# Case Study: Sarah's Bathroom Transformation
## Background
Client:
Sarah Thompson, 68 years old
Location:
Melbourne, Victoria
Property:
Single-story unit (built 1980)
Challenge:
Progressive Multiple Sclerosis with increasing mobility limitations
Timeline:
6 weeks from assessment to completion
NDIS Contribution:
$42,500 (100%)
## The Story
Sarah was diagnosed with Multiple Sclerosis fifteen years ago. For most of that time, she maintained her independence with minimal support. However, in the past two years, her condition progressed significantly. What started as occasional use of a walking stick evolved to requiring a walker full-time, and her occupational therapist suggested preparing for eventual wheelchair use.
The most challenging part of Sarah's day had become using her bathroom. The standard 1980s design featured:
Over-bath shower with high step (400mm)Standard toilet (low at 380mm)Pedestal basin with no knee spacePoor lighting and small mirrorSlippery ceramic tilesNo grab railsNarrow doorway (760mm)## The Crisis Point
**March 2024** - Sarah fell while attempting to exit the shower, resulting in a minor fracture to her wrist. This incident was the catalyst for change.
*"I'd been avoiding showering because it was so difficult and frightening. That fall made me realize I couldn't keep living this way. I was sacrificing my hygiene and dignity out of fear."* - Sarah
## Assessment and Planning
**April 2024** - Occupational therapist David Morrison conducted a comprehensive bathroom assessment:
### Current Barriers
**Shower access:** 400mm step impossible to navigate safely**Toilet height:** Too low for safe transfers, causing strain**No support:** Absence of grab rails increased fall risk**Basin:** Couldn't use while seated**Door width:** Would not accommodate future wheelchair use**Flooring:** Slippery when wet**Poor lighting:** Inadequate for someone with visual challenges### Goals Established
Eliminate fall risks completelyEnable independent showering with dignityPrepare for progression to wheelchair useMaintain as much of Sarah's independence as possibleCreate a calm, spa-like environment (Sarah's request)## Design Solution
Architect:
Emma Richardson, Accessible Spaces Design
### Key Design Decisions
**Complete Bathroom Redesign** rather than piecemeal modifications:
Remove bathtub entirelyCreate 1200mm x 1200mm roll-in showerInstall comfort-height toilet with integrated bidetWall-hung vanity with wheelchair accessWiden doorway to 920mmComplete retiling with slip-resistant porcelainEnhanced lighting design### Design Philosophy
*"We wanted to create a space that felt like a sanctuary, not a hospital room. Sarah deserved beauty alongside function."* - Emma Richardson
## Funding Process
### NDIS Application
**April 2024** - David Morrison prepared comprehensive OT report:
Detailed current functional limitationsFall history and risk assessmentImpact on daily living and mental healthReasonable and necessary justificationThree quotes from registered providersQuote Comparison:
Quote 1: $38,500 (selected)Quote 2: $41,800Quote 3: $45,200Selected Melbourne Accessible Bathrooms for:
NDIS registration and experienceTransparent pricing breakdownReferences from similar projectsUnderstanding of progressive conditions12-month workmanship warrantyApproval Timeline:
Report submitted: April 15Additional information requested: April 22Final approval: May 318 days total - relatively quickApproved Amount:
$42,500 (adjusted quote with minor additions)
## Construction Process
**May 13 - June 21, 2024** - Six weeks including planning
### Week 1: Demolition and Preparation
Day 1-2:
Sarah temporarily relocated to sister's homeBathroom fully stripped - bathtub, vanity, toilet removedTiles removed from floor and wallsPlumbing exposed for reconfigurationDay 3-5:
Doorway widening (structural assessment confirmed no load-bearing issues)Plumbing relocated for new layoutElectrical rough-in for additional lightingWaterproofing preparation### Week 2-3: Core Construction
Shower Installation:
1200mm x 1200mm shower base with integrated fall to wasteLinear drain for optimal water flowAquaboarded walls for waterproofingGrab rail blocking installed in studsFlooring Work:
New concrete screed for level floorR11-rated slip-resistant tiles installedHeating cables under floor for comfort (Sarah's addition)Threshold elimination - level with hallwayWall Preparation:
Moisture-resistant plasterboardReinforced areas for grab rails and fixturesRecessed shelving niches in shower### Week 4-5: Fixtures and Finishes
Toilet Installation:
Wall-hung design: Geberit in-wall cisternComfort height: 480mm (customized for Sarah)Integrated bidet function with warm waterSoft-close seatDrop-down grab rails both sides (rated 150kg)Vanity Installation:
Wall-mounted at 800mm height600mm depth with clear knee spaceCeramic undermount basinLever mixer tap with extended reachSoft-close drawer for accessible storageShower Finishes:
Porcelain tile walls (easy to clean)Fold-down shower seat: 450mm x 450mmHeight-adjustable shower head on railHand-held shower wand with 1500mm hoseThermostatic mixing valve (safety)Vertical grab rail near controlsHorizontal grab rail on side wallBuilt-in niches for toiletriesDoor:
New door hung with offset hinges (additional clearance)Lever handle at 900mmD-pull on insideAutomatic closer adjusted for easy operation### Week 6: Final Touches
