Making a Bathroom a Sanctuary Available to Us All

Sally Madeley-Carr, OT
10 Nov 2022

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For most adults, the bathroom is a sanctuary. It's the place where no-one can get you and where you can do uninterrupted thinking. It's you who controls the lighting, the temperature, the sound and the warmth.

The bathroom and the kitchen are the two most dangerous rooms in the house and so it is important that safety is adhered to.

For the person who has mobility needs, dexterity issues, vision loss and / or general weakness brought on by accident, illness, old age, or has had since birth, enhancing a bathroom with special aids or equipment can again promote the feeling of sanctuary.

 

Safety in the Bathroom

Old age may bring instability and knocking against a hard surface (e.g. the corner of a wash hand basin or a shower screen) may cause bleeding and even unconsciousness.

For the individual who wants to maintain independence for as long as possible, thought and action needs to be given to adapting the bathroom to suit that person.

Points to consider include:-

• Lighting - Eyes change with age, from presbyopia (the age-related loss of ability to focus on nearby objects) to other eye conditions, including tunnel vision, blurred vision and patchy vision. Lighting can be adapted to focus on key areas e.g. light switches, the toilet and location of towels, making it easier to identify needs.
• Privacy - A double-sided lock will maintain the individual's privacy, with the safety of help being at hand in an emergency.
• Flooring - Flooring should be non-slip, so rough rather than shiny tiles will meet this need. Stone tiles absorb moisture and so offer that extra element of safety. Also, place non-slip mats in appropriate areas e.g. outside the bath and shower.
• Moving around - Grab rails should be placed within easy reach of each other, so that the individual with weakened mobility can hold another grab rail before letting go of the other. A walking frame is another option, if there is sufficient turning room available in the bathroom.
• Door widths - Door frames sometimes have to be widened, to allow access to wheelchair users. A second option is to use a shower seat which has wheels, to aid moving around.
• Water temperatures - Some illnesses and also some medications make it difficult for the individual to know when water is way too hot or far too cold. Installing water gauges can take this worry off the list and ensure that independence is still possible.

 

Bath or Shower - Reasons for Choices

Strength and stability are the deciding factors when choosing a bath or shower. If both are good, a shower will be safe. If one or both are questionable, a bath may prove to be the safest choice.

Weak grip, shaky hands, arthritis and reduced upper body strength, as well as unsteady balance and weakened lower body strength, can affect both bath and shower. Tailoring solutions to meet individual needs is paramount to overall safety and independence.

• Making the Bath Safer

Fit a grab rail just outside the bath, to hold onto when getting in the bath, as well as on the wall inside the bath area, to hold onto when getting out.

To aid getting into the bath from a sitting position, a bath board can be locked into position across the width of the bath, from which the then seated individual can edge their way over the bath and lower themselves into the water.

A bath mat inside the bath itself is a must, as it can eliminate the risk of slipping during the bathing process.

A bath mat immediately outside the bath is of equal importance.

A bath lift can truly enhance the bathing experience. High-tec and also battery-operated bath lifts support the user both into and out of the bath water.

With waterproof controls, some bath lift designs attach to the bath base via four strong suckers and so are easy to install.

Bath lift designs vary, with some offering:-

• reclining backrests
• two side flaps which aid getting onto and off the bath lift
• easy assembly and disassembly
• corrosion-free materials
• plastic construction, which is durable, waterproof and lightweight
• safety in knowing that the bath lift will only lower you into the bath if it has enough charge left to raise you back out.

Bath cushions keep the user steady in the bath water and are particularly beneficial to people who are somewhat bony, as the air lift provided by the bath cushion gives a little leeway between body and bath base.

Bath cushion designs vary and so, when choosing, take the following information into mind:-

• a single bath cushion will support the user's position in the bath
• a dual-surface bath cushion (rather like an open book) gives support to the user's back and to their bottom, with suckers reducing the risk of sliding by holding the cushion firmly in place
• an extra-long bath cushion can cover the whole of the bath base and reach up for back support, as well.

 

• Taking the User into Consideration

Most bath lifts can take up to 140 kgs. / 22 stone in user weight, with more heavy duty models taking up to 170 kgs. / 26 ž stone. Always take this into consideration, when purchasing the right bath lift for you.

Always check seat width and length, as the right fit is paramount to both safety and comfort, supporting the individual whilst seated. Seat width should come close to hugging the user and seat length needs to support the whole length of the thigh, whilst still allowing the leg to bend comfortably at the knee.

• Making the Shower Safer

Falling in a shower could lead the user to banging against the shower screen or shower walls, which could result in broken bones and head injuries. Fitting a grab rail both inside and outside the shower will aid getting in and out of the shower space.

Once inside the shower, have a grab rail available for standing and another lower down for sitting, should the user be making use of a shower seat whilst washing oneself.

A shower mat inside the shower space is a must, as it helps the user to get a firm grip with the shower base. This mat is particularly important when shower gel slips to the shower base, making an uncovered base very dangerous indeed.

A shower chair can be either of the variety which stands on the shower base, or can be one which is attached to, and can fold up against, the shower wall.

Shower chairs take the stress out of showering, as the body is supported by the chair and the user can have both hands free for washing.

Wet rooms offer easy access to wheelchair users and people using a shower seat with wheels, as there is no lip or step to cross to enter the shower area.

• Taking the User into Consideration

Shower seats can take weights of up to 160 kgs. / 25 stone.

If the user has upper body instability or weakness of grip, look for bath seats which have armrests, to give that extra security and peace of mind.

Always check seat width and length, as the right fit is paramount to both safety and comfort, supporting the individual whilst seated. Seat width should come close to hugging the user and seat length needs to support the whole length of the thigh, whilst still allowing the leg to bend comfortably at the knee.

When purchasing a bath lift or a bath cushion, always check guidance on how easy it is to keep the product clean, as well as free from mold and bacteria.

 

Toileting

Balance problems and a weakened frame can make toileting a problem and so finding ways round this helps keep independence still in sight.

Rising from a seated position on a standard height toilet basin (17 inches / 42.5 cms.) isn't easy for all, so purchasing a higher toilet height of 20 inches (50 cms.) or 21 (52.5 cms.) inches can make it easier to get into a standing position.

Grab rails appropriately placed around the toilet basin can make it easier for the user to steady him- / herself when sitting and standing.

Some designs of shower seat with wheels can fit around the toilet basin and, designed with a hole cut out of the shower seat, toileting can be done from there.

 

Summary

Adapting a bathroom to meet particular health needs can make this important room a sanctuary available to all.

With a bath lift and a shower seat, insufficient length to support the full length of the thigh could cause the user to slide forward and fall.

Always check the user's weight and measurements, to assist you in purchasing the right piece of equipment, as failing to take these into consideration could lead to accidents to the user and/or a breakdown of the equipment which may not be covered by the warranty.

Always have a seat and towel available immediately outside the bath/shower, to prevent any risk of falling whilst trying to reach a place to sit.