Hi Steve. We live in a 2 story century home. Single bathroom 2nd floor. We had put up railings to assist my husband but stepping over the tub wall was beginning to be a struggle. Hence so were the stairs to get there. One day Don said,” I can’t do it anymore “. And on that day I removed the dining room furniture and brought our bedroom down. My brother had already installed a toilet in the corner and we put up a temporary partition. Shortly after, our friends got together and installed an open shower stall, wheelchair accessible. We chose an elongated toilet which pairs well with the wheelchair commode. When he his done toileting, I shower him in the same spot. A detachable shower head is easier for the caregiver to help and safer if the water surprisingly gets too hot.