Lighting:
Recessed LED downlights (3 x 6W)Waterproof rating IP65Warm white (3000K) for ambianceMotion sensor control optionSeparate vanity lighting above mirrorNight light near toiletAccessories:
Mirror: full-width above vanity, 1800mm heightToilet roll holder at optimal heightTowel rails at multiple heightsHooks for grab-bag and towelsChrome finishes throughoutVentilation:
Upgraded exhaust fan with humidity sensorAutomatic operationQuiet operation (<20 decibels)Final Inspection:
Building inspector approvalOccupational therapist walkthroughSarah orientation and trainingHandover with care instructions## Features in Detail
### Roll-In Shower
Dimensions:
1200mm x 1200mm
Access:
Zero threshold - level with bathroom floor
Floor:
Slip-resistant porcelain (R11 rating)
Drainage:
100mm linear drain with 1:100 fall
Walls:
Floor-to-ceiling porcelain tiles
Shower Seat:
Fold-down design (space-saving)450mm x 450mm when deployed450mm height from floorWeight capacity: 180kgTextured surface for safetyEasy-clean white powder coatControls:
Thermostatic mixer valveAnti-scald protection (38°C maximum)Easy-grip lever handlesPositioned 900mm from floorWithin reach from seated positionShower Heads:
Fixed overhead rain shower: 250mm diameterHand-held wand: multi-functionHeight-adjustable rail: 600-1800mm1500mm flexible hoseEasy-clean silicone nozzlesGrab Rails:
Vertical rail near controls: 600mm lengthHorizontal rail on side wall: 800mm length32mm diameter stainless steelKnurled finish for gripRated to 150kg loadPositioned per AS1428.1 standards### Accessible Toilet
Type:
Wall-hung comfort height
Height:
480mm from floor to seat top
Clearance:
1200mm transfer space on both sides
Cistern:
Concealed Geberit in-wall system
Flush:
Dual-flush button on wall (900mm height)
Bidet Function:
Integrated warm water bidetControls on side panelAdjustable pressure and temperatureAir dryer includedReduced need for toilet paperIncreased independence and hygieneGrab Rails:
Drop-down rails both sides800mm length eachReturn to vertical when not in useWeight-rated to 150kgEasy-grip surfaceLockable in down position### Accessible Vanity
Design:
Wall-mounted floating vanity
Height:
800mm to suit Sarah
Knee Space:
Full depth clearance underneath
Basin:
Ceramic undermountOverflow protectionCentered in vanityRounded edges for safetyTap:
Single lever mixerExtended spout (200mm)Swivel functionTemperature limiting valveEasy one-hand operationStorage:
Single soft-close drawerPull-out design for easy accessOrganizer inserts includedReach from seated position### Doorway Modification
New Width:
920mm clear opening
Door:
Hinged with offset hinges for additional clearance
Hardware:
Lever handle at 900mm height
Swing:
Outward-opening for emergency access
Closer:
Automatic with adjustable speed
## Life After Transformation
**June 21, 2024** - Sarah uses her new bathroom for the first time
*"I actually cried when I saw it. It's beautiful - but more than that, I felt safe. For the first time in years, I wasn't afraid of my own bathroom."* - Sarah
### Daily Impact
Morning Routine - Before:
Avoided showering unless absolutely necessaryAnxiety about fallingRequired sister's help 3x per weekOften used baby wipes instead of showeringProcess took 45 minutes with restsExhausting and undignifiedMorning Routine - After:
Showers daily with confidenceIndependently and safelyEnjoys the experience (warm floor, good lighting)Process takes 20 minutesNo exhaustion afterwardDignity restored### Independence Regained
Toilet Use:
Bidet function eliminates difficult reachingComfort height reduces strain on jointsGrab rails provide confidenceNo longer needs sister's assistanceSelf-Care:
Can do hair and makeup at accessible vanitySeated while washing hands and faceEverything within easy reachBetter lighting helps with MS vision issues### Emotional Impact
*"I underestimated how much my bathroom struggles were affecting my mental health. I was becoming isolated because I couldn't maintain my hygiene independently. Now I feel human again."* - Sarah
Changes Noted:
Increased confidenceResumed social activitiesImproved moodBetter sleep (no longer anxious about morning)Reconnected with friendsOverall quality of life significantly improved## Three Months Later
**September 2024** - Follow-up occupational therapy assessment
### Outcomes Achieved
Functional Improvements:
100% independent bathroom useZero falls since installationDaily showering resumedImproved hygiene and self-careReduced reliance on family supportDesign Success:
All features used as intendedWheelchair-ready for future needsEasy to clean and maintainBeautiful aesthetic maintainedExceeded Sarah's expectations### Minor Adjustments
Added After Completion:
Additional hook near shower for walkerShower caddy relocated to better positionSlight adjustment to shower seat tensionAll minor tweaks completed under warranty### Unexpected Benefits
Energy Efficiency:
LED lighting reduced electricity costsThermostatic valve reduced water wasteFloor heating on timer (efficient)Property Value:
Real estate agent estimated $15,000 increaseDesirable feature for aging populationUniversal design appeals to broader market## Cost Breakdown
Demolition and Preparation:
$3,500
Strip existing bathroomDoorway wideningPlumbing relocationElectrical upgradesWaste removalWaterproofing and Tiling:
