Making Bathing a More Independent Experience for Elderly People

Sally Madeley-Carr, OT
28 May 2021

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With age, what used to be straightforward (e.g. opening a tin with a tin opener) becomes more of a challenge than a chore, as we work out how to adapt our lives to meet the onset of old age and the pressure it places on our everyday lives.

Relaxing is a break from daily pressures and, for some, the only place for such 'me' time may be the bathroom.

Having everything available in a bathroom to maintain independence adds to the pleasure of bathing or showering and increases self-esteem and confidence.

Some points which may seem little in their own right can greatly add to creating that feeling of independence, whilst adding built-in safety to the overall experience.

Enhancing the Experience

An inflatable bath cushion gives added support to the back and neck and the extra comfort adds to the bathing experience.

Using a bath cushion for disabled people gives extra peace of mind, as the added support helps keep the user positioned and therefore more at ease.

Similar to a hand dryer for hands, a wall-mounted body dryer allows you to dry all of your body, drying parts of the body that limited dexterity might make difficult to reach.

Long-handled washing aids allow the user to reach the feet and also the back without having to re-adjust one's standing or sitting position, thus helping to avoid unnecessary trips or falls.

Mounted shampoo and soap dispensers make bathing a more stress-free experience, as everything is at hand.

An anti-fog mirror has a special coating which absorbs moisture and so allows the person to view themselves whilst bathing or showering.

Bath Cushions and Bath Mats

There are several designs of bath cushions and bath mats, all designed to give extra comfort and security whilst in the water. Some of these include:-

• A bath cushion ( measurements tend to be around 43 cms ( 18 inches) squared and, when placed on the base of the bath, they can be inflated to give a softer seat in the soothing water
• A cushioned bathmat which is similar in design to a sun bed mattress, lying along the base of the bath and then also forming a backrest-cum- pillow, keeping the user safe from slipping further into the water
• Whilst there are many designs of bath lift and bath hoist, the simplest and cheapest is an inflatable bath cushion, which can lower you into the bath and then raise you back up again, simply by the press of a button. Once in the bath, you can also remove all of the air from the cushion, so as to rest on the bath base itself to enjoy a more natural soak

Bathing or Showering from a Seated Position

A bath board is designed to allow the user to edge oneself into the bath or shower from a seated position, thus preventing falling or slipping when getting in or out of the bath tub.

For stand-alone showers, a shower chair gives added safety and increased pleasure when showering.

Wet rooms are not raised from the floor and so, for a wheelchair user, are much easier to enter than a regular shower unit or bath.

A wheelchair user can take advantage of the shower chair with wheels when entering a wet room, which can also be used to move around the bathroom itself.

A bath bench or bath chair will greatly improve the bathing experience, as some elderly people may have weaker or unsteady frames, or be unable to stand due to illness or injury.

Walk-in bath tubs and the integral seat might not be everyone's idea of a pleasing bathing experience, though they do remove the worry of falling or tumbling when trying to enter or exit the bath.

The Popular Whirlpool and Spa Experiences

If you have health conditions which would benefit from regular hydrotherapy sessions, a whirlpool bath or spa bath could prove worth its price and so somewhat enhance quality of life.

Some benefits include:-

• When soaked in water, your heart is encouraged to work harder and so it is kept healthy
• It can help reduce arthritic pain and discomfort and so increase motion in your joints
• It can improve your confidence and self-esteem
• By allowing you to relax, it can both reduce headaches and improve quality of sleep
• It can help reduce blood pressure.

The pleasure which the moving water bestows upon you relaxes your whole being and has quite a positive effect on your emotions.

The main difference between hydrotherapy and a spa session is that the spa is about floating or sitting, whereas hydrotherapy means putting in some hard work, as your body moves against the water.

N.B. Hydrotherapy should always be used with caution and, should you have health conditions, always check with your doctor if hydrotherapy would prove suitable to those conditions, before making a purchase.

Bathroom Hazards

As many as four thousand people every year drown in the bathtub, with the bathroom being one of the most dangerous rooms in the house.

Some medications can lead to hypertension and dizziness, which in turn leads to limited mobility, making bathing independently a little more complicated.

Wet floors can lead to slipping and the hardness of the floor can lead to serious injury. Rugs (make sure they have a non-slip underside) can reduce an injury which can be incurred by hitting a hard floor.

Never use a towel rail for support, as their purpose is to hold towels and not to take someone's weight.

Bathroom doors which lock only from the inside can lead to being unable to quickly reach the person in the bathroom in an emergency. Locks on both sides of the door can give privacy but also swift emergency entrance.

A temperature of 54 C / 120 F is an ideal temperature for bathing. However, due to health conditions, medications or neurological damage, as well as ageing and possibly thinner skin, an elderly person may be unable to register that the bath / shower water is too hot, meaning that even brief exposure to such heat could cause scalds and serious burns.

Using a bath can cause spills to the floor, so adding a weighted shower curtain (tucked inside the bath) as an optional extra can help prevent water spilling onto the bathroom floor.

Safety Measures

Grab rails in a bathroom are safety handles which are placed near the toilet, wash hand basin, bath / shower and any other place deemed necessary, to have something to hold on to whilst moving from one place to another, as well as for steadying oneself during the bathing / showering experience.

Bolts should be used to install grab rails, rather than suction cups, as bolts offer more permanency.

A bath mat inside the bath or shower allows for more surety of step, as not all bath and shower bases have raised imprints to prevent slipping.

Things to Look Out For

Weakened strength or dexterity may mean than twisting taps on and off isn't an option, so lever taps or tap turners may prove to be the way forward.

Elderly people who use walking frames might have difficulty lifting the walking frame over the door frame threshold; even a half an inch / 1 cm. rise making entry into the bathroom somewhat more difficult.

For wheelchair users, widening the door into the bathroom may need to be addressed.

Again, for wheelchair users, attention may need to be given to the height of wash hand basins and mirrors, which may need to be lowered to accommodate the user's seated position.

Increasing the Experience for Those with Vision Loss

According to the RNIB (Royal National Institute for the Blind), around one in thirty people in the United Kingdom live with some degree of sight loss and such vision changes can also be supported to improve the bathing experience. Consider:-

Addressing the lighting to support the type of vision loss the user may have (e.g. distorted, blurred, or tunnel vision) would benefit from the installation of spotlights, floor lights and down lights, to give definition to areas within the bathroom

De-cluttering the bathroom of any overload of shampoo and bath gel bottles, so as to make identifying the right one for user easier, or make use of mounted shampoo and soap dispensers

Removing tripping hazards such as bathroom scales or waste bins

Using towels which contrast with the wall colours, to make their location more easily identifiable

Making use of a Smart shower, which allows the user to switch off the shower by voice activation, instead of having to locate the water control point.

Summary

While bathing / showering can be a relaxing and independent experience for most, general weakness, reduced mobility, grip and dexterity, as well as sight changes which come with age, can bring challenges to performing this personal task.

Even the smallest of changes will help an elderly person maintain a dignified level of personal care.

A bath cushion for disabled people gives that extra grip to the body, lessening any likelihood of sliding down into the water.

Before purchasing a hydrotherapy bath, check that your health condition is compatible with using this therapy style system.

Be aware that the bathroom is one of the most dangerous rooms in your home and tackle tasks which limited functioning may make more hazardous, highlighting the need for safety measures to be identified and addressed.