Planning Bathroom Changes and Choosing Professional Help

The bathroom is a small room with hard surfaces, water on the floor, and few things to grab. It is where many falls at home take place. This guide shows how to plan changes to a bathroom in the right order, from cheap fixes you can do this week to bigger work that needs a skilled tradesperson.

This guide is part of our Aging at Home hub. Its sister guides cover reviewing entrances, steps, thresholds, and doorways, improving lighting and reducing household obstacles, and making kitchens, storage, and laundry easier to use.

Key takeaways

• The Centers for Disease Control and Prevention (CDC) counted about 234,094 nonfatal bathroom injuries treated in emergency departments in one year of its study, and 81 percent of them were caused by falls.
• More than a third of those injuries, 37.3 percent, took place while bathing, showering, or getting out of the tub or shower.
• About 1 in 4 adults age 65 and over falls each year, the CDC says, so bathroom safety is part of a wider home plan.
• Start with grab bars, a shower seat, and better lighting. Move to a walk-in shower or a new layout only if the simple changes do not meet the need.
• Hire licensed help for plumbing, wiring, and bars that must hold a person's weight. A bar fixed to tile alone can pull out when it is needed most.

Why the bathroom comes first

The CDC studied bathroom injuries using emergency department records. It found an estimated 234,094 people age 15 and over were treated for nonfatal bathroom injuries in 2008, the study year. Falls caused 81 percent of those injuries. Bathing, showering, or getting out of the tub or shower was the activity in 37.3 percent of cases. Injury rates rose with age, and the rate was highest for the oldest adults.

Those are old study figures, but the pattern has not changed: wet floors, high tub walls, and nothing firm to hold. Planning a bathroom change means removing those three risks in order. You do not need to rebuild the whole room to do it. Most of the risk sits in a short list of spots: the tub or shower entry, the shower floor, and the toilet.

The changes, in the order to plan them

First, add firm support. Grab bars by the toilet and in the tub or shower are the core fix. Under the ADA Standards for Accessible Design, grab bars are set 33 to 36 inches above the floor. Bars must be fixed to studs or to solid blocking in the wall, so they hold a full person's weight. A towel rail is not a grab bar, and a bar held by suction cups is not a safe bar.

Second, make sitting possible. A shower seat or a built-in bench lets a person wash while seated. A hand-held shower head on a slide bar pairs with the seat, so the water comes to the person. A raised toilet seat or a taller toilet makes standing up easier on knees and hips.

Third, cut slips and trips. A non-slip mat or strips in the tub, a clear path from the door, and bright, even light all help. Night lights on the route from the bed to the bathroom help too, since many trips take place in the dark.

Fourth, plan the big work only if the need is there. A walk-in shower removes the tub wall that causes many falls. A wider door lets a walker or wheelchair pass. Moving a toilet or tub means moving pipes, and that is where costs jump. Get the first three steps done and live with them before you decide on the fourth. Many homes never need it.

Choosing professional help

Some of this work is safe to do yourself or with family help: mats, lights, a hand-held shower head. The rest needs a pro.

One test before you pay the last part of a bill: pull hard on each new bar. It should not move at all. If it moves, it is not done.

• Grab bars, plumbing, and wiring: hire a licensed contractor, plumber, or electrician as the work demands. Ask for proof of license and insurance. Ask if they have done bathroom safety work before, and ask for the name of a past client you can call.
• Design help: an occupational therapist can assess the person, not just the room, and say which changes matter most for how they move. Some home health agencies and hospitals offer home safety assessments.
• Aging-in-place skill: some remodelers hold the Certified Aging-in-Place Specialist credential, run by the National Association of Home Builders. It is a training credential in home changes for older adults. Ask any contractor if they hold it, and check the answer against the association's own listings.
• Quotes: get at least two written quotes that list the same work, item by item. A quote that names the bar model, its place on the wall, and how it will be fixed is worth more than a low lump sum. Never pay the full sum up front.

Who covers what

• Original Medicare: does not pay for bathroom remodeling, grab bars, or raised toilet seats. These are home changes and comfort items, not the medical equipment Medicare covers. Do not let a seller tell you Medicare will pay for a walk-in tub.
• Medicaid: home and community-based waiver programs in some states may pay for home changes, such as bars or a roll-in shower, for people who qualify and get approval in advance. Each state sets its own rules, so ask your state Medicaid office or local Area Agency on Aging before you spend.
• Private pay: most bathroom safety work is paid out of pocket. The simple fixes cost little. Bars, seats, and lights are the cheap part of this plan, and they carry most of the benefit.
• Veterans: the Department of Veterans Affairs runs grant programs that can help pay for home changes for veterans with service-connected disabilities. Ask the VA about its housing grant and home improvement programs if this fits you.

Sample Situation

Ruth, age 81, slipped getting out of her tub and bruised her hip. Her son priced a full remodel first, then stepped back and planned in order. A licensed contractor fixed two grab bars to the studs by the tub and toilet, set at the height the standard calls for. Ruth added a shower seat, a hand-held shower head, and a night light on the hall route. The work took one day. She bathes seated now, holds a bar each time she stands, and has put the big remodel off unless her needs change.

Your next step

Bathroom work is often the first job on a longer home list. Our Providers directory can help you find home care and local services when a home change alone is not enough.

Sources

• https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm
• https://www.cdc.gov/falls/data-research/facts-stats/index.html
• https://www.access-board.gov/ada/chapter/ch06/
• https://www.nahb.org/caps
• https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
• https://www.va.gov/housing-assistance/disability-housing-grants/: