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Once the doorway to the bathroom is made wide enough to allow a wheelchair to pass through, he or she needs to be able to move around freely. This is achieved by either removing the door and replacing it with a curtain, or by replacing the hinges of the door with Swing-clear™ hinges found here.
- For instance, a radiator can be removed in favor of a portable space heater or overhead heating unit.
- It may be necessary to reposition an existing sink or remove the bathtub in favor of a roll-in/walk-in shower. (These are more expensive options, but less expensive than tearing down walls or moving.)
- The vanity for the sink can be replaced with a smaller one and the door of the vanity can be removed to provide knee space for a seated person. The hot water pipe must be covered with insulating material or moved back out of the way to protect legs from scalding.
- Vanities can be raised for someone having difficulty bending over or lowered to accommodate a seated person. If you have several people living in your home, decide on a compromised height.
- Toilet height is also important: if the toilet is too low, it's difficult for many people to lower themselves down to it or to get back up. Toilets that are too high are difficult to reach. This can be remedied with portable toilet seats. Many different styles and types are available, as well as safety straps and other aids.
- Grab bars should be screwed directly into wall studs on either side of the toilet and in the bathing area. Molly bolts or screws in sheetrock are not adequate. Grab bars should support a maximum of 250 pounds. If the person weighs over 200 pounds, the wall studs must be further reinforced. Grab bars help a person transfer on and off the toilet and negotiate the bathing area. Sheltering arm grab bars provide additional balance and thus may be more appropriate. Sheltering arm grab bars are firmly secured to the toilet to surround both sides of the toilet and have legs that reach the floor.
- Make sure to place anti-slip rubber decals on the bathtub or shower floor to prevent slips and falls.Small bathroom rugs are dangerous and should be avoided completely.
- A hand-held shower will bring the water down to a comfortable level. It's also possible to install a stand or adjustable pole to free up the bather's hands.
- Shower chairs or benches come in many styles for the bather who needs to remain seated, transfers out of a wheelchair, or has poor balance. Bathtub lifts are also available through catalogs, the Internet, and medical supply stores, however most of them require another person to assist.
Last of all, single-lever faucets are easiest to use for weak hands or hands with decreased sensitivity. When skin has decreased sensitivity, an anti-scald device should also be installed in both the bathtub/shower and bathroom sink.
Renters need to carefully investigate the general accessibility of an apartment they're considering renting, as well as bathroom situation. Visualize which options will provide access to the apartment. Talk to the landlord about the changes you need to make. Ask if the bathroom walls are reinforced or will be reinforced prior to the move-in date in order to install grab bars. If necessary, ask to have the bathroom door removed for the duration of the lease. Consider whether a portable ramp will be enough to make the front door accessible, or is there another accessible entrance. New buildings, especially new elevator buildings, are fully accessible (providing the real estate company has followed ADA guidelines; if not, redoing accessibility features after the fact is much more costly and the company will be fined as well.) Remember that because of the Fair Housing Act, it is illegal for a landlord to outright refuse to make reasonable accommodations. The tenant pays for these accommodations. When tenants move out, they must restore the dwelling to its original condition, if the landlord desires. Sometimes a landlord will pay for part of the accommodations because accessibility features enhance the dwelling. Grab bars or levered door handles will make a unit potentially more marketable to more people, such as elderly tenants or tenants with limited mobility. The landlord and tenant should be able to work out the modifications amicably.
For more information on the Fair Housing Act and Amendments of 1988, see the U.S. Department of Housing and Urban Development (HUD) website. HUD also offers a "Disability" resources page loaded with helpful information.