The following 4 video interviews are all referenced in this episode. They’re each rather lengthy but feel free to check them out!
Sarah: [00:00:00] You’re Listening to Good Fit Poor Fit. A podcast that explores the interaction between people, design, and activity. Good Fit Poor Fit is part of The Universal Design Project, a nonprofit organization with a vision for every community across the USA to have a surplus of homes and opportunities for social participation that are universally and financially accessible. Learn more at universaldesign.org.
[00:00:27] Hi, Good Fit, Poor Fit listeners. Welcome to another episode in our mini series, Candid Conversations. Lauren, Sally and I are going to chat today about the much needed accessibility of public bathrooms. Lauren, can you share some background on where our info is coming from and today’s discussion?
[00:00:46 ] Lauren: Yes! In 2017 and 2018, the Universal Design Project conducted interviews with 24 individuals to learn more about their needs and hear from their own perspectives about the barriers they face, at home and in the community, due to design.
[00:01:02] While listening to these, a common theme mentioned was the need for more accommodating public restrooms. I was reflecting on these conversations the other day, while I was scrolling through Facebook and came across a post recently shared by a friend that was originally posted in 2016. This post was written by a mother who is fed up with the lack of safety and accessibility of public restrooms.
[00:01:24] Namely the small toilets, weight limit on the changing tables, and the inaccessible grab bars. This post was accompanied by a picture of the woman’s son, who is dependent for self-care, and was laying on some sheets on the bathroom floor of a public restroom to be changed. Seeing this really pulled at my heartstrings, as I’m sure it did for many others that saw it on their Facebook feed.
[00:01:46] And it got me thinking, what can be done and what can continue to be done about this problem?
[00:01:52] Sally: I’m so glad we’re talking about this Lauren, because public bathrooms are definitely in need of some attention and redesigning here in the U.S. I don’t know anyone who actually enjoys the experience of using a public restroom, so clearly there’s a need to make them cleaner, more functional, and more accessible to people with a wide range of abilities and needs.
[00:02:12] The bathroom experience is much more challenging for people with disabilities and their caregivers as they often face barriers related to limited space or lack of necessary design features. I may be able to get in and out of a public bathroom pretty quickly, but for many others, using the bathroom is a much longer process.
[00:02:30 ]Lauren: For someone that’s never experienced the limitations presented by public restrooms, we pulled some excerpts from our YouTube interview, to provide some perspective. First, we will hear from Tiffany McManus, who has a brother with cerebral palsy, which is a disorder that affects a person’s ability to move and maintain balance and posture.
[00:02:49] She describes the difficulties. Her family had to face to complete his self care task in public restrooms that didn’t accommodate his needs.
[00:02:58] Tiffany: My brother used to diapers cause he couldn’t stand. However, that does bring up, um, the baby, we had to put him on the baby things to change him. You know, we had to when we were out. Um, and you know, putting a hundred pound kid on one of those baby things is kind of scary sometimes.
[00:03:14] It would be really nice if there was like a table or something in every bathroom for someone who’s larger.
[00:03:20] Sarah: I’ve seen things online about that as well. And mom’s taking pictures of them, like changing their, larger grown child on the floor they carry a blanket with them and because they’re like, otherwise they’d have to go back home. There are a lot of people who are older, who can’t fit in those baby things anymore because they probably weren’t designed in that way.
[00:03:42] Tiffany: Or even just a dedicated space, maybe not adding in a whole, another piece of equipment, but just like a dedicated, larger space that’s kept clean and is only for that kind of thing. Or even, um, nursing mothers or something, you know, like those kinds of things where you kind of need that extra space, but not everyone should just go in there cause then it would be dirty.
[00:04:02] Sarah: You know, they would need a lot of space to kind of lay things and same thing with nursing mothers who have a big bag of stuff. So, I mean, it may work for the same type of thing.
[00:04:12] Lauren: This example, she gives really mirrors some of the challenges and unsanitary conditions experienced by the mom from the Facebook post I mentioned earlier. Tiffany and Sarah discussed an interesting point about the benefits of a multi-use area, such as a family bathroom, for both caregivers to complete their client, or loved ones toileting tasks, and also for mothers who are breastfeeding and wanting a private area to do so. While having a changing table that could hold the weight and size of an adult would be helpful addition to a public restroom, a separate room such as a family room would be ideal, especially when the caregiver and individual needing assistance are different sexes, as in the case with husband and wife pair, Donna and Don Shiflett. Donna Shiflet has post-radiation plexopathy, which is a neurological impairment of the peripheral nervous system caused by radiation therapy.
[00:05:05]Donna requires assistance from her husband to complete safe transfers, but as you’ll hear, this can be tricky where there are no family or gender neutral bathroom options avaliable.
[00:05:16] Sarah: Yeah. I mean, if you don’t have another person there, it’s tricky. Very tricky. Yeah.
[00:05:22] Don and Donna: And for, if you go out, uh, to, in public, you know, I’m a guy and she’s a woman, so I don’t usually go into the ladies room and that would be, that can be disconcerting for other people. Um, so unisex bathrooms might be a good thing for disabled people.
[00:05:42] Sally: I like that this example really brings to light the need for gender neutral bathrooms to accommodate the caregiver and the person with a disability. I spent some time each week with an 11 year old boy with autism and when I have to take him to the bathroom, I take him with me into the women’s restroom. Although, I don’t mind doing this and he doesn’t seem to either, we do sometimes get puzzled looks or a little bit of judgment because he does look old enough to use the restroom independently and also, autism is considered an invisible disability. So, people might not understand why he’s with me. Having a gender neutral option would help everyone in this situation feel more comfortable. I wouldn’t have to worry about the judgment or explaining to people why he needs to be with me and other people, maybe those who aren’t as understanding, wouldn’t have to feel uncomfortable about a young boy being in the women’s restroom. And this only gets more complicated when you’re talking about adults. People may be more understanding of my situation because the child I’m with is still pretty young, so it’s easier to imagine that he may need help. But, as Don mentioned, it can feel weird as an adult breaking those boundaries and can also be disconcerting to others using that public space.
[00:06:56] Sarah: Definitely. And like you said earlier, Lauren, maybe this could also be looked at as family bathrooms too, or have one larger bathroom for people who need privacy and extra space than the traditional multi-stall bathrooms. This could also incorporate some of the features that Lauren discussed earlier, in regard to Tiffany’s story with her brother, and the need to have some sort of changing table or an adjustable bench that was large enough to fit an adult who couldn’t stand and needed to wear diapers.
[00:07:27] And this could easily be done in a wall that’s an easier transfer level than on the floor, like they were describing.
[00:07:34] Lauren: Yes, good point, Sarah. While the layout of multi-stall bathrooms may not accommodate the needs of everyone, a separate family changing room that incorporates a little bit of non-slip flooring, that has anti-microbial properties, would be helpful for this issue.
[00:07:49] There are a couple of public restrooms in restaurants in my local area that have a separate sink and hand dryer in the handicap accessible stall. Which is great, if this space also provides adequate turning radius to navigate for people using a mobility device or for people who don’t require assistance of a caregiver from the opposite sex to enter the bathroom with them.
[00:08:10] However, to be the most functional for more individuals, having an accessible sink that is high enough for someone on crutches to use and low enough for someone to roll up their chair under and use, that also has a hand dryer or paper towel dispenser within reach, would be great additions to a family bathroom where a person could easily enter and be assisted by caregiver.
[00:08:32] Another issue I heard in these interviews came from Chris and Becky Grandle. Chris has spina bifida and discusses the unsanitary conditions presented to those using crutches or manual wheelchairs.
[00:08:44] Chris: Um, one of the things that Becky and I – that I constantly complained about when you go out to dinner, the accessibility restaurants in the community is still terrible. As far as I’m concerned. There’s a lot of newer ones that are good and that type of thing, uh, exceptions are floors and cleanliness of floors, especially in the bathrooms.
