Bad form abounds in purportedly accessible public bathrooms, whether it’s fixture configurations that don’t suit the needs of people with disabilities or the conduct of able-bodied people who misappropriate the space. Accessibility advocates participating in a recent online discussion highlighted some practical adjustments and low-cost investments that could improve safety and convenience, giving people with disabilities more assurance to learn, work, play, enjoy social relationships and contribute to the economic and cultural life of their communities.

“At its core, where we go to the bathroom when we’re away from home is a question about equity and our right to the city,” observed the discussion moderator, Rhonda Solomon, a PhD candidate and researcher at University of Toronto’s School of Cities and Centre for Global Disability Studies.

That has prompted the sharing of details about private bodily functions so that designers, contractors, landlords and property/facility managers can gain a clearer understanding of how best to accommodate — or avoid thwarting — the intended patrons of accessible bathrooms. Julie Sawchuk, a Rick Hansen Foundation Accessibility Certification (RHFAC) professional and author of the resource manual, Building Better Bathrooms, explained some of the practicalities from her perspective as a paraplegic wheelchair user reliant on a catheter to empty her bladder.

“These are uncomfortable conversations, but if you don’t know the whys behind an accessible toilet set-up then you can’t really understand why a set-up just isn’t right,” she said. “I could have filled this presentation with stories of what not to do because that’s primarily what I see.”

Similarly, Michelle Cousins, mother and principal caregiver to a young teenager reliant on a wheelchair, decried the lack of accessible bathrooms properly equipped for children’s smaller physical size and shorter reach. That’s an inadequacy she has encountered even within relatively recently constructed schools where bathrooms comply with adult-sized accessibility standards.

“When I had to approach the school board and say: ‘this bathroom is not accessible’, they were perplexed,” she recounted. “How we do some very intimate tasks is not something that most people talk about. Yet it’s through this vulnerability and this willingness to share that we really educate and inform, and hopefully bring about change.”

The basics of fixture placement and respectful accommodation

Sawchuk sketched out some of the basics, beginning with well-lit identifying signage that includes Braille and is placed adjacent to the door latch for maximum visibility and reachability. Inside, the sink, taps, soap dispenser and hand-drying towels/equipment should be reachable from a sitting position and all reachable from each other. There should be an adult-sized changing table and an emergency call system.

There should be a minimal height differential between toilet seats and wheelchairs. U-shaped toilets with a space in front allow catheter-users to more easily reach between their legs. That should go in tandem with a toilet seat lid that will protect and cushion their backs as they lean backwards. Grab-bars should be installed on both sides of the toilet and the sanitary disposal container should be easily reachable from the toilet.

“Grab-bars serve the purpose of balance,” Sawchuk advised. “If you need one grab-bar, more than likely you would benefit from having the use of two grab-bars.”

The toilet roll holder should be placed so it doesn’t obstruct gripping of the grab-bar or pose a hazard for knocking hands or elbows, and it should be operable with limited dexterity. Uncovered toilet rolls that can be easily dispensed from below the grab-bar or within the grab-bar itself are recommended.

“In commercial set-ups, you always see those giant toilet roll holders, and where are they? Always right above the grab-bar,” Sawchuk noted.

Meanwhile, grab-bars calculated to be within an adult’s reach risk throwing children off balance, particularly if their feet can’t touch the floor because the toilet is geared to an adult’s height. That height differential can also create an added challenge for those, like Cousins’ daughter, who use a transfer board between their pediatric-sized wheelchair and the toilet.

“I have become the human grab-bar for my daughter,” she said. “There is a gap in public settings between what we need and what we find.”

Among other frustrations, she calls out able-bodied people for using accessible public bathrooms. Although there is general social censure around illegitimately commandeering designated accessible parking spaces, attitudes tend to be more ambivalent if accessible bathrooms are conveniently nearby and unoccupied at the time.

“There is nothing inherent in the design of these accessible bathrooms that safeguards the space for the intended end-user, which is the person with the disability,” Cousins reflected. “We have to rely upon social conditioning and the goodwill of others to make sure they reserve those spaces for those who need it.”

Looking to the United Kingdom’s example

Joining the conversation from afar, Karen Hoe, national development manager for the Changing Places program in the United Kingdom, briefly outlined her organization’s successful campaign to gain regulatory recognition for accessible facilities that can meet more complex needs. Since June 30, 2022 specified new buildings or major expansion projects — including: assembly space for a minimum of 350 people; malls with a minimum of 30,000 square metres (322,000 square feet) of retail space; community centres and sports venues with at least 5,000 square metres (54,000 square feet) of floor area; retail stores with a minimum of 2,500 square metres (27,000 square feet) of floor space; hospitals and primary health care facilities; and cemeteries and crematorium buildings — must comply with Changing Places criteria in addition to existing requirements for standard accessible bathroom facilities.

The new Changing Places standards mandate a space that is at least 12 square metres (129 square feet), accommodating a height-adjustable adult-sized changing table, a ceiling hoist to lift patrons from their wheelchairs onto the changing table and a peninsular toilet so that caregivers could stand on both sides, if necessary. It’s estimated that about 7,000 new Changing Places facilities will be added to the U.K.’s national building stock annually via these standards, augmenting the approximately 1,800 that now exist.

“The Changing Places logo is trademarked. If you see that logo, it’s a guarantee of what you’ll expect to find behind that door when you walk in,” Hoe affirmed.

Accredited facilities are registered and highlighted on a publicly available national map. The Changing Places program is also working with the U.K. government to oversee the design and installation of 600 new facilities, funded with a £32 million (CAD $52 million) allocation in the 2020 budget, and targeting England’s local authorities and motorway service stations.

Sawchuk applauded the United Kingdom’s leading example, but urged building owners/managers everywhere to proactively upgrade their accessible bathroom facilities ahead of regulatory dictates.

“Kids with disabilities become adults with disabilities, and if you need a changing table then you need a changing table,” she said. “And that means that you don’t have to use the floor or the back of a van or a folding table at an arena.”

Barbara Carss is editor-in-chief of Canadian Property Management.