There are great advances in the design of toilets, allowing for specification of a fixture that better supports transfer and ease of use.
The complexities of transfer onto and off of the toilet make this a space where each situation may have a different "best practice."
Transfer from a wheelchair to a toilet seat relies on the height of both seats being equal (see Figure 8.52). The elongated bowl and raised-height toilet at 17 to 19 inches (432 mm to 483 mm) that was first created to facilitate transfer from a wheelchair has become popular as "comfort height" or "right height" because it is often more comfortable than the traditional toilet height of 15 inches (381 mm) for a person with back strain, reduced strength, or joint conditions that make sitting and standing more difficult (see Figure 8.53).
In reality, the chair height can change over a client’s lifetime, and it is sometimes best to plan flexibility in the height of the toilet. The addition of a thick toilet seat or spacers may look institutional,
FIGURE 8.52 For ease of transfer, the height of the wheelchair seat and the toilet seat should be the same,
but they are flexible in that they can be changed as needs change. Be sure to consider your client’s specific needs when determining toilet seat heights, and when planning more than one bathroom, consider specifying variable heights.
The mainstream adoption of comfort or right-height toilets is enhanced by the added features, including heated seats, automatic flushing, remote controls, integral washing systems, and recently the addition of an LED light source within the fixture to guide the way for nocturnal visits (see Figure 8.54).
A wall-mounted toilet with the tankless flushing system concealed in the wall can be a beautiful choice that improves access and use of the fixture, provided the cost of changing the waste connection is realistic. To begin with, the toilet can be placed at the exact height that will be most effective for the client, and as mentioned earlier, the clear floor space increases as up to 5 inches (127 mm) is saved in the depth of the fixture. The open space below the toilet makes rising from a seated position easier as the user can position his/her feet farther under his/her body weight. This open space also provides for much easier maintenance. The flush plate is easy to use for most because it can be pushed with a closed fist and does not require grasping, and in some cases, a remote control is available (see Figure 8.55). Another feature that contributes to the youngest among us is the integral child seat that is built into the cover of the traditional standard seat (see Figure 8.56).
The inclusion of a bidet, or a washing system, that is incorporated into the toilet can be a solution to personal hygiene challenges when reaching and bending are difficult, and to cut down on constipation, a condition that can become more common with age (see Figure 8.57). An electrical connection is required for the systems that are integrated into the toilet, so as a minimum, a GFCI receptacle should be planned near the toilet. If the system is not installed, the receptacle near the toilet will allow for the easy addition of such a system at a later date. Consider features available as technology changes, including heated seats, self-closing covers, automatic flushing, bacteria and odor ventilation, and health monitoring systems.
FIGURE 8.55 The wall-hung toilet.
Courtesy of TOTO