Very Unsanitary, Very Public: The Lack Of Adult Changing Tables Creates Isolation And Embarrassment

Aug 21, 2018

Similar to infant changing tables, an adult changing table is basically a cot, but one that’s sturdy enough to support several hundred pounds of weight, and can be adjusted for height. Many people may be unaware that these tables even exist, in part because there are so few of them. But they’re necessary.

People with any number of medical issues or disabilities use this amenity, including those who are post-stroke, have dementia, Parkinson's Disease, are on the Autism spectrum, or are paralyzed.

Pittsburgh advocates say the only public bathroom with a changing table is located on the third floor of UPMC's Children's Hospital in Lawrenceville. The lack of these tables is both isolating and degrading say disability advocates and caretakers. 

Pam and Grady Jordan at their home in Squirrel Hill.
Credit Sarah Boden / 90.5 WESA News

“When he was smaller, we were able to use the baby changing stations,” said Pam Jordan, whose 20-year-son Grady is incontinent due to a seizure disorder and cerebral palsy. “Then when we weren’t able to use those anymore …we occasionally change him on the floor, but that’s feels very unsanitary and very public.”

Many wheelchair accessible stalls are too small for Jordan to maneuver Grady for a diaper change, so ideally the Jordans find a private family restroom. If that’s not an option, Jordan must lift her 73-pound son from his chair, lay him on the floor of a women’s restroom, and then diaper him out in the open.

It might be surprising to some that most public restrooms don't accommodate people like Grady Jordan, in part because 1990s Americans With Disabilities Act mandates that public spaces be wheelchair accessible. ADA 2010 restroom design standards include the installation of grab bars, accessible faucet controls, and larger toilet stalls, but omit any provision for adult changing tables. 

Retail and installation costs for these tables can exceed $11,000 - one reason they aren’t more common. Another, some bathrooms are too small to retrofit.

Nancy Murray is president of the Arc of Greater of Greater Pittsburgh at ACHIEVA, a nonprofit that serves individuals with disabilities and their families. She said the personal care of an adult child, sibling or parent isn't something people often discuss publicly.

"It's just something they handle within the family," said Murray. 

Maria Paul, a special education teacher for Pittsburgh Public Schools, said the reluctance to discuss a natural bodily function that everyone experiences makes the situation worse, and hopes honestly will lead to better restroom accommodations for people with disabilities. 

“I wouldn’t go to the bathroom with a stall door open,” said Paul, “so I would not expect my students to be in that situation as well.”

Paul’s class has nine students between the ages of 12 and 14, each of who gets changed at least twice a day. Her room is equipped with a changing table, medical-grade lift, and privacy screens.

The only bathroom facility at Wightman Park is a portable toilet. Improvement plans include bathroom facilities with an adult changing table.
Credit Sarah Boden / 90.5 WESA News

But on field trips, Paul said it’s a different story, one that often involves public diaper changes on the ground.

“A lot of my kids are very aware of what is going on around them, and they definitely show some embarrassment and feel a little awkward in that situation for sure,” she said.

Despite the difficulty, Paul said these outings are a priority because they’re the only times some students visit the theater or zoo, and other cultural offerings.

“My kids deserve to have the opportunity too, and I shouldn’t have to not take them because we don’t have access to bathrooms,” she said. “That’s just unfair.”

Happily for Paul's students, more public places in Pittsburgh might soon contain tables. 

Plans for the Wightman Park improvement project in Squirrel include designs for an adult changing table. Pittsburgh International Airport might soon install one as well, and Mt. Lebanon State Rep. Dan Miller said he's researching legislation that would make the amenity more common.