For wheelchair users, accessibility to the washroom and its various facilities, one of them being the shower, is of critical concern. Without the proper clearances through hallways, doorways, and inside the bathroom, basic hygiene practices can be near impossible to manage.
The basic shower stalls being primarily designed to be used standing can easily be accommodated with proper clearance and accessibility equipment to facilitate the activity.
The following guidelines, based on ADA recommendations, will provide you with an evaluation of the possibilities in your bathroom.
Step 1 - Define Minimum Floor Space
1.1 - Measure Space
Start by checking the floor space in your bathroom. An accessible bathroom with a shower needs to be larger than 54 square feet (five square meters) to provide a turning circle to maneuver the wheelchair.
The very minimum size for a wheelchair is 30x47 inches (750x1,200 milimeters), but keep in mind that they’re made to be adjustable in width and in length.
This makes it necessary for the confined space of the bathroom to provide a clear space of 60x60-inches (1,500 x 1,500mm) for a wheelchair to be taken in and spun around 180° without any obstructions from the toilet, the sink, the shower, or even the door.
This turning space can also include the space under the fixtures as long as there’s enough room for the feet to pass.
1.2 - Account for Door
Since most bathroom doors swing in, make sure the 60x60 inches clear space is not hampered by the swinging door, which must open a full 90°. If this isn't an option, you can always consider installing a pocket door or making it an outswing door. Possibly just switching the hinged side will be enough.
1.3 - Make Sure You Have Turning Space
If you have a smaller bathroom, it could still be made to work out if it provides a turning space that is T-shaped with 36 inches (914 mm) wide aisles while making a three-point turn.
1.4 - Keep the Front Clear
Keep in mind that to allow for a frontal approach to a fixture, there should be a clear space of 30 inches wide by 48 inches deep (760x1,200mm) in front of it to accommodate the wheelchair.
Step 2 - Consider Bathroom Expansion
If the bathroom is too small to accommodate a wheelchair, consider the possibility of adding extra floor space from adjoining rooms. You could maybe remove a wall to gain the space from a closet, a spare bedroom, or some other rooms.
If you’re not missing much more, sometimes rearranging the fixtures along the wall, or replacing fixtures with more compact ones can offer extra possibilities.
Step 3 - Bathroom Accessibility and Maneuverability
3.1 - Compare to Guidelines
By ADA guidelines, an accessible route to the bathroom should provide 36 inches (920mm) of clear width between the walls without any obstructions, with a bathroom door threshold of at least 32 inches (810 mm).
A swing door must provide such clearance taking into account the door frame, the space used by the hinges, and the door itself protruding from the hinge pivot point.
Since ADA guidelines don’t necessarily apply for private homes, the clearance between the walls can, if necessary, be reduced to a very minimum of 32 inches (810mm), providing that there isn’t any protrusion whatsoever from the sidewalls to hamper a wheelchair passing through.
The ADA offers an extensive list of specifications that should be consulted concerning the accessibility to the bathroom with a wheelchair and from different directions, all available online for every specific situation.
Word of Caution—With the flexibility to adjust wheelchairs making them available in all sorts of dimensions, make sure you check the overall width and depth of the wheelchair before making your final decisions.
3.2 - Level the Floor
The floor area within the required clearances for maneuvering a wheelchair should always be level and clear of any obstructions even across the threshold—although a 1/2 inch (13 mm) maximum raised threshold can be acceptable providing it is further beveled with a slope not exceeding a 1:2 ratio.
Step 4 - Decide on the Right Shower
You can choose from two types of accessible showers. The transfer shower is where you transfer from the wheelchair to the shower seat with transfer boards or other accessories while the roll-in shower lets you inside the shower while staying in your “rolling shower chair.”
4.1 - Consider a Transfer Shower
If the available maneuvering space area of the bathroom is absolutely restricted to the minimum clearances allowable, you’ll probably be limited to using a transfer shower, which will require either caregiving assistance or an accessory like a slideboard to use.
A shower seat between 17 to 19-inches in height can be built-in but if someone else using the shower prefers not to use it and wants to move it out of the way, you could go for installing a secured retractable or a folding seat or even use a portable stool.
In any case, the shower should have a minimum inside dimensions of 36x36 inches with a less than 1/2-inch curb at its entrance.
4.2 - Consider a Roll-In Shower
With a minimum and beveled curb, the ADA compliant roll-in shower should have an inside dimension of no less than 60x30 inches offering a much more secure venue and privacy when attending to your personal hygiene.
