuverability issues to deal with such as those you might face working with a more traditional floor lift, since you do not have to deal with accommodating both the manual lift and the wheelchair in the bathroom at the same time. In cases where the manual lift is being used, sometimes the bathroom cannot accommodate both at once and the person I work with has had to actually transfer into the commode or shower chair outside of the bathroom and then be brought into the bathroom and, of course, be brought back out of the bathroom to be removed from their shower chair afterward, whether it is to be transferred into a different wheelchair or onto their bed.

 One final feature of most, if not all, of the bathrooms in  apartments that I have assisted people in is the presence of a sliding door in which the actual door slides into the wall.  This of course is considered more access-friendly for someone who is accessing their bathroom from the confines of a wheelchair and who doesn't wish to deal with the extra backward and forward motions necessary to open a conventional door.