[00:09:06] Um, They are very slick with crutches. And I don’t, when I go to a restaurant, I don’t have to take my wheelchair all the time and I want to get along on my crutches. And so I would wish, I wish they do things different. There are some restaurants that have changed things the way they do it.
[00:09:22] Sarah: Now I have a friend that uses forearm crutches due to an amputation and she always complains like in the bathrooms you wash your hands and then they put the towels way far away. She struggles because she’s like, okay, I’ll have to wipe my hands on my pants, just to be able to get to the towels.
[00:09:37] Chris: Then you get water on the floor from just worrying about wiping or drying your hands on your pants. Then there’s the water to slip on it.
[00:09:44]Greasy floors are the worst, the fast food restaurants around, and I empathize with them, I mean, I’m sure it’s difficult to get that film off the floor. But they’re just not conscious of how well they do it.
[00:09:57] Becky: And a lot of the floors is, well, let me say very smooth, anyway. When they’ve got a little bit of texture to them, you know, it’s not as, not quite as bad.
[00:10:08] Sally: I think it’s interesting that Sarah mentions how, in some bathrooms, the paper towels are on a separate wall than the sink. So if you’re using crutches, you have to wipe your hands on your clothes and then hop over to get the towels. Chris jumps in to mention how this may even be a safety issue, because the floors can get very slippery from the water dripping from your hands onto the floor. Although this seems like such a small, simple detail, it clearly makes a huge difference in the functionality and the safety of the environment.
[00:10:39] Lauren: So we know what kind of bathrooms we are looking for, but are these kinds of public restrooms easy to find? The final interview excerpt we will share with you comes from Max Quillen and Jo Chan. Jo Chan sustained a spinal cord injury in 2012 and now uses a wheelchair.
[00:10:55] They discuss their experience with locating accessible bathrooms.
[00:11:00] Sarah: What is one thing in your community that you would want to change to make it easier for you to participate in things you enjoy?
[00:11:07] Jo: More family bathrooms, without a doubt. That would be my number one wish. Yeah, because otherwise, if you drive anywhere, you just think: Okay, where – where can I find a bathroom?
[00:11:19] And we did a trip down somewhere, and this is spent like, epically long period of time is trying to find a bathroom that will work. Yeah. We waste a lot of time that way.
[00:11:28] Max: Yeah. Road trips can be kind of stressful to you. You look for certain name brands like Target or Walmart will tend to have the most modern shopping malls do. Um, but you know, sometimes you think a place would it turns out not to, or it’s out of order or there’s construction going on or something that you have to totally re-think.
[00:11:45] Jo: For example, Universal Studios, um, we thought, oh no, they’re so disabled friendly. Surely they must have a family bathroom similar. I mean, the kids go there all the time. In the morning when I first got there, it was not busy, so I managed to sneak into the men’s bathroom. But at the end of the day, when it was, you know, a lot of people I couldn’t do it. So, but we found
[00:12:08] Max: – No, we didn’t find, we hunted and asked –
[00:12:11] Jo: -a first aid station.
[00:12:14] Max: And when we asked around for accessible bathrooms and no one knew anything about it. And they said go to the first aid station, which is like, like a miniature hospital, you know, with like nurses there for people who injured themselves in the park. And so we’re like, we don’t have any injuries we just need to use your wheelchair accessible bathrooms. They were fine with that, obviously, but still, it was like awkward. We had to go way there’s only one of those in the park and the park is large. So, um, it was, did it take a lot of time. I mean, it’s probably spending an hour of your day at the amusement park and you spend however much money, and you spend an hour, hour and a half of that like worrying about
[00:12:46] Sarah: worrying about bathrooms.
[00:12:47] Lauren: These personal anecdotes really shed light on common issues experienced with finding a public restroom, which is horrible to hear, because I know I would feel so limited if I had to pre-plan places I could go to or need to be nearby in case I had to use the restroom. I would probably avoid going out as much and running into this issue, which could be really socially isolating.
[00:13:09] Sally: What a great point to bring up Lauren, a lack of accessible bathrooms not only limits people from doing very basic activities, such as toileting, but it also might restrict participation in other valuable occupations, like shopping and socializing. Even if you are successful in finding places to spend your time in the community near accessible bathrooms, it must feel pretty limiting to have to plan your outings around the bathroom.
