S2E5 Transcript: Inclusive Bathroom Design for the Third Age

Lori
Hello, and welcome to the Third Age Design podcast, sharing essential information on senior environments. I’m Lori Pinkerton- Rolet, and I’m a senior living design geek. Today I’ll be speaking with Ed Warner, founder and CEO of Motionspot about inclusive design, and in particular bathroom design for the Third Age. And these days, there’s a lot of buzz about technology, not actually technology buzzing that only happens on my iPad, but this month, we’re going to have an extended version of our Innovation Spotlight. Would you like to walk with an elderly person around Portugal from the comfort of your home or from anywhere in the world? I would love to do that with my father. He couldn’t do that anymore. Or could he? Keep listening and all will be revealed. By the way, the Third Age Design website and transcripts of all of our podcasts are now available transcribed in 12 languages in addition to English, and we’d like to welcome our newest listeners in South Korea, Romania, India, and Belgium. Thank goodness for translation, my Romanian is a little rusty. I start each Third Age Design podcast with a quotation and it’s usually somebody like Voltaire or Oscar Wilde, you know, people which will make you think I’m really smart because I quote them. Well, here’s one from the lesser known Mark and Angel social media stream of practical tips for productive living. “The goal isn’t to get rid of all of your negative thoughts, feelings and life situations, that’s impossible. The goal is to change your response to them.” I really love that. So when you think of the environmental conditions in which many seniors live, does that elicit negative or positive thoughts in you? Third Age Design is here to share information and learn from the experiences and research of experts to improve environments for the Third Age as a result, if you’re listening now, it’s probably because you’re interested. Whether it’s designed for retirement village care facilities or an update in your private home, you’ve come to the right place. In addition to the podcast, we have a website full of useful information. And if you hit join, you’ll automatically receive our latest TAD extra, which is exclusive information issued each quarter to our community members. It’s really easy to sign up and entirely free, go to www Third Age Dot Design. Okay, let’s get started. My guest today is Ed Warner, founder and CEO of Motionspot which he started in 2012. Since then, he’s built Motionspot to become an award-winning design company working with literally hundreds of homeowners, businesses, occupational therapists, architects and interior designers to deliver beautifully designed access for all. In 2019 Ed was appointed the UK Government champion for accessible design of spaces and products. Hi, Ed, thank you for joining us on Third Age Design. Great to be with you Lori. Could you just share with us what started your interest in inclusive design because I believe you’ve got a very personal story about this.

Ed Warner
Yeah, I’ve been passionate about accessible design for a number of years I my first introduction to accessible design came about through my friend and co founder of our business motions but a guy called James Taylor who sadly experienced a diving accident age 25. He suffered a spinal cord injury, spent eight months in Stoke Mandeville Hospital, and then returned to his home in Battersey in South London to live his life as an independent wheelchair user. His home at the time was beautifully designed his wife Catherine loves her interior design all the styles choices, materials that are readily available to us. But James is a wheelchair user was presented something very different. And he had a number of rooms refitted to suit his independence as a wheelchair user and I had dinner with him in 2011. And he said to me over dinner ‘every morning I wake up and I’m reminded of my condition because the products around me’. And I’m a big believer that if you get the environment right for people, you can really positively impact cognitive and physical health. So that was that was where I started looking at this market and industry and realise that there was a real opportunity to do something very different in the world of accessible design.

Lori
And when you first started looking at this, what were the let’s start with products. What were the things that jumped out at you as I can’t believe this is how it is we must have change there. So what were those areas that you saw?

Ed Warner
Yeah, we always call them design crimes in those. You know, and unfortunately for older and disabled people, there are design crimes all over the home. The area that we decided to focus on first was the bathroom. And it was the bathroom because the bathroom is always the area that people want the greatest independence, we will spend a significant amount of time in our bathrooms, and we want our bathrooms to represent what we’re all about and have them looking beautiful in the home. And unfortunately, when it comes to adaptable and accessible bathrooms, there’s been a tendency in our industry to design very functional clinical-looking spaces. So for us, the bathroom was where we started. But you know, the Motionspot accessible design business has extended beyond that into all areas of the home and commercial areas over the last 10 years.

