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Not a fan of ADA's handrails in senior living

September 22, 2010
by Lisa Cini
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The Americans with Disabilities Act (ADA) specifies that handrails be used in skilled nursing. The U.S. Department of Housing and Urban Development (HUD) specifies that even in residential environments, one side of a corridor must have ADA handrails.

Assisted living has held out and used lean rails in lieu of the ADA handrail for two reasons:

1. They look more residential.

2. It’s typically is easier for a senior with arthritis to use a lean rail versus an ADA handrail.

Why then are ADA handrails designed the way they are and mandated in most senior living homes?

From what I have been taught throughout my years of experience is that ADA was actually framed for 18-24 year old males coming back from war with enormous upper body strength. This would allow them to get around or transfer easily like gymnasts on parallel bars.

The interesting part is that ADA’s rules are actually in conflict if you evaluate the mandated door handles vs. the ADA handrail. Round door knobs are not allowed under ADA and have to be changed to levers, which are easier for a senior to use. But then there’s the ADA handrail, which is round in nature, instead of the flat lean rail, making it more difficult for someone to stabilize themselves when walking. There is no doubt, however, that the ADA handrail is easier to use while going up and down stairs due to the pulling motion.

I am curious to see who is doing what in independent living, assisted living, memory care, etc. There seems to be little consistency and the topic often becomes a hot button for whoever is discussing it.

There are more residential looking ADA rails out there but the transitions back to the wall tend to be sharp or they are rounded and come off very institutional. These also tend to have a bottom to them, which becomes a gathering place for used tissues, gum, food, and other detritus, creating an issue for housekeeping and infection control.

I would love to hear feedback on what you use, where you use it, and the pros and cons experienced.

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Comments

I will not argue against lean rails, but there is a fallacy in your doorknob vs handrail shape argument: the operation of round doorknobs requires torsion (twisting) strength and ability, which degrades with age. Lever-type hardware eliminates that need, requiring only a gravity-assisted downward push. However, torsion ability is irrelevant with grab bars, since one is not trying to twist the grab bar. Also, their round shape conforms to the hand's natural grasping contour.

A research study may provide the convincing evidence you need to establish new best practices and influence a change in legislation.

Lisa Cini

President and CEO

www.mosaicdesignstudio.com

Cini is president and CEO of Mosaic...