Best Practices in the Design of Toileting and Bathing Facilities for Assisted Transfers

4.20.7 Bathtub Enclosures.

None of the respondents indicated that there were any variations from ADAAG regarding the enclosure except for the walk-in fixture described below.

Alternative Designs.
One alternative design that was used by OWP&P for less frail, ambulatory individuals was the Kohler "Precedence" bathtub (Figure 14). The tub has a non-institutional appearance, a fold-down seat, and a swinging side entry door with a pressurized seal for ease of access. Similar "walk-in" units, although slightly more institutional in appearance, are made by Arjo ("Freedom" tub) and others. The walk-in capability makes this fixture suitable for either independent or assisted use by individuals with a reasonable level of mobility. In addition, the fixture is also taller than most average bathtubs (24" above the finished floor) which permits immersion in the water even when using its fold-down seat. Whereas the added height and side-entry features address the primary shortcomings of a traditional tub, they also create the two shortcomings of this tub. First, it must be drained to open the door to exit the fixture. As a result, an older individual who can only get out through the door must sit in the tub until it is drained. Second, the tub does not meet ADAAG grab bar provisions. The 24" high sides make it impossible to install the two grab bars on the back wall in the manner prescribed in ADAAG. As a result, in facilities where this fixture (Figure 15) was used, one of the back wall bars was eliminated in order to comply with the distance of 9" from the rim of the tub and 33" –36" distance from the floor to the grab bar. In addition, OWP&P placed a low wall surrounding the tub on one or more sides (usually the foot end and/or the long side opposite the entry). Although this increased the overall space requirement for the bathing room, it provided easier access by a caregiver to assist in the bathing process, enabling them to sit on the wall as well as reach over it.

Figure 14. KohlerPrecedence Bathtub

Figure 15. Bathtub Configuration at Memory Loss Unit at C.C. Young Retirement Community, Dallas, TX (OWP&P)