Something to lean on: Handrails in LTC facilities need a change

Designers are sometimes challenged when using the design that is the most appropriate might not be compliant with current codes. A perfect example of this is using an “ADA handrail” compared to using a lean rail.

The American Disabilities Act (ADA) was established in 1990 and was based on both the Rehabilitation Act of 1973 and the Architectural Barriers Act of 1968. The intent of the ADA was to reduce barriers to independence and increase mobility for those with disabilities. Unfortunately, the strictness of the ADA creates a mess of an issue because sometimes, when following the code, it actually restricts independence and mobility more than it helps.

My argument—of which I am not the first to raise—is that seniors, especially ones with arthritis, have difficulty “cupping” their hands around a cylinder rather than leaning their hand on a flat surface to steady themselves when walking.

Typically it has been said that the history of the original ADA handrail was designed for Vietnam Vets returning without legs. These men had great upper body strength and, like a gymnast, could maneuver quite well in a restroom with the ADA (cylinder) handrails. However, the residents of long-term care facilities have different issues to deal with and they don’t have the same build as these vets did.

In HUD-financed independent living buildings it is required to have at least one side of the hallway have an ADA handrail. This tends to look odd if the rail in not mirrored on both sides so you usually end up with them on both walls of the corridor. While I was in-house at an assisted living company, we would petition to get approval to use a lean rail as it was more helpful to the residents and less clinical. We would win some petitions and lose others. However, in skilled nursing the battle is not worth fighting.

While ADA has helped in numerous ways for those with disabilities, it has become so strict that we seem to have lost our common sense. Although we should not do away with these laws, I would like to see them be more adaptive to the community at hand. For example, a senior-specific adapted ADA that would encourage independence and mobility and that is as residential looking as possible.