Sure! But be cautious about ”Universal Design.” I have found that it compromises, trying to be good for all. Instead, it is good for some and leaves others stranded in a handicapped bathroom on a toilet too far from any wall to get a grip on anything to help you get up! (Yes, that is my own personal story and I ended up having to turn halfway round and use the plumbing pipes on a flush-o-matic to push off of for a lift, while the stadium usher who took me there was likely wondering if I had drowned!)
Universal design works (most of the time) in public facilities, where people of various abilities will be using the bathrooms. When designing a bathroom for an individual, though, you have the opportunity to meet their own current needs and plan for future changes. So, your person uses a wheelchair. Figure out some of their needs by assessing their abilities, need (and future need) for assistance, and the size and plumbing constraints of the room. Explore technology that can help, like hoyer-type lifts to elaborate ceiling track systems that can pick someone out of their bed or chair into a sling system, then using ceiling tracks, transport them to a commode, bathtub bathtub, or shower in their bathroom. I have seen a few houses for sale where such track systems were in place, presumably for long-term disabilities.
If your person can transfer from their chair to the toilet unaided, you figure out what room they need from which angle, and where grab bars are needed. There are trombone slide like grab bars that mount onto the wall behind the toilet and hinge up agaist the wall or down next to the toilet as needed. If a person needs somone on one side or other, or beside/behind the toilet to assist, you need to provide room for this. One wheelchair universal design guideline for commercial spaces said that a handicapped toilet was to have 5 ft of open space on three sides, which is how I, a walker user with bad knees, almost got stranded. So figure out what is needed now, and what is reasonably to be expected in the future. If your person needs grab bars, figure where to attach them.
Wheelchair accessible sinks are available that hang on a wall or sit on a floating counter that are deep enough to allow a person in a wheelchair pull up and reach the sink without hitting their legs on the wall behind. Most major manufacturershave one or two. There are even vanities available that have a bit of storage that will hold these sinks. They are wall-hung, to allow footrests to swing under the counters without obstruction. They cost a few thousand dollars, more than they look like they should, presumably due to low consumer need. Then there are the white plastic pumbing covers that you often see in medical settings below the sinks. These are installed so that if a user is pulled up under the sink and their leg makes contact with the plumbing, a hot tap water supply pipe or a hot drain won’t burn them.
Wheelchair users sometimes use a specially designed shower chair that they transfer into outside the shower (or even in the bedroom) that can be wheeled into a shower and which allows access for reaching to wash most places. Others, who have good sitting balance, may use a simpler shower stool that they transfer to from the wheelchair. This would require a more open space and room for the wheelchair to sit in the room while the person is in the shower. There are also swivel transfer benches that are great for people who can stand to transfer. They are perhaps 3 ft long and have a chair that swivels and slides along a track. We used one of these for my father in law before we remodeled our bathroom. He would stand and pivot so that his back was to the tub, then sit onto the bench seat. His caregiver would then push the seat backwards while lifting his legs, lock the slider, unlock the swivel, and turn the seat so he was facing the shower controls and lower his legs into the bathtub. The seat had a back to it and optional arms.
For an open showeer situation, where the bather may need assistance at times, there are short, 3 ft tall folding caregiver shower doors. These keep the water confined into the shower better than a curtain, letting the caregiver stand outside the shower and keep their legs out of the spray. You top these plastic or glass panel folding shower caregiver doors with a short shower curtain above them that is long enough to stay behid the caregiver doors when the person does not need assistance and is using the sprayer. Generally, people find it easier to use a chair or stool that is mobile than a built-in shower bench. It is a matter of being able to reach better to assist a person who is not up against two walls.
Think also about whether the wheelchair user might sometimes use a scooter or a power chair. These may limit how close a person can get to a sink to wash their hands, so a semi-recessed
sink like mine, which protrudes from the counter may be better for them. These are not necessarily made for handicap use, but may work better in some circumstances.
For the shower itself, you can have a custom tiled shower made to your specifications. Often, people will use a floor that slopes from the room floor to the back wall of the shower with a long linear drain or trench drain at the back wall. You will need to consult with a builder or other professional to learn if this is an option for the home. Constraints sometimes arise about how to fit in the slope needed. I chose a premade solid surface shower instead. My drain is at the front of the shower floor, a 4” square you can see in the center front. It has a half-inch high dam that directs water to remain in the shower and head for the drain and a half-inch deep trough under the metal drain cover. This is inadequate to hold the water in at times (I went through some hair loss in which I could slow the drain with hair before a single shower was through!) and I do overflow into the bathroom fairly often. That is why my entire bathroom floor is waterproofed using a barrier method that my builder had trained in, and why there is an actual sloped Kerdi shower kit making up the majority of my bathroom floor. I have a floor drain in front of my shower as back up, and it is the best design choice I made (with the help of the pros here at Garden Web/Houzz).
See the dark square in front of the vanity leg, by the reflection off the tile? That is my floor drain.
I chose my shower because it is easy care Solid Surface and because it is 37.75” deep. It gives me much more depth than the Swanstone Handicapped Shower at 34”. Transolid made mine. Swanstone does have a much better guarantee, though. My builder was able to make the shower level with the floor by removing the subfloor over the floor joists and replacing them with subfloor between the joists that is level with the top of the joists. This gave us 3/4” and the shower floor under the room floor did the rest. We did have to make the flooring slope upwards from the doorway to meet the shower floor in the room floor. It is noticeable, but no one has tripped yet walking into the room.
Because my shower floor is level with the room floor, it does provide me with a 5 ft turning radius at the toilet and at the shower, which is recommended for wheelchair users. Another space consideration I made was to go to the local wheelchair store and get the turning radius for an electric wheelchair that fits me. I then made my bathroom counter a mere 16” deep, to give me space enough there. My builder made my walnut vanity only 14” deep at the bottom. He built it from my design.
I chose a 36” pocket door for maximum access. This is the house’s only full bathroom. We did move the shower wall out about 6 - 8” into the adjoining bedroom. That made the bedroom‘s closet that much deeper, so I stole it back by having an 11” deep cupboard put in the lower half of the closet for the bathroom. This is how we fit a handicapped bathroom, with storage, into a 8.5’ long basic bathroom.
I hope this gives you lots of key words to search on and an idea of how thought processes work when dealing with this kind of remodel.
Q