It’s a natural consequence of aging that our tactile sensitivity decreases and thermoregulation becomes less efficient, and for those of us with cognitive impairments, the bathing experience can be intimidating. For clients with sensory and perceptual/cognitive issues, there is significant risk of injury from water that is too hot. In response, the bathing and shower center must first include controls that have temperature limits and are either pressure balanced or thermostatic mixing valves. This will help protect the user whose sensitivity to temperature has been compromised, as well as reducing the risk of error caused by confusion or distraction. Beyond this, pre-programmed controls can further reduce the guesswork in controlling flow and temperature of the water. Additional enhancements, including massage, chromatherapy, and aromatherapy can reduce anxiety and enhance the bathing experience.
Bath and shower controls should be offset toward the room for easy operation, within reach, at a height that works for the bather and does not interfere with grab bar installation (see Figure 8.33). Recent access code changes have added a fold-up seat to the roll-in shower and with it, a directive that the controls must be within reach of that seat, which may cause difficulty with keeping those controls accessible from outside the shower. In our privately owned, single-family residential work, we have the freedom to make this a matter of carefully matching clients’ needs and preferences with the space parameters of the shower. Fittings with a lever control are easier to grasp and turn than smooth round knobs.
The controls should also be easy to understand. Although some feel color cueing takes away from the beauty of the fitting, it should be clear that red is for hot and blue is for cold. In addition, a visible arrow or line on the faucet that points to red or blue helps determine what direction to turn the control without scalding. Last, raised characters provide tactile cueing, and today LED enhancements send red light with the hot water and blue light with the cold.
In the Bathtub
As mentioned earlier, the controls should be offset toward the room for easy reach, and at a height within everyone’s reach yet not interfering with the placement of grab bars, usually 33 to 36 inches
(838 mm to 914 mm) above the floor. A handheld spray, used as a showerhead or in addition to a showerhead, should be included, preferably with a trickle valve or control at the head for ease of use by a seated bather. To ensure that the spray reaches comfortably to the bather, the hose length should be increased to 72 inches (1829 mm) long, or the length you determine will be needed. If installed on a sliding bar to double as a showerhead, the lowest position should be no higher than 48 inches (1219 mm) and well within reach of the seat in the tub. The higher position should be 72 to 78 inches (1829 mm to 1981 mm) to serve as a showerhead. The diverter or separate control for the handheld spray will ideally be within reach of the bather when seated in the tub. Tub and shower fittings are available today with additional features that improve the user interface (see Figures 8.34 and 8.35).