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Overview

Healthcare is moving beyond the walls of the hospital. This is partially due to a growing population of patients who require medical care but are stable enough to be treated at home (including older adults with acute and chronic conditions). Caring for these populations in their own home is more convenient and cost effective than providing that same care in a traditional medical setting. Home environments that support medical care can reduce unnecessary hospitalization, influence health and wellbeing, and help to maintain a person's independence.

  • Layout - Overall

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Adequate space for two people to assist patient if using hydraulic lift. citation
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Adequate space for two people to assist patient if using hydraulic lift. citation
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Three-fixture bathroom adjacent to bedroom on main level (i.e., street level) with 60 in. turning radius or acceptable T-turn space and 36 in. (or 30 x 48 in.) clear space (minimum dimensions for independent use; additional space needed for caregiver). citation
    • Flexible layout. National Research Council, 2011
    • Adequate space for patient to perform activities of daily living while using/navigating medical devices/equipment. citation
    • Adequate space for durable medical devices (e.g., wheelchairs, walkers) and medical equipment (e.g., oxygen tanks, specialist equipment) to support changing levels of care. citation
  • Fixtures/Accessories/Equipment

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Non-slip flooring and/or mat in bathtub/shower. citation
    • Adjustable seat/chair/bench (e.g., swivel seat, high-low seat) for use in tub or shower. citation
    • Curbless shower (if shower is used) with a minimum width of 36 in. citation
    • Bracing in walls around tub, shower, shower seat, and toilet for installation of grab bars to support up to 500 lbs. citation
    • Patient lifts (portable or ceiling-mounted) and other repositioning devices supporting safe ergonomic conditions for patient handling and movement. citation
    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Patient lifts (portable or ceiling-mounted) and other repositioning devices supporting safe ergonomic conditions for patient handling and movement. citation
    Desirable Outcome(s)
    • Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Adjustable seat/chair/bench (e.g., swivel seat, high-low seat) for use in tub or shower. citation
    • Adjustable/handheld showerhead with 6 ft. hose. citation
    • Curbless shower (if shower is used) with a minimum width of 36 in. citation
    • Wheelchair maneuverable bath (if bath is used) located on main level, with 60 in. turning radius or acceptable T-turn space and 36 in. (or 30 x 48 in.) clear space (minimum dimensions for independent use; additional space needed for caregiver). citation
    • Toilet seat at 17–19 in. (or adjustable toilet seat). citation
    • Lever handles or pedal-controlled faucets. citation
    • Wall-hung sink to provide space for wheelchair use and/or use of bathtub transfer bench.
  • Casework/Storage

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Large sharps containers with leak-proof covers. citation
    • Storage for gloves and other personal protective equipment to facilitate proper safety protocols (e.g., in the event of exposure to blood or other bodily fluids). citation
    • Easily accessible storage and disposal for non-reusable supplies (e.g., medication, adult diapers, incontinence pads, bandaging). citation
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Upper wall cabinetry 3 in. lower than conventional height. citation
    Desirable Outcome(s)
    • Efficient delivery of care
    Design Strategies
    • Maximize space for medical supplies. citation
    • Easily accessible storage for first aid supplies.
  • Flooring

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Safety; fall prevention
    Design Strategies
    • Level, smooth flooring with minimal variations allowing for freedom of movement, especially when navigating with medical equipment. citation
    • Minimize thresholds (less than ¼ in. vertical, or between ¼ and ½ in. beveled). citation
    • Non-slip flooring and/or mat in bathtub/shower. citation
    • Remove loose rugs. citation
    • Avoid carpet. citation
    • Smooth, non-glare, non-slip/slip-resistant flooring. citation
    • Avoid flooring materials with intricate, high-contrast patterns (especially for patients with impaired vision). citation
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Level, smooth flooring with minimal variations allowing for easy push/pull of floor hoists. citation
    Desirable Outcome(s)
    • Minimize undue strain during recovery
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
  • Walls

    Desirable Outcome(s)
    • Safety; infection control
    Design Strategies
    • Easy-to-clean materials to reduce surface contamination. citation
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Structural provisions for wall-mounted hoists. citation
    • Bracing in walls around tub, shower, shower seat, and toilet for installation of grab bars to support up to 500 lbs. citation
    • Wall support and provisions for adjustable counters (or counters of varying height) and removable base cabinets. citation
    • Horizontal and vertical track system with adaptable products for various bathroom functions.
    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Structural provisions for wall-mounted hoists. citation
    • Bracing in walls around tub, shower, shower seat, and toilet for installation of grab bars to support up to 500 lbs. citation
    • Wall support and provisions for adjustable counters (or counters of varying height) and removable base cabinets. citation
    • Horizontal and vertical track system with adaptable products for various bathroom functions.
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Wall support and provisions for adjustable counters (or counters of varying height) and removable base cabinets. citation
    • Grab bars, including a vertical grab bar at shower/bathtub entrance and a diagonal grab bar on long side of bathtub. citation
    • Light switches lowered to 44 in. off the floor. citation
    Desirable Outcome(s)
    • Patient control and independence
    Design Strategies
    • Wall support and provisions for adjustable counters (or counters of varying height) and removable base cabinets for wheelchair accessibility/roll-under counters. citation
    • Grab bars, including a vertical grab bar at shower/bathtub entrance and a diagonal grab bar on long side of bathtub. citation
    • Light switches lowered to 44 in. off the floor. citation
  • Ceiling

    Desirable Outcome(s)
    • Caregiver safety; minimize risk of physical injury
    Design Strategies
    • Track-mounted hoists in areas where space is tight and transfers occur frequently. citation
    • Track should end directly over toilet with option to bathtub/shower.
    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Track-mounted hoists in areas where space is tight and transfers occur frequently. citation
    • Track should end directly over toilet with option to bathtub/shower.
  • Doors

    Desirable Outcome(s)
    • Safety; fall prevention
    Design Strategies
    • Minimum door width of 36 in. citation
    • Minimize thresholds (less than ¼ in. vertical, or between ¼ and ½ in. beveled). citation
    • Easy-to-open doors (consider handle grip, mechanics, and weight).
    Desirable Outcome(s)
    • Accessibility; ease of use
    Design Strategies
    • Minimum door width of 36 in. citation
    • Minimize thresholds (less than ¼ in. vertical, or between ¼ and ½ in. beveled). citation
    • Easy-to-open doors (consider handle grip, mechanics, and weight of door).
  • HVAC

    Desirable Outcome(s)
    • Patient satisfaction and comfort
    Design Strategies
    • Efficient ventilation to minimize unpleasant smells.
  • Lighting

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    • Light in tub/shower stall. citation
    • Interior motion lighting/sensor-activated lighting without glare, and/or nightlights. citation
    • Smart home sensor technology to light up path from bed to toilet. citation
    • Night lighting system providing both horizontal and vertical cues (e.g., under bed and around doorways) to support postural control and stability. citation
    • Amber-colored LED night lighting to avoid disrupting circadian rhythms. citation
  • Technology/Monitoring Equipment

    Desirable Outcome(s)
    • Safety; fall/injury prevention
    Design Strategies
    Intercom system, voice-activated smart cell phone technology. citation
    Desirable Outcome(s)
    • Communication/Interaction with care provider
    Design Strategies
    • Intercom system, voice-activated smart cell phone technology. citation
    • Toilet seat with integrated technology to measure weight, temperature, and urine content. citation