Lori
It’s interesting, because years ago, we came to a similar conclusion in my business where we thought of providing tickets to people for crimes against interior design, and that we would be the interior design police, which obviously you can’t do, but the whole the whole thinking is the same. It’s like it’s a crime people live like this, why? Why are these products the way they are, and they are so utilitarian or there used to be, but it obviously has moved on. So I think your company appears to do both accessibility but also what we refer to as inclusive design. And I certainly know what that means a lot of our listeners will but for those that don’t, how would you characterise inclusive design?

Ed Warner
So for us inclusive design is about removing the barriers in the built environment that cause undue stress and separation for people very simply. We do an awful lot of work in later living providers in hospitality as well as in commercial offices to help them design really beautiful, accessible, and inclusive buildings. For us inclusivity goes beyond designing accessibility into a space. It’s about, you know, how can we design for someone who has a disability, but also how can we design for someone who may have, you know, a temporary condition they might have an ear infection they might have, they might have had a skiing accident and needed need to access a space in a in a slightly different way? But for us, inclusive design stretches beyond visibility into design for faith and cultural considerations as well as designed for gender, which we’re seeing an awful lot more focus within commercial environments in particular.

Lori
And in terms of bathrooms, specifically, what are the crimes that you’ve seen committed?

Ed Warner
But common bathroom design crimes, I suppose. My top design crimes are things like hospital looking vinyl flooring, which however nice you try and make the finish of that vinyl flooring, it still tends to feel like a rather clinical institution. Massive over specification of white plastic grab rails or if they want to push the boat out maybe blue plastic grab rails. As we’ll come on to talk about I’m sure there are so many different choices and finishes now available for support rails and a much better understanding that support should be positioned to suit individuals rather than just be positioned for everyone at the outset. Other sort of common issues we see commercial operators who love a red toilet seat and the use of red in particular throughout the bathroom red sit as seemingly become a statement for designing for dementia. And that’s a slight misconception in our industry. So for us as accessible designers we work, with clients to say actually, it’s all about the contrast you have with different colours rather than having to have a bright red toilet seat or red support rails

Lori
and it’s been read has read has other associations such as danger that they could be working really against their own best interests in that way.

Ed Warner
Don’t sit on this toilet say we’re going to we’re going to colour it red. I’ve got a real bug bear over lighting at the moment and we see so many. We see so many commercial operators who were building homes for later living put one single light source in the bathroom often just a single light in the centre point of the ceiling, and for so many older people with you know who are processing less light through their eyes as we will get older we naturally process less light, having tasks really good task lighting, by the toilet and basin and an in the shower area is really important and having lighting on dimmers, as well as simple things like that make such a difference to mood and general well being. So they would be some of my top design crimes.

Lori
Are you a fan of PIR lighting coming on at a low level for older people in bathrooms?

Ed Warner
light Absolutely, particularly at night. So you know, the most common accident happens at night when someone’s trying to access the bathroom from the bedroom. So being able to detect that there’s movement at night and have the really important point is, as you said, have a really low level PIR light so that the chemicals in our brain don’t get triggered by bright light that wakes us up. So having a having a low level, sort of ambient orange glow to navigate to that important location which is the toilet and then back again to the bedroom safely would be something we’d very much recommend.

Lori
And just so people know low level lights if it’s red toilet seat don’t look good either. Another reason not to do that. Let’s go back to flooring for just a second. So you talked about the utilitarian almost hospital like look of vinyl floors. What alternatives do people have because some clients will express a concern about falls. And obviously in a wet room situation for example, you’re not going to put in a carpet. So what are alternatives that you and Motionspot would recommend to vinyl flooring.

