Beyond Accessible Toilets: Bathing as an Overlooked Dimension of Hospital accessibility of India

Hospital accessibility is commonly assessed through ramps, lifts, entrances, circulation and accessible toilets.These provisions are essential, but they do not necessarily enable patients with mobility impairments to perform Activitiesof Daily Living (ADLs) independently during prolonged hospitalization. Bathing is particularly demanding because itcombines wheelchair manoeuvring, transfers, water, balance, caregiver assistance, safety and privacy, yet it is rarelyevaluated as an independent architectural environment. This study examines bathing accessibility in three tertiaryhealthcare hospitals in western India using qualitative multiple-case study and post-occupancy evaluation. Architecturalobservations were organized around spatial accessibility, functional usability, safety, caregiver accommodation, andprivacy/dignity. The findings show a clear gap between regulatory accessibility and practical usability: all three hospitalsprovided basic barrier-free infrastructure, but only Hospital A offered a dedicated bathing environment with adequateturning space, roll-in shower access, transfer clearance and caregiver accommodation. Hospitals B and C relied onconstrained conventional bathroom layouts, resulting in restricted manoeuvrability, difficult transfers and greaterdependence on caregivers. Based on these findings, the Accessible Bathing Evaluation Matrix (ABEM) is proposed as amultidimensional architectural assessment framework, together with a Universal Accessible Bathing Module for futurehospital planning and renovation. The study argues that healthcare accessibility should be evaluated not only by whethera patient can reach a space, but by whether the space enables essential daily activities to be performed safely,independently and with dignity.