AIA White Paper: A Proposal for additions to accessibility Standards for Nursing Home & Assisted Living Residents in Toileting and Bathing

Executive Summary

Since the Americans with Disabilities Act Accessibility Guidelines (ADA) were initially issued in 1991, millions of Americans have benefited from changes to the built environment that provides greater opportunity for full participation in society and an enhanced quality of life. Like most other accessibility codes, standards, and guidelines, they are intended to promote independence, generally based upon the stature, strength, and abilities of younger adults with a single disability, most of whom transfer directly from wheelchair to toilet.

Goals of the recommendations in this white paper are to:

1. Optimize functional abilities of this population

2. Reduce Resident falls

3. Improve caregiver safety ( or decreasing staff injuries)

Specifically, this White Paper:

1. Describes differences in functional abilities of frail older adults in Assisted Living and Nursing Homes with ambulatory needs that necessitate an addendum to the ADA and ANSI A117.1

2. Summarizes the evidence base for changes to ADA and ANSI A117.1 to define what we know and what we don’t know

3. Identifies specific requirements in both the ADA and ANSI A117.1 related to toileting and bathing that are and are not supportive of older adults, specifically in Nursing Homes and Assisted Living communities

4. Recommends additions and modifications to the guidelines/standards based on what we know from existing data that are intended to broaden the range of accessible designs for Nursing Home and Assisted Living communities

5. Recommends further research where sufficient evidence does not exist.

The recommendations provided are based on how frail elderly individuals transfer to the toilet with and without assistance, and how space for staff and equipment must be accommodated. The bathing/showering area, proposed changes would enable supportive design options in a cost-effective way, so that more buildings could be constructed with a shower in the resident’ room bathroom, which supports person-centered care that is being mandated by the Centers for Medicare and Medicaid Services [CMS].

File Size and Type: 1.14MB PDF