Ed Warner
Yeah so, the things to think about as an alternative to vinyl floor I mean first and foremost is to make sure that your flooring is level access and that that’s sounds an obvious point but so many bathrooms have got a threshold or some form of trip hazard going from the corridor into the bathroom. Were lovers of slip resistant porcelain floor tiles over the vinyl floor. Porcelain floor tiles as long as they have a slip resistant rating of without getting too technical 36 Plus PTV and the wet which all tile manufacturers will be able to tell you what the slip resistant rating is on tiles, it just ensures that you know where residents are coming out of the shower with wet feet the bathroom will inevitably get wet it’s not prevent it’s not posing a potential trip hazard in that space. But also we need to think about how easy these tiles and flooring is to clean because if tiles have those sort of natural contours that are created in often slip resistant tile, it becomes very difficult to clean that floor. So there’s got to be a balance between the ease of cleaning as well as the as well as the slip resistant properties. But going back to your point around falls the reality is underneath vinyl flooring there has to be a hard concrete you know sub floor so it’s not like vinyl flooring is going to cushion a potential fall. And for us, its really important that the temperature of flooring is thoughts about so many people are very sensitive to cold surfaces. So having ideally a plumbed under floor heating in the bathroom but as a secondary have a have electric under floor heating would be our suggestion.

Lori
And in terms you were talking about level access, if somebody’s in a private home because I know Motionspot does both large scale commercial projects but also individual homes. What about a bath? Not everyone wants a hoist for example. And the baths that open up you have to sit in while you’re waiting for the water to drain out so you can get out of the bath. Is there any way around that problem?

Ed Warner
There is we’re often asked that in our residential business so within the Motionspot group we have a business called Fine and Able enable which works with people in their own homes to create really beautiful accessible bathrooms. And we have a number of clients particularly older clients that have grown up with baths and they want to keep their bath. The first thing that we would we would do is to is to work out whether there is space within their bathroom to have both a bath and a separate shower. Because it is still a bit like your point about the low level lighting at night getting in and out of the bath is still a it’s still a trip hazard potentially for people. And wherever possible, we look at designing a shower over bath, but we have plenty of clients that say that they want to bath alongside the shower. Like you, we’re not massive fans of the walk in bath. The walk-in bath is the, I suppose the industry lead within this sector, but we don’t supply any walk-in baths because if you’ve ever used one, you have to get in, and you get cold while the water well, water fills and even worse, you’re then wet and you have to wait for the water to drain before you open the door and go out. So the principles for us around a good accessible bath are having a bath that is shallow enough, that is not going to be a really deep bath to get into, we would always plan what we call a transfer shelf on the back of the bath. So a space that someone’s able to sit on to swing their legs over and then through subtle position of support rails that would could potentially double as a towel rail, for example, you’re able to ease yourself down into the bath before then getting back onto the transfer shelf. It’s all about it’s all about sort of ease of access and accept from that bath.

Lori
And that’s where this supply chain becomes very important because there are towel rails that look like towel rails, but they actually do take full support. Are there other aspects of the supply chain that you have seen getting better while you’ve been working with Motionspot?

Ed Warner
Yeah, over the last 10 years, the design of accessible products has significantly improved in the bathroom. And that’s been because, you know companies like ours and also you Lori have been championing that we can’t put up with the design crimes in in this space. We’ve got a long way to still move. So there’s still head room to push on here. But, the type of improvements that we’ve seen are things like, you know, support rails being finished in a number of different colours… matte black is particularly appealing at the moment hospitality is all going down the route of matte black brassware. So let’s have matte black support rails in place, we’ve got a really innovative system of removable, grab bars and shower seats, which enable operators to be able to fit those items when a resident requires it. But actually, if their condition changes or they move on from that apartment, you’re able to very easily remove those support rails without any damage to the walls. We love features like sort of jewel design features like beautiful ceramic basins with integrated handgrips in them, you can hang hand towels from it, but you can also support yourself while standing at the basin or be able to access underneath it. And then features like when- we’ve never been a fan of a clinical shower cut in any of our accessible bathroom. So number of years ago, we designed out the shower curtain and put in a bi-folding glass door which looks like a fixed pane of glass but actually can fold back to the wall when the shower is not in use. Opening up the circulation space and providing access for care of washing if required.

Lori
…and better ventilation, presumably, absolutely, yes,

Ed Warner
opening up opening up the space. So there’s been real progress. But you know, we’re constantly trying to push the boundaries as to as to further improvements.

