Summary
In this CareLab episode, Emilia Bourland and Brandy Archie take viewers inside Emilia’s own home to break down a real-life example of aging-in-place problem-solving: a tiny first-floor “closet-turned-bathroom” designed to make daily living possible without navigating stairs. By walking through the space together, they demonstrate how occupational therapists assess layout, safety, usability, and intent—highlighting both smart design decisions and areas that could be improved with today’s accessibility standards.
Key Questions Answered
-
Why was a bathroom added to the first floor of this home?
The house originally had no main-level bathroom, making it impossible for someone with mobility limitations to live safely on the first floor without navigating stairs. -
How does the bathroom function in such a small space?
It’s designed as a fully enclosed wet room, similar to a boat bathroom, with a sink, toilet, and shower sharing one compact area and a floor drain to manage water. -
What is one simple improvement that could significantly increase accessibility?
Installing offset door hinges would allow the door to swing fully out of the way, increasing usable doorway width without major renovation. -
What accessibility challenge does the bathroom still present?
A raised threshold (step) is required to contain water, which creates a barrier for wheelchair users or anyone who cannot step over it. -
Why is temperature control an important accessibility feature?
A built-in heat lamp helps keep the space warm, which improves comfort, reduces joint stiffness for people with arthritis, and helps manage muscle tone for individuals with neurological conditions.
Transcript
Hey everyone, before we get started, keep a second like and subscribe to the show.
best way to help us share great information with more people. Thank you. Welcome to CareLab everybody.
We have a really special episode today.
Because we're in person and we wanted to do this on purpose because instead of just talking about the things that we care about, like home modifications, we thought maybe we should.
Emilia Bourland
Yeah, that's right. We talk about this stuff all the time, I think it's a lot more meaningful if you can actually see what it is and how we might reason through this process. So we're actually here in my house today.
Brandy Archie
There's already been some changes made to your house and the sleuth that we are as OTs is easy to notice like maybe what they were thinking and what they were trying to accomplish and so we thought would be a great time to show you how you might consider making some changes in order to make a space work for you.
Emilia Bourland
Yeah, so obviously if you are listening to this right now, you probably have already figured out that this might be a good episode to watch. If you're listening on Spotify, the video is already there. You can just go ahead and switch over to the video. If you're not listening on Spotify, that's totally fine. Just head over to our YouTube channel. We're gonna link it in the show notes and you can watch the whole thing there.
Brandy Archie
Okay, so since we're in your house, maybe we should just get started. Okay, so we are in, actually what is this room? We're in a...
Let's get started.
Emilia Bourland
We call it the den. Okay, but I mean, I think it's had many uses. It's also like our office It's where we will it's the only place that we have like TV in the house and it has anyway It's probably had many uses over the years one of which is what we're about to talk about today
Brandy Archie
Yes. So we're here in a den and tell me like what you think is going on in the history because we don't have like a before and after. we're going to think about the before and after as we talk about how they created a bathroom in here. Yeah.
Emilia Bourland
So this house was built in the 20s. It was pretty traditional in the 20s. If you had a sort of really symmetrical room framed up like this with a fireplace in the middle to have a window on either side and then below the windows, you would have shelving or storage. Again, like very, very symmetrical. The reason that I think that is how this room originally was is because there are actually windows on either side of this fireplace. One is now in a closet.
And the other one is in said murder bathroom. You can't see the one in the murder bathroom. You'll see why it's kind of all covered up. But we can tell from the front of the house that there are two windows there. So probably that's how this was before. And I think that's helpful just to have context of what did these folks start with when they were trying to figure out how to make it so someone could live on the first floor of the house.
Brandy Archie
And why do you think it was important that somebody that they needed to add about?
Emilia Bourland
Well, there are, as you know, Brandy, there are no other bathrooms on the main level of this house. So probably when the house was built, there were no bathrooms at all on the main level of the house. have got, are stairs galore. Listen, y'all, we talk all the time about thinking ahead and buying an accessible house.
And we're not gonna talk about when you bought this house because it's not that long.
It's not the most accessible house in the world. But someone already had to solve this problem, which is why this is actually a great example, I think, to go over.
Brandy Archie
Yeah, that makes sense. Okay, so that's a closet. is a Okay, and then this is the bathroom.
Yeah.
Emilia Bourland
This is the bathroom. you guys ready? Are you ready to see the murder bath?
Brandy Archie
Okay, so we are in this closet turned bathroom. First, lay us out. How big is
Emilia Bourland
It's pretty tiny So there are definitely some parameters here where if you were a larger person this probably still would not work for you. Okay, but so width of the doorway We're looking at about 29 inch and That does not so that that is bigger than this is with the without an offset hinge. So Offset hinges, which I think you can get on AskSAMIE.
Brandy Archie
You totally can.
