Aging-in-Place Bathroom Remodel Checklist for San Antonio Homes

An aging in place bathroom in San Antonio starts where hard, wet surfaces meet the movements that get harder with age: stepping over a tub wall, sitting and standing at the toilet, turning in a tight space. A CDC study of nonfatal bathroom injuries among people 15 and older found that injury rates were highest in or around the tub or shower, that rates rose with age, and that falls were the most common cause. In that data, falls caused about 81% of the injuries, and about 68% happened in or around the tub or shower. The CDC's older adult fall prevention page adds that falls are the leading cause of injury death for adults 65 and older, and that falls can be prevented. CDC also reports that more than one in four older people fall each year.

An aging-in-place remodel addresses those risks without making the room look clinical. The bathroom might be for you, a parent or a veteran in your family; the same questions come first.

Aging in place bathroom priorities: what to change first

Bathroom remodeling for seniors works best when the budget goes where the risk is. If you can only do part of the list now, this order puts the money in the tub, shower and toilet areas first.

Start with how the room is used

• Does anyone use a walker, wheelchair or shower chair, or are they likely to soon?

• Does a caregiver need room to help at the toilet or in the shower?

• Which bathroom will be the main accessible one, and is it on the main floor?

• Can the doorway be widened, or is it in a load-bearing wall?

• Does anyone get up at night to use the bathroom?

Write the answers down. They decide the shower type, the door and how much floor space you need.

Use published dimensions as a reference

The 2010 ADA Standards for Accessible Design are written for state and local government facilities and businesses, not private homes. They are still a helpful reference because the U.S. Access Board publishes plain-language guides with the dimensions. The ICC A117.1 standard is the related building-code accessibility standard, and the ICC notes that it includes provisions for Accessible, Type A and Type B dwelling units.

Reference points from the Access Board guides to toilet rooms and bathing rooms:

Treat these as starting points and fit them to the actual person. A shorter or taller user may need different heights. When someone already uses a wheelchair full time, build to the complete ADA bathroom remodel clearances for San Antonio homes instead of picking a few.

Shower checklist

• Low-threshold or curbless entry. Curbless usually means recessing or building up the floor and often a linear drain. On a slab, the plumbing contractor may need to cut concrete.

• Continuous waterproofing that extends beyond the wet area, which matters more when there is no curb.

• Hand-held shower on a slide bar, plus a fixed head if you want one.

• A built-in or fold-down seat placed so the controls can be reached while seated.

• Controls near the entry, so water can be turned on before stepping in.

• Anti-scald protection. Ask the plumber which valve type they recommend.

If you are replacing a tub, our walk-in shower conversion guide explains the build.

If you keep the tub

Some people still want a tub for soaking. The CDC's Check for Safety home fall prevention checklist recommends a non-slip rubber mat or self-stick strips on the tub or shower floor, and grab bars next to and inside the tub. Add a hand-held shower and a tub seat so bathing can happen sitting down, with the controls reachable from outside the tub.

Grab bars and blocking

The CDC study's authors pointed to grab bars inside and outside the tub or shower and next to the toilet, along with non-slip strips, as ways to reduce falls. A grab bar is only as strong as what it's anchored to, so add solid blocking inside the walls around the toilet, shower and tub while they are open, even where you won't install bars yet. Photograph the blocking with a tape measure in view before drywall goes up.

Give the toilet area the same attention as the shower

The same CDC study found that toilet-related injury rates climbed steeply with age. Among people 85 and older, about 52% of bathroom injuries happened at the toilet, compared with about 39% in or around the tub or shower. Plan the toilet area with the same care:

• A grab bar beside the toilet, anchored in blocking.

• Room on the open side for a walker or a helper.

• Toilet paper within easy reach, so no one twists or leans to get it.

• A flush handle on the open side.

• A light the person can find in the dark, such as a motion night-light.

Doors, toilet and vanity

• Widen the doorway where possible, or use offset hinges to gain clearance.

• Consider a pocket door, or a door that swings out, so a person who falls inside does not block it.

• Choose a comfort-height toilet in the reference range above.

• Use a wall-hung or open vanity so a seated user can roll under, with the pipes covered or insulated.

• Pick lever faucets and handles that work with one hand.

Floors, lighting and switches

• Slip-resistant floor tile, with smaller tiles and more grout lines in the shower.

• Bright, even lighting and a night-light path from the bedroom. The CDC checklist notes that some night-lights turn on by themselves after dark.

• Rocker switches at a reachable height.

Rough in now for needs later

Aging in place remodeling pays off when the hard-to-change parts go in once. While the walls and floor are open:

• Add blocking at every spot a grab bar might go.

• Frame the doorway as wide as the wall allows.

• Set the shower floor level with the bathroom floor so a curb never has to come out.

• Place the shower valve and slide bar where they can be reached from a seat.

• Choose a vanity that can come out later to open knee space.

• Ask the licensed electrician about an outlet near the toilet if a powered seat might come later, and a switch at the door.

Permits for a senior bathroom remodel in San Antonio

Inside San Antonio city limits, licensed trade contractors handle electrical and HVAC work and contractor-performed plumbing, obtaining the trade permits for their work. For plumbing only, DSD allows an eligible resident owner to obtain a permit for an existing homestead. The homeowner affidavit requires personal work without assistance, excludes business or rental property and requires City inspection. Painting, sheetrock repair, tiling, cabinets and countertops are on the City's No Permit Required list, but properties in Historic, Neighborhood Conservation or Corridor Districts may face restrictions on design and materials. Nearby cities set their own rules: Alamo Heights, for example, lists all interior remodeling of single- and two-family homes as work that needs a permit. Our San Antonio building permit guide walks through the City process.

Paying for the work

If a veteran in the home has a service-connected disability, our guide to VA SAH and HISA grants explains those programs. Confirm eligibility with VA before you finalize a budget. For how accessibility features change an estimate, see what drives bathroom remodel cost.

VA SAH, SHA and HISA grants: what each one covers and how to apply

VA's SAH, SHA and TRA housing grants work differently from the HISA health care benefit:

• SAH (Specially Adapted Housing): helps a veteran with a qualifying service-connected disability, such as loss or loss of use of more than one limb, buy, build or change a permanent home they own or will own.

• SHA (Special Home Adaptation): covers qualifying disabilities such as loss or loss of use of both hands, certain severe burns or certain breathing injuries. The veteran or a family member owns or will own the home.

• TRA (Temporary Residence Adaptation): helps change a family member's home where a veteran who qualifies for SAH or SHA is living temporarily. The veteran doesn't have to own the house.

• HISA (Home Improvements and Structural Alterations): a VA health care benefit for medically necessary changes such as roll-in showers and lowered sinks, with a lifetime limit of $6,800 or $2,000 depending on the disability category.

SAH, SHA and TRA applications use VA Form 26-4555, and VA may adjust the grant maximums each year, so check the current figures on VA's disability housing grants page. HISA starts with a VA physician's prescription and VA Form 10-0103, plus an itemized estimate and a color photo of the area before work.

Before the site visit

Bring your answers to the use questions, the user's measurements (seated and standing reach) and any equipment sizes. Our site-visit scope worksheet has room for all of it. 214 Veteran Solutions is a veteran-owned general contractor in San Antonio that plans and manages bathroom remodels for seniors and coordinates licensed trade contractors for plumbing and electrical work. Learn more on our bathroom remodeling and VA construction and renovation pages.

To walk through your checklist with us, call (210) 796-3695, request an estimate or book an estimate consultation.