Lori
In turn, if you were to wave a magic wand and say, what I’d love to see in inclusive accessible bathrooms in the future would be can you fill in that the end of that sentence?

Ed Warner
I’d love to see accessible and inclusive bathrooms in every single development for older people. This shouldn’t be about well… I’d like to see them also in every single development full stop. This shouldn’t just be about designing a bathroom for the Third Age or designing a bathroom for someone who’s younger and disabled. These principles and products are good for everybody. So I’d love for mainstream housing providers to be adopting them in terms of where I see the industry going. I see a real opportunity for technology and accessible and inclusive bathrooms. So already, you know we’ve got we’ve got low level tech going into our bathrooms around digital showers that are particularly good for users with limited dexterity, particularly arthritis. There are lots of washing dry toilets now coming to market, we actually see technology developing in that toilet technology that can start to take readings of whatever you’re putting through that toilet. And already there’s technology out there that can give you blood count, pH levels, glucose levels, hydration levels, and we see the toilets and bathrooms of the future actually being able to diagnose conditions before the person using that toilet even knows there’s a problem. Plastic, it’s about that sort of technology being smarter. I’d also love to see accessible and inclusive bathrooms become more modular in their approach so that we can build at scale, and ensure that any developer that’s looking at modular housing solutions can drag and drop and accessible bathroom pod into that development.

Lori
That’s, that’s fantastic. Well, first of all, thank goodness for the Japanese because they sort of really led the way on developing toilet technology. But also, I don’t know about you, but I’ve never met anyone that doesn’t age. So they’re not here anymore if they don’t age. So basically, to build things that have a shortened lifecycle is rather short-sighted. So who knows what’s going to happen with any of us? So it’s um, I love the way that you think, and how much Motionspot has really pushed the industry in this way. Thank you so much for being a guest.

Ed Warner
Thanks for inviting me. Good to see you Lori.

Lori
Last month, I spoke with Sir Muir Gray. And following that conversation, he kindly put me in touch with our next guest, which is Mr. Charles King, Chief Operating Officer of ROVR systems, a virtual reality treadmill system. I’ll be blunt. Can you tell us Charles…just a background of what virtual reality really means?

Charles King
Yeah, of course Lori , the virtual reality or VR is a is a computer generated three dimensional, real or imagined the environment that can be explored and interacted with by a person. So the person wears VR glasses and earphones, which provide complete visual and hearing immersion. And the effect is of real presence, the sense that I am here, no longer just watching this scene, but present within it.

Lori
Right, even though it is a computer generated thing, the mind takes you into that environment. Is that correct? That’s right.

Charles King
That’s our brains kind of have been described by a guy at MIT is kind of data processing, your eyes feed the data in and your ears see the data in and then the brain kind of generates what the real world is from that. And, if you present it with the right information, then the brain says, Well, this must be real. And then one of the first actions we find people want to do when presented with somewhere they can walk and explore, is to step forward. And without safe and naturally intuitive movement, VR immersion that sense of being present is broken. And it’s really for this crucial reason we developed over several years, that kind of virtual reality treadmill.

Lori
And so what how does this work with the treadmill? What keeps you from falling off? For example? And also are you doing this? Totally by yourself? Are you doing it with other people, I don’t understand how that all fits together.

Charles King
Okay, so keep people safe, so they can walk forever. A virtual reality treadmill is, is something which is a platform which you can walk in any direction. So sometimes called omni-directional treadmills, you can walk in any direction forever, without any fear of colliding with the real world. And, and movement of the feet on the treadmill matches the movement of speed in the virtual world. So what you get a kind of one to one translation, as you move your feet, you move in the virtual world, just as you would expect. So if you can walk at three miles an hour in the in, in real life, then you can set it up to walk three miles an hour and in the virtual world. And, and that enables you to walk around and explore places. And one of the things that we actually discovered way back in 2016 was an extraordinary experience, which some Minecraft users would be familiar with. Certainly the children would be familiar of playing with friends, and being able to walk around in that environment. And Miss Minecraft users can’t do that. But we set it up so that we could it is extraordinary and being social in that environment where you can walk and explore and hide from each other and lose each other. So that social content suddenly became a real imperative for us that we felt. That’s what’s missing in VR. Yes, being able to walk freely as one, but actually, the social content is really important as well.