Emilia Bourland
And are these really great tools that you can use to swing the door all the way out of the way and fully take advantage of the entire width of the frame of the door right now without an offset hinge, which probably didn't exist back. You're looking at about 26 and a half inches.
I'm sure.
Brandy Archie
So help me understand this off the hinge thing a little bit. I'm gonna... Can you show us like what that actually means?
Emilia Bourland
Yeah, so this is right now a traditional hinge, right? So there's one part of the hinge is on the frame and the other part of the hinge is on the door and then you know the door just swings on that. With an offset hinge it's basically like a a almost like a double jointed like double hinge system and so what that does is it allows the hit the door to swing fully out of the way and so instead of there being this part of the of the width of the door that is taken up by the actual door itself when it's open, you can have the door swing all the way out of the way, and you can take advantage of the entire width of the frame. Which is kind of like a double hinge system.
Brandy Archie
really important here because how thick is this door?
Emilia Bourland
I mean, this door, listen, this is an old door. It's pretty thick. The door itself is about two inches thick, but it's not like flush off of the frame. So including that, it's another inch, which is why we go from having a 29 inch doorway to actually having a 26 inch doorway without using an offset hinge. So that's one really quick, easy way that you could actually improve this situation if you needed to in the future.
Brandy Archie
Makes total sense. Okay, so the door with the usable space right now you told us is 26 inches. Yes.
Emilia Bourland
The usable space is 26 inches. And then let's go inside the bathroom.
Emilia Bourland
From wall to wall, we've got 47 inches here. Okay. So standing inside the bathroom. So just under four feet and just under 45 inches here.
Brandy Archie
So under four feet, we're about like three, three, eight and a half. So under a four by four square of space and we have access to all three things you need to back.
Emilia Bourland
We sure do. If you've ever been in the bathroom on a boat, this is a very, very similar concept here. So we have a sink, we have a toilet, and yes, we even have a shower. So you could technically go to the bathroom, brush your teeth, and take a shower at the same time. There are also mirrors everywhere here for some reason, so you could watch yourself do it, which is why my husband also calls this the efficient narcissist bathroom.
Brandy Archie
Okay, but where's all that water going?
Emilia Bourland
Well, that's why I call it the murder bathroom. Because there's a drain in the floor here. And as you can see, so like I said earlier, behind this wall, there's actually a window. So the wall was fully enclosed. You can't see it here, but even the ceiling is tiled. So this is a complete wet room, would be kind of the name for it. There's a hole in the floor that functions as a drain if you're using it as a shower. Have we used this? Not as people. But we do bathe our dog in here.
Brandy Archie
Accessibility works for all kinds of situations!
Emilia Bourland
Yeah, it's actually been really handy because we have a big dog and it's hard to get her up the stairs. So we bathe her in here. But yeah, so what else was I going to say? You can, every single surface of this bathroom can get wet, including (the toilet paper).
Brandy Archie
They thought of everything. I love that. I was just thinking that I was like, what are we doing about the toilet paper? You have soggy roll of toilet paper.
Emilia Bourland
That's right, so literally the only thing that you have to do when you come in here is like take out the extra toilet paper and then it's a fully enclosed wet room.
Brandy Archie
That's great. They even did that with the lighting too. So if you flip the switch on the light, you can see.
Emilia Bourland
which probably makes me look less scary like it is a murder bathroom.
Brandy Archie
That's a fully enclosed light container so that that doesn't get wet on the inside. And the same thing they did at the top too, to make sure that everything was protected. So they thought about the fact that they were using this super small space in a wet way.
Emilia Bourland
You probably also noticed that there are grab bars in this bathroom, which is one of the big clues that this was put in for accessibility and not just so that they could have a full bathroom down on the bottom floor. There are actually grab bars across horizontally for if you were stepping in here and then again for getting on and off the toilet.
Brandy Archie
There you go. Okay, so how might we do some things differently now? Because it exists and it's pretty good, but there are some challenges in here.
Emilia Bourland
That's right. So one we already talked about putting an offset hinge on the store would be a huge, a huge increase in how wide the spaces to allow someone else to get in and a very, very cheap and easy fix. You could just do that in an afternoon. No problem. One of the other big barriers though, I want to direct your attention down.
So as you can see, there is a step that you have to get over in order to access the bathroom slash wet room. They did this clearly so that there was a way to keep water from getting out if you did need to use it as a shower. However, that does create a barrier. Something that I might do differently is knowing that this section of the house has a crawl space underneath it. What I would probably do if I could was actually...
Instead of having a step here, I would put in some extra drainage across the way in addition to the middle of the floor drain and instead make this a curbless shower because a lot of times if you have a crawl space that gives you a little bit more room to put the plumbing lower and put the shower pan lower so that you can actually have a roll in or curbless shower situation.
