The bathroom is a different place when mobility changes. What was once considered a simple daily activity becomes something that necessitates a plan, caution, and probably even a twinge of anxiety. For many people with limited mobility, the shower is where independence as long as possible remains strongest, but it’s also one of the most dangerous places in the home.
Falls are a leading cause of injury in the home and while falls can certainly occur anywhere in a home, bathrooms contain certain elements and features that make them more precarious. Showers are one of the most dangerous areas. Wet surfaces, slippery tiles, a threshold to step over, nowhere secure to hold onto combine to present a perfect storm of potential hazards. Yet what many people fail to remember is that the vast majority of hazards can be removed with a little care.
What is an Accessible Shower?
It’s important to note that an accessible shower is not simply a shower with a grab bar. It’s not a last-minute consideration when trying to “age in place.” An accessible shower is one that’s reconfigured to eliminate barriers and introduce supports where it’s needed most.
For example, the first barrier that needs to go is the step. Traditional shower trays sit above the bathroom floor two-four inches or more. This becomes increasingly difficult to negotiate when mobility decreases. Low-threshold showers reduce this barrier to one inch or less; zero-threshold showers (commonly referred to as wet rooms) remove it entirely. For someone contemplating bathroom options for accessibility, a disabled shower that makes this adjustment is oftentimes the differentiator between being able to manage alone or needing assistance.
The flooring also needs to accommodate accessibility needs. Standard ceramic tiles become incredibly slippery when wet, even with bath mats that are meant to absorb more water. Proper non-slip flooring utilizes textured ridges or slip-resistant materials that help maintain traction when soap and water are introduced. This doesn’t mean rough and rugged surfaces though; contemporary anti-slip options feel good beneath feet while providing the right kind of support needed to prevent injury.
Support and Stability Needs
Grab bars are often suggested in every conversation about bathroom safety but without proper placement, they’re not effective. Randomly placed grab bars might look good but they won’t actually help someone where help is needed most. The best configuration will depend on how someone moves through their shower space.
For example, vertical bars help people either step into showers or transition between positions. Horizontal bars help support someone standing still or moving throughout the shower to collect products. Diagonal bars, placed at about 45 degrees, help support versatility of movement for all angles. Many people will find that multiple directions work best – bars at the entry point, by controls, and along the length of where one would be standing.
The shower seat often gets overlooked but its existence is critical, if not required. Even if a seat isn’t required, it’s good contingency for those days when standing feels more difficult than expected. Fixed seats offer the strongest support while fold-down seats take up less space in smaller bathrooms. Their height and placement are critical, however, as well as those who use them, if they’re too low, getting up off of them becomes difficult; if they’re too high, they’re not supportive at all.
Temperature Control and Shower Head
Thermostatic mixer valves may sound like luxury accessory options but they may be necessary for safety purposes. They ensure consistent water temperatures relative to changed water pressures from other areas of the house, someone won’t suddenly get blasted with hot water from a flush or tap; it will remain steady which is critical when reaction times are delayed or sitting doesn’t afford them a quick escape from direct water.
Handheld shower heads make it possible for someone to wash while sitting down (in addition to being able to control where they point the water). This needs to be flexible on a slide bar so someone can either put it back in the holder at a higher position or down below once they finish using it. Fixed rainfall heads may be pretty but they’re not practical for those needing control.
Spatial Considerations
The actual size and layout of the shower space needs to consider more than comfort – does someone have enough room for mobility? Does a caregiver have enough room for assistance? Will wheelchairs be effective? For example, standard 30 by 30 inch cubicles may be enough for fully mobile individuals who feel stable; they can prove cramped and unsafe, however, for those with limited mobility.
Wet rooms convert an entire bathroom floor into the shower space; there aren’t separate enclosures to navigate but rather a sloped floor with a drain in it. This provides maximum space and versatility but requires proper waterproofing and drainage to work appropriately.
Walk-in showers provide low, or no-threshold barriers to entry as the happy middle ground – they create defined shower spaces but do not have barriers to entry; beyond that, any shower screen/door swings outward giving a wide enough opening that doesn’t complicate entering/exiting.
Installation Considerations
Converting a standard bathroom into an accessible one generally won’t happen over the course of a weekend. Depending on what’s involved, it could take a few days or even weeks. It’s important to remember that removal of old tubs/installation of walk-in showers involves plumbing issues, waterproofing, tiling and potentially leveling floors.
Costs vary incredibly depending upon what extent modifications are needed. Disabled walk-in showers will cost a few thousand pounds; wet room transformations cost exponentially more. Grants and funding options are available in many cases though, especially for those with disabilities or age-related considerations for need, most local councils have funds available to assist with adaptations needed and an occupational therapist can help assess someone’s needs and support any funding application.
What Needs to be Prioritized
When working on a budget, not everything has equal weight. However, if there’s something that can make the biggest different for safety, accessibility should be prioritized in this order: first, eliminate the threshold/hurdle; second, make sure there’s slip resistant flooring; third, assess where grab bars are best placed; fourth, determine if handheld shower fixtures would work better than fixed ones.
Thermostatic controls should come next in priority alongside good quality seating options.
Everything else, for built-in storage at easy to reach heights, sufficient lighting, easy-to-use controls, are merely upgrades instead of necessary safety improvements.
The goal shouldn’t be creating a clinical looking bathroom that’s disassociated with attractive design because accessible bathrooms can be just as gorgeous as any other modern bathroom option equipped with safety features in subtle ways, attractive grab bars in appealing colors/designs, beautiful non-slip tiles that still serve their purpose, well designed wet room layouts that accentuate bathrooms in ways everyone can appreciate.
Moving Forward
Bathroom adaptations often get put off for fears of costs or overwhelm, and truthfully, after-the-fact makes everything more complicated, but waiting until after accidents occurs prevents people from getting proactive assistance easier. Taking time to establish adaptive measures when time allows affords people options to research suggestions instead of responding hastily in an emergency situation.
It all starts with an assessment determining which modifications will make the biggest impact; an occupational therapist can assess current and future needs so changes made today will last as they work down the line with mobility adjustments in the future.
Making showering truly accessible makes one of the most challenging daily activities not only manageable but fully independent again. It’s about addressing barriers and providing supports where they’re most needed, and ultimately creating a space where independence can comfortably exist. The peace of mind knowing it’s not a fall-risk area anymore? That’s more than worth any time or money investment needed!