Lori
So what are some of the places that you could explore currently on the system?

Charles King
Haven’t started with the hardware side of things, we then had to kind of pit it to moving away from kind of providing the hardware and the drivers a little bit like the mouse for VR, if you will. So people are lost if they don’t have a mouse or a trackpad to move around on a screen, so we provided the mouse. So we had to pivot away from just doing the hardware, which we which we continue to do, but also providing some content. And we were really fortunate in in Innovate UK government agency providing us with some funding and grant funding, to look at developing systems for Care Homes, for Assisted Living settings for older people to kind of recondition them after, after COVID. And so we have to start looking to how to generate places for people to go in VR. Because the vast majority games are not really set up for that and the few that are kind of shooting, you know, first person shooter type games, which is not really suitable for that. So the audience we’re after. And actually we want to do some education. So we one of the amazing things about the technology, which has happened over the over recent years is the ease with which one can generate 3d models, walkable 3d models of real places. So we have a couple of wonderful places down in Cornwall. The Minack Theatre is an amphitheatre on the Cornish coast, looking out to sea, spectacular views, wonderful environment. And we have that completely captured in VR with kind of photo-realism. So you can do my photo realism. And so a couple of pieces down in Cornwall, we’re just preparing a lovely 13th century castle here in Oxfordshire, to do the same. We’ve got a wonderful model of a place in northern Portugal. And in fact, that was the first place that I and my colleagues went to and in COVID lockdowns, everybody was locked down here in the UK, in 2020, through March of 2020, and in the earlier part of that year, we, we I’ve got I’m in Oxford, I have a colleague in Buckingham, I have another colleague over in Brussels, Belgium, and the three of us met in northern Portugal, in a model of a place called Bom Jesus Do Monte, which is a UNESCO site. So we are we’re gradually building these places that we can visit. And of course, the revitalise which is this, this VR treadmill system. When we got into some of the these, these care settings, and assisted living settings, we found that people were more deconditioned if you don’t exercise, that’s true for all ages, by the way, it’s just that the younger you are, the faster you recover. And what we were finding that we really need to start at an earlier stage than them putting them straight onto a treadmill.

Lori
Right. And so you I believe you’ve developed three different systems. I think they’re called Relieve, Restore and Revitalise. And you’ve mentioned, you know, a lot of this is in response to people losing a certain amount of mobility from lack of use during COVID. Can you just briefly say how each of these systems, what they’re meant for in terms of use in care or with the elderly in general?

Charles King
Yeah, very much so. So, Restore was, was a product we were actually requested to build by one of the UK kind of larger care providers. And what it does is it provides an introduction to VR. It’s for seated, companionable or solo VR experiences which are essentially 360 video, or CGI that we’ve generated, some computer generated and you sit. So definitely for people who may be chair or bed bound, but also just as a means of encouraging conversations and connections and reminiscences. And so assumed a good number of the people we have seen more or less in stages of dementia. They’re not all and end all of them all of that group across the range, enjoy being presented with new environments to look at. We can provide music or the natural sounds. And that is that’s a really lovely introduction to VR and it’s an introduction to wearing a VR head set an introduction to being able to not just looking in one direction. We find, and it’s not unreasonable, that people have been looking at TVs for such a long time that they think they can, there’s only one looking direction once you put it on you just look ahead. And it comes as rather strange when they find that they can actually move their head around and what they see changes. It’s as if they’re in that real place. And we’ve got places from around the world as well as some local tourist spots in Oxfordshire as well so and elsewhere in the UK. So it’s really an introduction to VR and one which works very well to getting people acclimatised to wearing these VR glasses.

Lori
So that’s the Restore and Revitalise is the is the walk around on the safely on the treadmill, what is the Relief offer?

