Are our accessible bathrooms inaccessible to people in wheelchairs?

A new study has found that the majority of washbasins in accessible bathrooms are not usable for some wheelchair users. While accessible bathrooms are designed to enable independent, safe and comfortable use for people living with disability, the Australian Standard basin heights are prohibitive for many wheelchair users, says Dr Konstantina Vasilakopoulou from UNSW.

“The study of participants found the washbasin height prevented them from using the washbasin efficiently, with approximately half of participants excluded from using them at all,” says the Acting Director of the Home Modifications Clearinghouse at UNSW Art, Design & Architecture and Leader of the Livability Lab.

“The research demonstrates the need to re-evaluate Australian Standards. These kinds of public spaces should promote the user’s safety, autonomy and dignity, however with the current standards, some of the wheelchair users’ knees would touch the washbasin or the pipework underneath it, preventing their effective use.”

The Home Modifications Clearinghouse (HMinfo), established in 2002 by Emeritus Professor Catherine Bridge, conducts and translates research for industry and consumers to promote a more inclusive built environment. It publishes evidence-based practice reviews, resources for industry and factsheets for consumers to improve their wellbeing and quality of life through home modifications.

The research team also runs the Livability lab focused on biomechanical studies to inform design for improved liveability and useability of the built environment. The multi-disciplinary staff, including biomechanist Mr Jai Raina, physiotherapist Mr Rahm Ranjan, occupational therapist Prof. Bridge, has offered a better understanding of the participants’ needs and how these can be translated into design opportunities.

Assessing usability

“The Lab enabled us to explore and assess a range of scenarios with participants using motion capture and video technologies to record participants’ movements,” Dr Vasilakopoulou says.

The study into the spatial requirements of wheelchair users in public accessible bathrooms was commissioned by long-term HMinfo partner Caroma. Participants were interviewed and completed an optional survey to share their thoughts and experiences, before undertaking tasks at a custom-built test rig in the Livability Lab.

Participants simulated using a washbasin, including how the interaction between different elements – for example, soap dispenser, tapware, and washbasin – influenced effective and hygienic handwashing.

“We were interested in the usability of the bathroom elements, as well as of the overall experience of the user,” Dr Vasilakopoulou says. “For example, almost all the participants – 19 out of 20 – mentioned that the accessible bathrooms should have more free space for the person to be able to enter, close the door, manoeuvre, use the bathroom and exit the space safely and comfortably.”

The position of the tap and the types of taps used had the potential to prevent adequate handwashing, the research found. “[Additionally] mirrors, soap dispensers, light switches, automatic hand-dryers are often placed too high for people in a seated position,” Dr Vasilakopoulou says.

The study also found that the inclusion of change tables, the use of steps, the appropriation of accessible bathrooms for storage, and issues with the doors increased their inaccessibility as well as the possibility of injury during transfer from wheelchair to toilet.

 “This demonstrates that, despite our best efforts, even accessible spaces can be designed with an able mindset. It reinforces the need to co-design these environments with people with lived experience to ensure they are fit for purpose.”

Implementing adjustable environments will advance inclusive design

Refining the Australian Standards is important, however investing in more adaptable environments will help us embed inclusive design for the long term, Dr Vasilakopoulou says. Here we’re talking about environments that read and adjust according to the individual’s needs.

However, this is not just about accommodating people with additional needs – it’s applicable more broadly, she says. “Of course, there are costs associated with creating flexible environments, however … we are all ageing and our needs [will] continue to change over time,” she says.

Adjustable environments are not new. Today we have assistive technologies and automations that enable us to regulate conditions, such as temperature and lighting, as well as fixtures within our homes, such as height-adjustable dining tables and cabinetry.

“We have wearable sensors, we have artificial intelligence, we have automations and controls within the built environment,” she says. “We have systems that communicate and can make the world around us not only friendlier but completely tailored to the individual.”

The HMinfo investigates how implementing various home modifications and automations can improve the lives of different groups. Their research focus is driven by the HMinfo Advisory Committee made up of government representatives, allied health professionals, and consumers. The committee’s input ensures the relevance of the research for affected communities. It has also driven HMinfo submissions to government to promote policy change based on lived experience.

Translating research into practicable advice

The HMinfo has compiled factsheets on home automations for older people and people with disability and people with cognition who display aggressive or self-injurious behaviours. The HMinfo  factsheets break down the available research into accessible resources. They help consumers assess whether these kinds of inclusions would work for them, Dr Vasilakopoulou says.

“Home automations can control a whole range of elements, from opening and closing your blinds and curtains to operating your oven and other safety measures in the kitchen. There are cameras and mechanisms to open the front door and many other home automations that can help older people live in their homes more independently for longer,” she says.

For people living with dementia, there are automations that help to reduce potential triggers, such as thermal discomfort, too bright or dim lighting, and noise, and automations to help reduce the opportunity for injury during aggressive behaviours.

“This is a significant development considering the rise in dementia nationally; these automations and factsheets are aimed at both carers and people living with dementia themselves,” she says.

Adopting these kinds of home interventions can help vulnerable groups live independently for longer, she says. This has a positive effect on the quality of life for individuals as well as alleviating the costs to the state associated with aged care and other supported accommodation, she says.

“Inevitably, structural advantage is evident here – home modifications are dependent on having your own home [rather than renting].” State-driven investment within aged and other supported care facilities would promote greater equity of access.

The HMinfo has also conducted research on the most appropriate self-assessment tool for determining the appropriateness of your home environment, fire safety measures and the cost-benefit analysis of ramps versus lifts for older people and people living with disability. The promotion of autonomy and respect, as well as a focus on reducing stigma unites the research.

“Moving towards greater co-design with affected communities will enable design that is person-focused rather than ability-focused, design that fosters greater liveability, useability and inclusion,” Dr Vasilakopoulou says. “This is integral to combatting unconscious bias and the implicit able-mindset; focusing on the needs of older people and people living with disability grounded in their lived experience will ensure that we create a built environment that supports all people.”