"This is not built for me": A qualitative study of adult-sized changing tables and public restroom accessibility.

BACKGROUND: Adult-sized changing tables allow individuals with disabilities or medical conditions related to toileting to change with or without assistance. These tables are rarely found in public restrooms, and as a result, those who need them are often changed on floors, in vehicles, or are unable to stay in public spaces for more than a few hours. OBJECTIVE: This study aimed to understand how individuals who utilize adult-sized changing tables, or self-advocates, and caregivers for disabled people, access public restrooms and to report recommendations to improve inclusivity of public restrooms. METHODS: We virtually interviewed five self-advocates and sixteen caregivers in February and March 2023. We performed a qualitative analysis of the interview transcripts using MAXQDA 2022. RESULTS: Four major themes arose during interviews: social consequences, health effects, caregiver effects, and inaccessibility of restrooms in the healthcare setting. All caregivers have changed disabled individuals in vehicles, and 11 on public restroom floors, experiencing guilt and stress, and often receiving injuries. Several respondents reported limiting intake of fluids or using suppositories to prevent the need to toilet during unavoidable outings. Respondents most need height adjustable changing tables in healthcare settings, airports, and large recreational facilities. CONCLUSIONS: Without adult-sized changing tables, individuals with disabilities are forced to risk their health and dignity to utilize public spaces.

No Dignity on the Floor: A Human Rights Argument for Adult-Sized Changing Tables in Public Restrooms in the United States.

Many individuals with disabilities utilize adult-sized changing tables to take care of their toileting needs with the help of a caregiver.1 These tables are not explicitly required by the Americans with Disabilities Act (ADA), and no legal case in the United States has yet addressed whether the ADA requires public restrooms to have adult changing tables.2 This paper draws on an analysis of op-eds and news articles published in the United States to explore how individuals with disabilities and their caregivers access public restrooms that do not provide adult-sized changing tables. These experiences demonstrate violations of the human rights to accessibility, integrity, and health as outlined in the Convention on the Rights of Persons with Disabilities. Utilizing a human rights analysis, I argue that adult-sized changing tables are inherently the same as toilets and that providing one but not the other in public facilities may constitute discrimination under the ADA. Finally, I briefly explore promising initiatives that would increase access to adult-sized changing tables in the United States.