The curbless shower which is sloped down to the drain is ideal when using a wheelchair or a walker and is safer for everyone.
4.3 - Consider a Wet Room
An option that is becoming quite popular is transforming the current bathroom into a “wet room” which is basically a one-level bathroom rendered completely waterproof after installing a shower pan into it, level with the floor but also sloped gently towards a linear drain at the far edge.
Once the assembly is properly reinforced and completed, it is then completely waterproofed before the bathroom floor along with the shower tray gets tiled over providing curbless access to the shower area.
4.4 - Consider a Slight Curb
A simpler alternative to the shower pan is the solid surface shower base with a low profile curb, leaving you with a slight curb that can present an offset of 1/2 (13 mm) to 1-1/2 inches (38 mm) high but is easier to install with some models offering a ramped version.
If the curb exceeds 1/2-inch (13 mm), however, you’ll have to add an extra ramp extension kit and consider adding more maneuvering bathroom space to compensate for wheeling in the chair or the walker.
4.5 - Consider Your Largest Option
If further deterioration in the person’s health is expected in the future and if space allows when planning the shower, planning for a larger shower tray therefore more space inside the shower may prove to become a valued asset for an eventual attendant to assist.
Step 5 - Types of Equipment
Depending on the severity of the disability, there are also many varied types of equipment available to help in the transfer of patients from place to place from a laying to a sitting position or vice versa.
Hydraulic chair lifts, sling-type patient lifts, rolling transfer benches, and even ceiling lifts that can ease the operation of transferring directly from the bed, to the toilet, and to the shower where a shower wheelchair is in position. This, of course, is possible only for a wet room opened up to the bedroom.
As mentioned earlier, if the illness is expected to deteriorate in any foreseeable future, it may be a good idea to research into different options beforehand such as installing a walk-in tub with therapeutic jets, and plan the proper initial renovations and save bundles when future modifications become necessary.
The installation of some of the specialized equipment such as ceiling lifts requires careful considerations of the room’s framework due to load capacity requirements and can only be completed by a certified technician.
The battery-operated lift will require yearly inspections of all its mechanisms and safety devices and should be scheduled at the time of installation.
Step 6 - Safety and Accessibility Inside the Shower
6.1 - Source Non-Slip Material
Non-slip tiles should always be used inside the shower to avoid an accidental fall. But if such tiles are not a possibility, you should get some textured anti-slip tape and apply strips of it at intervals across the floor. Non-slip tape comes in rolls and is available in many different widths.
6.2 - Guarantee Good Lighting
Make sure that you have adequate lighting overhead inside the shower.
6.3 - Plan Switches for Access
The light switches will probably need to be lowered at wheelchair accessibility, and they might even have to be replaced with switches having large toggles or push buttons. In certain situations when movements are more limited, motion detector switches might even offer a better alternative.
6.4 - Consider a Safety Valve
This is where you should seriously consider an anti-scald mixing valve to deliver the water at a stable and safe temperature and volume, where sudden changes in the household’s supply could have previously caused burns. The temperature should be set at 120° F (50° C).
6.5 - Place Controls for Access
All the shower controls should be placed or relocated where the operator can use them without getting wet and a handheld showerhead with a 60 to 80-inches (1.5 to 2.1 m) hose should also be installed to accommodate a seated bather.
6.6 - Install Grab Bars
Grab bars will also need to be installed in all bathing areas around the bathroom and you’ll need to select the most critical areas where they will best serve their intended purposes.
In a transfer shower, at least two walls should be equipped with grab bars—the back wall and the wall with the controls and the shower wand, near the controls. All three walls of a roll-in shower however should have grab bars to better assist the wheelchair user while moving around.
Grab bars installed vertically right on the outside edge of the shower (and the bathtub) will greatly improve the bather’s stability and balance when transitioning into the shower or the bathtub.
6.7 - Consider a Small Ramp
If you’re dealing with a shower pan with a curb or different floor heights to access the bathroom, transition ramps are the easy solution to close the gap. Made of rubber, they offer excellent traction against the floor and can be easily trimmed with a sharp knife to fit any threshold.
Transition ramps are available in several thicknesses to complement and hook up to each other, increasing their overall thickness.
6.8 - Position Accessories
The access to accessories such as bathrobe and towel hooks, towel bars, soap dishes, hair care dispensers, face cloths, and shower shelves should be carefully planned for easy access to the bather and provide a secure surface preventing the articles from falling to the floor.