Accessibility Recommendations
The following recommendations are based on accessibility requirements taken from the following sources:
- Belinda Parke and Kathleen Friesen, Code Plus: Physical Design Components for an Elder Friendly Hospital, 2nd Edition. Fraser Health; Dr. B Parke; K. Friesen, 2015
- General known best practices in the field of accessibility
- Expertise gathered from conducting accessibility audits
The outline contains both the best practice as well as a brief statement on the rationale of the suggestion.
The following summary does not address design for multi-stall washrooms, universal washrooms, parking and outdoor space requirements. For further detail please refer to the applicable Building Code and your city’s accessibility guideline standard.
Lighting
Best Practice | Rationale |
---|---|
| Using multiple light sources (natural & artificial, direct & indirect) will help maintain gradual changes in lighting, avoiding the disorientation of older adults. |
| Lighting that is even, soft and well diffused (i.e., full spectrum light bulbs) minimizes glare on walls and the floor. |
| Allow persons to control lighting levels. Low levels of light decrease visibility, which in turn can add agitation or frustration in some people. |
| Systems that control direct sunlight reduce glare. |
Colour
Best Practice | Rationale |
---|---|
| Warm colours are easier for older adults to see than cooler tones (blue, green, purple, or pastels). |
| Visual over-stimulation can exacerbate confusion in older adults. |
| Contrasting colour combinations help to highlight elements in the environment. |
| Using the same colour on the doors as used on nearby walls can reduce unwanted use or out of bounds areas. |
| Colour cueing/coding techniques in conjunction with assistive devices help people remember and feel safer. |
Flooring & Walls
Best Practice | Rationale |
---|---|
| Keep the walls behind handrails smooth to prevent abrasion injuries to knuckles. |
| Matte finishes reduce glare. |
| Helps older adults maintain stability and mobility. |
| Contrasting colours provides independence and safety for people with visual limitations when navigating. |
Hallways, Doors and Windows
Best Practice | Rationale |
---|---|
| Provide the space for larger mobility devices to complete a 360 degree turn. |
| Provides space for 95% of mobility devices used in North America. |
| Maintain a clear path of travel to ensure the passage of wheelchair users. Ensure equipment and supplies are stored in convenient locations outside of the path of travel. |
| Rest areas help promote walking, independence and mobility (i.e., in long hallways). |
| Maintain barrier free threshold for people who use mobility devices. |
| Ensure use by people with limited dexterity by choosing handles that do not require twisting or pinching and can be used with one hand or a closed fist. |
| Opening/closing system programmed to keep doors open for a longer duration than required by code is beneficial to older adults especially in high traffic areas. |
| Allow persons to control windows, drapes, blinds, or an energy efficient transparent sun screen system. Ensure controls are operable by people with limited dexterity and within reach from a wheelchair. |
Handrails
Best Practices | Rationale |
---|---|
| Supports patients who undergo medical diagnostic testing while promoting walking and mobility. Walkways with a gradient of 5% or less do not require handrails, but it is recommended that they are provided. |
| Ensure that handrail is continuous and uninterrupted. |
| Provides independence and safety for persons who have visual limitations. |
| Smooth, easy to grip design. |
| Communicates the end of the handrail to persons who have visual limitations. |
Wayfinding and Signage
Best Practices | Rationale |
---|---|
| More effective when used in conjunction with landmarks in key places (i.e., elevators). Allow people time to self-pace their examination of the information. |
| Helpful for persons with visual limitations as well as people between wheelchair and standing heights. |
| Light letters on dark, matte finish backgrounds are easier for older adults to see. Avoid combining yellow lettering on black, yellow on green, green on blue, or red on green. |
| Helps people orient themselves within the unit/ward and plan their route. |
| Avoids confusion and ensures consistency and instruction to help people problem solve. |
| Helpful for persons who have visual limitations. Makes signs more readable to all hospital visitors. |
Walkways, Ramps, Stairways
Best Practices | Rationale |
---|---|
| Supports mobility and prevents falling |
| Supports mobility especially for persons using a wheelchair, walker or cane |
| Colour contrast and Tactile Attention Indicators help persons with visual limitations |
| Rest areas help break up long walkways or ramps |
Acoustic Considerations
Best Practices | Rationale |
| Reduces acoustic reverberation to avoid over and under stimulation. |
| Single rooms should be isolating; noise levels should be monitored to avoid over and under stimulation. |
| Volume control options (i.e., television noise, overhead paging) especially in units and patient rooms support acute patient care as well as persons with hearing impairment. |
| Lighting that does not interfere with hearing aids. |
| Supports noise reduction and acoustic reverberation. |
Furniture
Best Practices | Rationale |
| The layout should avoid furniture with jutting or recessed bases. Furniture placed adjacent to the accessible path of travel. |
| Supports persons with limited range of motion as they raise themselves to a standing position. |
| Seating to facilitate transfer to/from a wheelchair; arms should cover the full length of the seat base. Avoid back tilting options or those that are on castors. |
| Contrasting colour combinations help to define the furniture edges from the surrounding environment. Supports persons with visual limitations |
| Supports persons with limited range of motion especial people who use wheelchairs/walkers and canes. |
| Supports patients and visitors who use wheelchairs/walkers |
Elevator
Best Practices | Rationale |
---|---|
| Supports independent wayfinding and mobility |
Equipment and Technology [Supplies]
Best Practices | Rationale |
| Provide at patient’s bedside and at entrances near waiting areas to support communication and travel outside of unit/ward |
| Provided near building entrance, common areas, in special function areas, and in patient rooms to support patients and visitors with limited range of motion |
| Allow persons to independently regulate heating and cooling |
| Supports older adults, patients, visitors and is dementia friendly |
| Monitors confused mobile older adults |
| Supports older adults with mobility limitations and those of low stature; eases the transfer of patients from wheelchairs/walkers. If not adjustable provide options at the lowest recommended height |
| Supports acute care patients |
| Equipment accessible to patients when monitored by physiotherapists, where appropriate |
| Supports the “rooming in opportunity” for visitor to stay overnight |
| Supports older adult’s mobility in and out of bed |
| Supports acute patient care |
| Supports older adults with limited range of motion as well as hospital staff and medical personnel |
| Supports persons with limited reach and dexterity |
| Supports acute care patient |
References and Resources
- Belinda Parke and Kathleen Friesen, Code Plus: Physical Design Components for an Elder Friendly Hospital, 2nd Edition. Fraser Health; Dr. B Parke; K. Friesen, 2015
- Wilber ST, Burger B, Gerson LW, et al. Reclining Chairs Reduce Pain from Gurneys in Older Emergency Department Patients: A Randomized Controlled Trial. Acad Emerg Med. 2005;12: 119-123
- Bradley SM, Hernandez CR. Geriatric assistive devices. Am Fam Physician. 2011;84: 405-411.