$8,800
Complete waterproofingFloor and wall tiles supply and installationShower base and wasteLevel floor constructionFixtures and Fittings:
$15,200
Toilet and bidet system: $2,800Vanity and basin: $2,400Shower fixtures: $3,200Grab rails and accessories: $1,800Door and hardware: $1,200Mixer valves and plumbing: $2,400Other fixtures: $1,400Electrical and Lighting:
$3,800
Lighting fixtures and installationExhaust fan upgradeFloor heating cablesSwitches and controlsProject managementTradesperson laborInstallation and finishingCertification and Approval:
$2,000
Building permitsInspector feesFinal certificationOT assessment and reportTotal: $42,500
## Technical Specifications
Compliance:
AS 1428.1 - Design for Access and Mobility (Clause 12: Sanitary Facilities)AS 3740 - Waterproofing of domestic wet areasNational Construction Code (NCC) Volume 2Plumbing Code of AustraliaProducts Used:
Tiles: Porcelain R11 slip-resistant (floor), R9 (walls)Toilet: Geberit Aquaclean comfort heightVanity: Custom wall-hung with caesarstone topShower fixtures: Methven Waipori rangeGrab rails: Care Quip stainless steelLighting: Martec LED downlights IP65Exhaust: Ventair Slimline Pro## Professional Team
Occupational Therapist:
David Morrison, OT, Enable Victoria
Architect/Designer:
Emma Richardson, Accessible Spaces Design
Builder:
Melbourne Accessible Bathrooms (NDIS registered)
Certifier:
Victorian Building Certifiers
Plumber:
Master Plumbers Association member
Electrician:
Licensed A-Grade electrician
## Lessons Learned
### What Worked Well
**Complete redesign** rather than piecemeal changes provided better outcome**OT advocacy** ensured NDIS understood necessity and urgency**Experienced builder** prevented delays and quality issues**Temporary accommodation** with family reduced stress**Focus on Sarah's goals** created space that exceeded functional requirements### Challenges Overcome
**Living without bathroom:** Stayed with sister (planned ahead)**Dust and noise:** Unit neighbors informed in advance**Product delays:** Builder had backup suppliers**Minor design changes:** Builder flexible and accommodating**Learning curve:** Training session with OT helped Sarah adapt## Advice for Others
### Sarah's Tips
*"Don't wait until you're in crisis like I did. If you're struggling, start the conversation with your OT now. The process takes time, so begin before you absolutely need it."*
Key Recommendations:
**Start early:** NDIS process can take weeks or months**Be honest:** Share all your struggles with your OT**Get involved:** Attend design consultations, share preferences**Plan accommodation:** Have somewhere to stay during work**Ask questions:** Don't hesitate to clarify anything**Think ahead:** Design for future needs, not just current**Document everything:** Photos, quotes, communications**Trust professionals:** But also advocate for your needs### David Morrison (OT) Insights
*"Bathrooms are often the most critical home modification. They impact dignity, health, safety, and independence. Sarah's case demonstrates that NDIS will fund comprehensive solutions when properly justified."*
Professional Tips:
Falls in bathrooms are leading cause of injury in people with disabilitiesDon't accept "standard" solutions - customize to individual needsComplete renovation often more cost-effective than gradual changesFocus NDIS applications on functional impact and safetyProgressive conditions require future-proofing## Six Months Later
**December 2024** - Sarah reflects on her transformation
*"This bathroom gave me back my independence and self-respect. I can invite friends over without worrying about my hygiene. I can participate in life again. It sounds dramatic, but it's truly life-changing."*
Current Status:
Using walker full-time now, considering wheelchairBathroom fully accommodates bothNo modifications needed as condition progressesMaintains complete bathroom independenceZero falls or close callsMental health significantly improvedReconnected with community and hobbiesUnexpected Joy:
*"I actually look forward to my morning shower now. The warm floor, the good lighting, the feeling of safety - it's become a peaceful start to my day instead of something I dreaded."*
## Conclusion
Sarah's bathroom transformation demonstrates that relatively modest home modifications can have profound impacts on quality of life, independence, and dignity. The $42,500 investment:
**Eliminated fall risk** preventing potential injury and hospitalization**Restored independence** reducing burden on family**Improved mental health** through dignity and confidence**Future-proofed** for disease progression**Increased property value** as bonus outcome### The Real Value
While the financial cost was $42,500, the value to Sarah is immeasurable:
Dignity restoredIndependence maintainedSafety assuredQuality of life enhancedConnections with others renewedSarah's Final Words:
*"If you're struggling with your bathroom, don't suffer in silence. There is help available. Talk to your OT, explore your options. You deserve to feel safe and dignified in your own home. I wish I hadn't waited so long."*
## Resources
NDIS Home Modification GuidelinesOccupational Therapy Australia - Find an OTAccessible Bathroom Design StandardsNDIS Registered Bathroom Builders by StateProgressive MS Resources and Support