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The Academy of Architecture for Health (AAH) provides knowledge which supports the design of healthy environments by creating education and networking opportunities for members of – and those touched by – the healthcare architectural profession.

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Academy of Architecture for Health Foundation Grant Abstract:

  • 1.  Academy of Architecture for Health Foundation Grant Abstract:

    Posted 03-01-2013 14:10
    A new study funded in part by The Academy of Architecture for Health Foundation (AAHF) is being presented at this year's Environmental Design and Research Association Conference in Providence, RI in May. Sheila Bosch with GS&P and Jon Sanford from Georgia Tech will be speaking about their study with investigated toilet room design for assisted persons. Looking forward to it!

    Thank you to our amazing donors, the AAHF greatly appreciates your support. To learn more about the studies that the AAHF has funded see our website:

    The study is slotted to be published in the Health Environments Research and Design Journal.
    Citation: Sanford, J. and Bosch, S.J. (in press). Non-compliant toilet room design for assisting persons on to and off of the toilet. Health Environments Research and Design.

    Optimizing Toilet Location for Assisted Toileting
    By Jon Sanford, PhD, Georgia Institute of Technology and
    Sheila J. Bosch, PhD., Gresham, Smith and Partners

    Objective: By comparing an Americans with Disabilities Act Accessibility Guidelines (ADAAG) compliant design with alternative designs, this pilot study resulted in recommendations for designing patient bathrooms to facilitate assisted toileting. 

    Background: The ADA Accessibility Guidelines were developed primarily to address the needs of a disabled population, such as returning Vietnam veterans, with sufficient upper body strength to transfer independently directly from a wheelchair to the toilet. However, the majority of older persons with disabilities (90%) stand to transfer to the toilet, rather than laterally moving from the wheelchair to the toilet.

    Methods: The research used a repeated measures research design to evaluate caregiver responses during assisted toileting for various toilet configurations. The study included 20 patients who were transferred onto and off of a toilet for each of four different configurations by one or two caregivers. Toileting trials were videotaped and analyzed by and occupational therapist. Additionally, caregivers completed 5-question, self-report surveys after each toileting trial.

    Results: Survey data indicate that staff members prefer the largest of the tested configurations, where the centerline of the toilet is 30" from the sidewall, rather than the 18" required by the ADAAG and where there are 2 fold-down grab bars provided. Care givers perceived the grab bar locations as better for helping them safely transfer subjects  in a modified (non-ADAAG) configuration, and also that the  grab bar style in a modified configuration (non-ADAAG) improved safety when transferring subjects.

    Conclusions: Although care givers were observed to safely transfer residents to and from the toilet for all configurations tested, regulations regarding accessibility of patient bathrooms should acknowledge the perceived benefits of increasing the distance from the side wall to the centerline of the toilet to as much as 30" and allowing 2 fold-down grab bars instead of the required side-wall and back wall grab bars.

    Erin Peavey Assoc. AIA
    Trustee, Academy of Architecture for Health
    HOK, Inc.
    New York NY