Charles King
So, the first one which is the CVR is Relieved, the Restore is really that bridge which bridges between being just seated and not doing anything but looking around and being immersed in an environment. And the Revitalise which is a fully ambulatory and then we find that there’s a need to get people’s legs strong again. So that’s one of the things that happens when, when we’re seated for too long. The quads, deteriorate the hamstrings, give out the I think the medics will call the kind of a calf muscles that kind of a little heart which is the thing which pumps our blood back up into the, into the heart if you flex your calf muscles and that helps to do that. And how do you do that? Well, so we if people can’t walk then the longer they stay seated, the worse things get. So the ROVR Restore is really about activating all the muscles attached to the knee. And so this is a seated but active VR experience. So you know people have gone from the gone from the Relief which they’re just seated and looking around. So now placed into Restore now this is a social environment. So they can we’ve got three different environments. Presently we’re looking at another one which would be rather a lovely one as well, which would be walking around the rim of the Grand Canyon. So you’ve got some spectacular views. And they’re you’re walking with a friend, or with a caregiver, and with others, and you can walk forever, essentially. And only last week, we had a lady and gentleman in one of the settings we were at, who were competing with each other to see who could walk a kilometer. Now these guys had never walked a kilometer for the last two years. So this was a new experience and one of them managed 800 metres and the other one managed just over a kilometer, which is pretty good. Fantastic. Really good exercise unwittingly done of course that you know, they didn’t that yes, they knew they were walking and they were trying to achieve this, but it was done while we were chatting and it was really lovely to watch.

Lori
…as you would if you were walking outside.

Charles King
Absolutely. Absolutely. It isn’t so much easier to walk five miles if you’re with a friend and if you’re walking alone. And I think that’s it’s that social context. That’s the and that’s all we have a wonderful medical director you mentioned in the beginning Sir Muir Gray and his encouragement always is in social connection in unwitting exercise where you can do At the CDC and the NHS both advocate 150 minutes of breathless exercise each week. And that’s tricky for many to do irrespective of age but it becomes more challenging in northern winters and you know, the weather isn’t always conducive to getting out

Lori
… depending on where you where you are in the world.

Charles King
Yeah can be tougher in Canada I suspect

Lori
…or anywhere near the Great Lakes in the United States and wintertime. If people would like to get more information about what it is you’re doing, how to engage with you or these products could you tell us where they would go for more information?

Charles King
Yeah, yes. So we have a website which is www dot rover dot systems ROVR dot system S on the end of systems there. Also inquiries or enquiries at ROVR dot system. Both of those will get us. And also info at ROVR dot system, any of those will come through to us. And I’m really happy to do that. We’re also really interest did in, in the short video 360 videos that people might have of their own localities which they’d be interested in contributing this. And that’s one of the things about the relief systems that we enable owners of these things to put their own videos and music on so that they can capture things which are relevant to their local environment or to relatives and friends which they might want to put on.

Lori
Well, I’ll get you the I’m making a pledge here that I’ll get you the beach front in Brighton and Hove, thank you so much for joining us.

Charles King
It’s lovely to chat to you, Lori. Thank you.

Lori
Time now for our monthly check in with the TAD International Events Calendar. The fifth annual Future of Aged Care Summit 2022 will be held at the Sofitel Sydney, Australia from the 15th to the 17th of June. ARCO’s integrated Retirement Community conference will take place over two consecutive days. First one is sixth of July at Savoy Place in London, United Kingdom, and on the seventh at Trowers and Hamlin’ in London, and that’s going to be a knowledge exchange day. Hope to see you there. And the Pflegemesse in Rostock, Germany, is the meeting place for new concepts and products in care and rehabilitation from the sixth to the eighth of September. You’ll find more international shows and conferences on the Events page at Third Age Dot Design, and drop us a note if you would like to have an event listed there. Thank you to our special guest Ed Warner of Motionspot to Charles King of ROVR systems to our fabulous producer Mike Scales, to Valerie Adler of The Right Website, to Peter Thorne, who composed our theme music and is playing the piano with Mary Blanchard on flute and to my German son in law Tom for helping me to pronounce Pflegemesse. Finally, to you. Thank you for being part of a community who believes we can improve senior environments together. I’m Lori Pinkerton-Rolet and I hope you’ll join me for the next one.