[00:13:33] I think it’s pretty wild that a place like Universal Studios did not have a family bathroom for Jo to use, because that is a place where families go with their children. But, this is just another great example of how much we need to re-think and re-design our public spaces, especially our bathrooms.
[00:13:50] Sarah: Yes. I really agree with that, Sally. The experience of having to look all over creation to find a bathroom and miss out on a lot of your day is so frustrating. I agree. Rethinking and redesigning bathrooms to make them more functional in more locations in our public spaces, is a must. People shouldn’t have to look so long or maybe have to go back to their car to find a private spot, to take care of business. I’ve known of some families that even drive all the way back home and cut their day short. We’ve actually been to outdoor weddings without accessible facilities and when you gotta go, you gotta go. And, without getting into too much detail here, sometimes you just have to resort to good old nature, going to the bathroom, behind a tree to take care of business. It’s actually quite frustrating.
[00:14:39] Lauren: Yes, I bet. All right. Let’s switch gears and talk about some more positive news on the same topic. A company named Universal Changing Places is providing some solutions. They advocate for adult changing tables and family changing rooms, which they state, like Sarah and Tiffany discussed, can double as a breastfeeding room.
[00:14:58] Some public spaces that have already been working on more functional public restrooms include Orlando’s International Airport, who added a facility that has a motorized passenger lift with the detachable sling and lots of space for maneuvering. More recently located in O’Hare’s Terminal Two, a 110 foot square foot facility was built, equipt with an adult adjustable changing table, passenger lift system, and an accessible roll-in-and-transfer shower and accessible toilet and sink.
[00:15:29] Sally: Wow. It seems like those airports go above and beyond. That’s pretty cool to have all of those features available in one bathroom. Traveling can be incredibly stressful, so I’m sure that having a safe, quiet and accessible space makes this process a bit easier for people with disabilities and their caregivers. Or, even just for the common traveler with lots of luggage.
[00:15:50] Sarah: And I want to add one more point here. The fact that they have a shower in there is actually quite exciting. I mean, there are a lot of people who travel, with disabilities or not, who may need a shower for different reasons. So that’s pretty cool.
[00:16:03] Lauren: Yes, definitely, thanks for adding that. In terms of legislation relating to adult changing tables, California was the first state that required all commercial places of public amusement built after January, 2020 to include and maintain at least one adult changing station for people with disabilities. It also required that any business renovated after January, 2025 must include adult changing stations in their plans. Last may Arizona followed suit, and now requires adult changing tables in movie theaters, concert halls, and other venues that attract large crowds.
[00:16:40] Oklahoma made headway as well, passing a bill named Max’s Law, that mandates the installation of variable-height changing tables in publicly-funded buildings.
[00:16:50] Sarah: This is really great to hear about some of these changes to public restrooms, to allow people to engage in community activities with greater ease and less worry.
[00:16:59] I know, at least in our family, that if there were public bathrooms that were easy to use, we would definitely go out and engage in more community activities.
[00:17:09] Lauren: The future OT in me is so excited to learn of all these new changes because social participation and community interaction are major life occupations for everyone.
[00:17:19] And when someone experiences barriers that prevent them from these activities, it can affect many other areas of their life, especially their social, emotional, and physical health. Stay tuned for upcoming Candid Conversations episodes, where we will feature more interesting tidbits we learned from past interviews. Be sure to check out the full interviews posted on the Universal Design Project’s YouTube channel, linked in the show notes below.
[00:17:44] Sarah: Have a great day.
[00:17:48 ]Thanks for listening to Good Fit Poor Fit. I’m your host Sarah Pruett, Program Director and Occupational Therapist at The Universal Design Project. Learn more about our work at universaldesign.org, and find more episodes and links to subscribe at goodfitpoorfit.com If you have questions or topics you’d like to discuss, email us at [email protected]
[00:18:15] Thanks for fitting us into your day!