Brandy Archie
But one thing I want to bring up about this is they probably also did this to save some money because it does cost more money to dig, to go down into the crawl space and create a fully flush area. And they were going to try to keep the water in anyway. So instead they put the shower pan inside of here, tiled it. And that's why the difference between here and here is three different, three inches. So that still gives you an opportunity to do something yourself and turn a closet into a shower as long as the person you're designing this for is going to be able to step over this now and in
Emilia Bourland
One other kind of nitpicky thing that I might change about this bathroom, if I were designing it from the beginning, is it has this shelf here, which is obviously really handy. You need to have somewhere to store things, to put things. So you need to have some kind of shelf or storage in a bathroom. However, this is fixed and it makes it really difficult to access, like for example, the top of the toilet if the toilet needed to be repaired or you needed to get another cleaning. So what I would do instead is I would either make this so that it could slip up and down or that it was just a removable shelf.
Brandy Archie
Okay, so it has grab bars in here, which is great. If I were doing this over though, I would probably put this grab bar at an angle. And the reason being, number one, as a taller person sitting in here, I need some leverage, so I really would prefer to hold on up here. And when you put an angle grab bar, that gives that latitude of where you can hold on to, and also gives you better leverage. So here, I need to hold here, keep a good grip, and be able to pull myself up into standing or use this one to pull forward. So on the toilet walls, I like to have angled ones. gives better accessibility for more different, it gives better accessibility for different body types. And if you're standing to use the bathroom, you then have something higher up to reach as well.
Emilia Bourland
The last thing I want to talk about is something that I think they did really, really well when they originally did the bathroom. And that is that they thought about temperature. So there's actually on the light switch out here, there's an option to turn on a heat lamp that is built into the ceiling there. This is a really important thing that often is not thought about, but people get cold. One of the most important things about comfort when you're bathing is not getting cold, especially if you have to have someone help you, if you're moving a little bit slower. This bathroom, it's an old house, so it gets pretty chilly in there. Having the heat lamp built in was a really great idea that doesn't cost a whole lot of extra money. It really just requires that forethought when you're planning to put in the space.
Brandy Archie
That sounds like a nice to have, but why might it be a need to have? Who would really benefit from having a warmer space and have better functional outcome because of that?
Emilia Bourland
Yeah, that's a great question. Definitely it's a nice to have. I would say that for the cost to the benefit, I would actually put it more in like the need to have category for most people because bathing one is supposed to be a positive experience. If it's not a positive experience, then you're going to be in a situation where people don't want to bathe, right? So making sure that the space is comfortable and warm is a really important part of that. Folks who have arthritis in particular really benefit from having a nice warm space as opposed to a cold space. It's just easier on the joints. It helps our tissue to be more flexible. So it's less likely to be kind of like creaking and cracking causing pain or causing injury. So that's a population that really benefits often from having a heat lamp or some kind of heating in the bathroom in order to make it more comfortable, but also less painful and make their mobility a little bit easier as well. Were there other populations you were thinking about?
Brandy Archie
I'd throw in anybody who has trouble with tone. So if they've had a stroke or if they have cerebral palsy or something that causes them to have really tight muscles already, the cold can make it so that you're even tighter and so this really challenging task of taking a shower is now even more challenging because you're not moving at your best.
Emilia Bourland
That's a great point. Yeah. So what Brandy is talking about is this idea of like hypertonia, meaning that there's too much muscle tone in a certain part of the body that's been affected by a neurological condition. And as she said, people are often susceptible to cold. When it's cold, that tone gets tighter and tighter. It locks you up. And that makes it so much harder to do any kind of voluntary movement, or even if voluntary movement isn't possible, if you're a caregiver, and you're trying to care for someone and clean them when they have high tone, making sure they're warm so that muscle can relax is a really, really big benefit.
Brandy Archie
So I hope that that was helpful for you. And one of the things that we've noticed as being challenging in that occupational therapists do all over the country is to do that exact kind of assessment that we just did on space and figure out what could be done here within your budget in order to make that space work for your needs. So if you have a space that you'd like us to review, send us a video or send us a picture and we'll be happy to do it on the show and give you some advice about how the place can be modified to meet your needs and.
Emilia Bourland
And if you're in the Kansas City area, then we'd be happy to come out to your house and do it live. So if you're in the Kansas City area or even if you're not and you have a space that you would love to get some advice on, send it to us, let us know, and we can take care of that right here on CareLab.
Brandy Archie
There you go. And for more content like this, and so you can never miss the next video or podcast, please like and subscribe, share it with a friend. We really hope that this is a useful tool that can help you think about how to handle your space and our goals to be a resource. So please share it and that helps other people find a show too.
Emilia Bourland
Thanks so much. We'll see you back here next Friday right here on Care Lab. Bye.
Bye!
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