Here are factors to consider when designing bathrooms for an aging population.

This shower exudes luxury and the flexibility of multiple, adjustable height showerheads. (Courtesy of John A. Petrie, CMKBD, Mechanicsburg, PA.)


In partnership with the National Kitchen & Bath Association, Supply House Times continues its year-long kitchen and bath educational series with a look at planning baths and selecting the appropriate products for an aging population. This article is excerpted from Bath Planning, one of nine books in the NKBA’s Professional Resource Library. It provides an overview of some of the typical changes that may occur as people age and offers recommendations on how well-conceived baths can contribute to the continued health, safety and independence of this growing demographic.

People reach a point in the growth process where a number of their abilities begin to change. They adapt themselves to the changes as they age and may not notice any difference until the environment is not supporting them. Being able to use the bathroom is critical for the independence of an older person, and the design of the space can make a difference. Just a few of the changes common as we age are included here.
  • Mental Changes. Some memory loss or occasional forgetfulness, as opposed to overall mental decline, is very common. Reaction time generally is longer.
  • Vision Changes. Physical changes in the eyes increase with age and can lead to vision impairment, such as difficulty seeing in dim light, increased light sensitivity, difficulty focusing on moving objects, and a decrease in peripheral vision. More time is needed for the eyes to adjust when transitioning between light and dark areas.
  • Hearing Changes. Another common occurrence is some level of hearing loss, usually beginning with difficulties with high frequencies and progressing to lower frequencies. Ringing in the ears is also common.
  • Other Sensory Changes. Some people have a decreased sensitivity to internal body temperature.
  • Bone and Muscle Changes. People experience a decrease in strength due to bone and muscle loss, causing an increase in accidents and fractures. As people “shrink” in height, reach ranges are shorter than those of middle-aged people.
  • Internal Functions. Changes in the nervous system result in slower movements and decreased balance and coordination due to inefficiency of the nervous system and central brain processes.

    Typical design considerations include:

  • Adjusted heights of fixtures, fittings, storage and controls, for an accommodation to shortened stature and reduced balance.
  • Intuitive controls and organization to compensate for memory losses.
  • Increased support throughout the space.
  • Optional seating at the major bathroom centers.
  • Increased and adjustable lighting.
  • Reduced risk of glare and increased intentional contrast used for way-finding.
  • Quick and easy access to the toilet, including in the middle of the night.
  • Protection from scalding.
  • Eased edges to reduce the risk of injury.
  • Insulation to reduce excess noise.
  • Raised heights in seating at the toilet, tub or shower.
  • Increased and even heating.


  • Controls should be easy to read, easy to operate and within reach but not in the way. (Courtesy of Kohler Co.)

    Bathroom Design Implications

    Sufficient clear floor space for functional passage is a design challenge for this age group. As strength, stamina and balance decrease, minimal passage clearances give people support as they move through a space. But with a mobility aid, more generous spaces are mandatory. Generous passage with integral options for support is one possible solution.

    Plan reinforcement in the walls throughout the space for additional support as user needs change. A good way to provide flexibility for additional grab bar installations is to install a layer of 3/4-inch plywood before the cement board or sheetrock. Increased use of support rails should complement the aesthetics of the bath, as with a chair rail moulding designed to double as a support.

    Install single-lever, easy-to-operate controls at faucets and doors. Use controls for windows, lighting and fixtures that are easy to reach, read and operate.



    Grooming

    Beside single-lever faucet controls, some ideas specific to the vanity and lavatory include:
  • Plan multiple-height vanities with opportunities for flexible knee spaces below. Remember to incorporate support for the lavatory and counter at a knee space, and to cover the plumbing for protection.
  • Storage should be placed at the point of use and within easy reach.
  • Increased lighting should be from varied sources, natural and artificial, with adjustable controls.
  • Provide for minimal glare through careful selection of materials and attention to light sources, including windows.


  • Bathing And Showering

    Beside consideration for grab bars and single-lever handles, the following ideas should be considered:
  • Specify a hand-held spray with 60-inch-long hose for flexibility in use.
  • Plan adjustable-height, multiple-head showers for flexibility in the numbers and needs of users.
  • Locate the tub/shower controls offset towards the room.
  • Plan for the option of sitting in the shower and to enter the tub.
  • Plan tub deck and shower benches at 17 inches to 18 inches above the finished floor maximum for a comfortable height.
  • Plan shower and other seats to allow users to put their feet under the seat for leverage.
  • Install slip-resistant floors.
  • Plan a no-threshold shower when possible.


  • Grab bars should be placed according to user needs. A standard placement is along the back of the bathtub 33 inches to 36 inches high and vertically at the control end of the tub, 9 inches above the rim.

    Toileting

    Grab bars should be planned at the toilet area. Also, plan toilet seat heights to be supportive to the users, usually 17 inches to 18 inches optimum, an increase in height from the traditional 15 inches, plus or minus. Because we shrink in height as we age, be sure to consider your client’s specific needs when determining toilet seat heights. When doing more than one bathroom, consider specifying variable heights.
  • Plan a bidet or select a toilet with a washlet system for personal hygiene and to cut down on constipation, a condition that can become more common with age.
  • As a minimum, plan a GFCI receptacle in the toileting area for possible addition of a washlet system.
  • Consider features available as technology changes, including heated seats, self-closing covers, and health monitoring systems.


  • Other Areas

    Some extras to enhance safety and security:
  • Install a phone and/or an intercom in the bathroom for added security.
  • Space in the bathroom for other creature comforts, such as exercise, reading or massage, creates a sanctuary and private retreat away from the rest of the home.
  • Space for physical therapy and storage of associated equipment/supplies may be needed.
  • A “morning kitchen” or a kitchen in or near the bedroom suite provides a place for coffee, vitamins and breakfast, or a late night snack close at hand. It usually includes under-counter refrigeration, a compact microwave, a coffee maker and a small sink.


  • This article is excerpted from Bath Planning, one of the nine books in the NKBA’s Professional Resource Library. Written by recognized industry experts and thoroughly reviewed by top technical editors and peers, the volumes cover design, products, residential construction, mechanical systems, business practices, drawing, project management and more. They are available only through the association, at www.nkba.org or call 800-THE-NKBA.