Monday, January 6, 2014

Accessible Bathrooms - These Are Not One Size Fits All

Since the beginning of my recovery, toileting(using a bathroom/restroom) was the first and biggest hurdle, and continues to be (not sure for how long, maybe until I get full recovery in my leg?). Initially, while in ICU, I was lifted from my bed using a mechanical lift (as mentioned in my first post) to a bedside commode. After that, before I was doing any walking, the commode would again be at bedside and with the help of the nursing staff , I'd be helped to standing and then told to pivot, basically rotating on my heals, to sitting on the commode. This wasn't done very often out of concern that my foot would tun on it's side thereby resulting in my ankle taking all my weight, which could result in many other problems such as a breaks or tears. I think that this is the reason for which I was fitted for an AFO (to protect and stabilize my foot and ankle) Eventually, I was given a wheelchair and taught how to get from both the bed to the wheelchair and from the wheelchair to the toilet by using what's called a slide board. One end of this board, (often made of a highly polished, finished plank of wood) is tucked under the thigh of the strong, unaffected leg and the other end is placed onto the toilet seat. The transfer to the toilet is then accomplished by sliding one's bottom along the board using the strong, unaffected arm to push the body to the other end and onto the toilet. Once there, all that is needed is to stand, lower the garments, then sit again. However, until I regained control of my sitting balance, I required some sort of support to hold onto (such as a bar on the wall or arms on the toilet - I had and have a commode, with arms, over the toilet) to keep from falling off the toilet these all introduce different considerations when using different bathrooms. Because the slide board can only be used on the strong, unaffected side, the placement of the toilet in the room is significant. For those with a strong right side (like me), the toilet needs to be on the left in order to approach it from the right, obviously,the opposite is true for left side strong. It also means that there cannot be any obstructions in the space to and from the toilet (the arms of the wheelchair and commode must be able to lift or lower out of the way for the transfer).

Once I started using the KFO to walk,transferring to the toilet was so much easier, I could walk short distances to the toilet from the wheelchair, turn myself around then do what's normally needed to sit. The only considerations then (and continue to be today) were (1) the height of the toilet from the floor and (2) are there any grab bars and where are they positioned? The grab bars are necessary to push myself to standing as my legs are not yet strong enough to make that push on there own. This combined with being a tall woman are the reasons that toilet height are important. Toilet and grab bar placement in the room remains an important issue as long as I have the use of only one arm. at home, I have a commode with arms placed over the toilet (it gives me the proper height and the arms allow me to get up at my own doing).

So I guess because there are a number of ways that a person with disabilities can make use of a bathroom, it's easy to understand how an 'accessible' bathroom may not be able to accommodate the needs of all; however, it still came as a surprise to me the first time that I made use of a 'public' restroom labeled as wheelchair accessible. The first time was during a trip to a hospital and an adjacent medical building (offices of doctors and other providers of medical services - I was there for an adjustment to my leg brace -KFO.) . I encountered a variety of 'problems'.

Because I am one-handed I must maneuver the wheelchair with one hand and one foot but because I also need my quad cane to move from my wheelchair to the toilet, it's necessary for me to carry my cane with my good arm (while resting it on my foot) and then have another person push my wheelchair around, so, being that my husband is typically my 'other person', the first problem to solve is how to gracefully (politely?) bring a male into the Women's bathroom with me. Some places have Unisex bathrooms and these, of course, are preferred, but the first place at which we were did not. My husband 'solved this problem' by opening the door to the Women's room and loudly announced 'Housekeeping' to determine if anyone was there (luckily, there wasn't). So, in we went. The other problem here was the placement of both the soup dispensers and paper towels. All were out of my reach from the wheelchair! This was especially surprising to me because I am a tall women with a very long reach. (Heck, I haven't been in the situation of not being able to reach since I was a child).

Other problems encountered:

  • - a couple of the bathrooms had the grab bar attached too high on the wall from the toilet, I couldn't get proper leverage to push myself to standing. I hate to be redundant but, being a tall woman, I can't help but wonder how people, shorter than I, manage to get up again, I'd still be stuck there if my husband hadn't helped (lucky for both of us, he's very strong)
  • The door into the bathroom was so heavy on one bathroom we used and the spring on which it swung such a quick release that my husband had a difficult time holding it open while pushing the chair in at the same time (how do people alone manage that one?)
  • One stall had barely enough room to fit the wheelchair in and allow proper closing of the stall door afterward
  • BTW - we've been in other facilities since and the problem of bringing a male into the Women's bathroom was solved with the help of building staff (first, checking to see if anyone is currently using the bathroom and then to stand watch outside the room to alert women entering that there's a male in the room. Some places are very accommodating.

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