Maintaining independence and safety with self-care activities such as personal grooming, bathing and toileting can help promote living independently in the community. These activities occur on a regular basis, so it’s worth investing the time and resources to make them as easy and safe as possible.
Whether accessing a bathtub or shower stall, making sure the area is safe is the first concern. When properly installed and used appropriately, grab bars will help prevent slips and falls. Towel bars and soap dishes, while convenient, are not designed to support your weight and will likely pull off the wall. In general, three types of grab bars are available: tub-mounted, floor-to-ceiling poles and wall-mounted.
Tub-mounted. This type of grab bar clamps onto the bathtub and provides a stable handhold. It does not require any holes drilled in the walls, but the grab bar may be in the way as you get in and out of the bathtub.
Floor-to-ceiling poles. These devices can be positioned almost anywhere in the bathroom, as long as there is a solid ceiling. Some have a horizontal cross piece that can be rotated around the pole and locked, so that the grab bar can be positioned where most convenient.
Wall-mounted. Most wall-mounted grab bars are secured directly into the wall, so it is important to ensure they are correctly positioned before actually fixing them. When properly installed, this type of grab bar can provide very solid support.
Suction-mounted grab bars are also available, but the tile needs to be smooth and of sufficient size to contain the entire suction cup. In addition, the tile must be secure and the surface solid.
When bathing or showering, place a rubber-backed mat outside so that you do not step out onto a slippery floor. Once you have dried off, put the mat away so it does not become a tripping hazard. A bath mat or other non-skid surface should be in place before you step into the bath tub or shower to prevent slipping.
Bath seats and benches
A bath seat or bench is often recommended for the bathtub or shower. Generally, it is easier to sit than stand during bathing and your balance will be better. However, sitting on the floor of the tub is often not realistic.
A bath seat sits with all four legs within the tub or shower, whereas a bath bench sits with two legs inside the tub and the other two legs outside the tub. This allows you to sit on the bench when outside the tub, then move back on the bench and swing your legs in. By doing this, you avoid having to step over the lip of the tub.
Bath benches usually come with a back support, while bath seats can be found with or without a support. Both seats and benches are height-adjustable, and should be set to a height that makes getting up and down easiest.
When considering using a bath seat or bath bench, make sure the bottom of the tub is solid. Fibreglass tubs that are not well supported may crack when you sit on the bath seat or bench. A hand-held shower should also be installed so you can control the direction of the water. Mounting hardware may be available so that you can place the nozzle within easy reach when you are sitting.
If you or the person you are assisting would prefer to sit in the bathtub, consider installing a bath lift. This allows you to be gradually lowered down into the water. Check the weight capacity of these devices before purchasing. Also, a bath lift takes up space in the tub, so there is often less room for the legs.
Accessories and aids
A number of smaller devices have been designed to make bathing easier. A long-handled bath sponge extends your reach to make it easier to clean your back and feet. A foot scrub attaches via suction cups to the bottom of the tub or shower and holds a bar of soap between two foot pads. Feet can be washed by rubbing them on the soap, then on the foot scrub.
Placing a chair outside the tub/shower or just outside the bathroom can provide a convenient place for you to sit, dry off and get dressed. Make sure everything you need is located nearby, including towels, clothes for the day, socks, slippers or shoes and any devices you need. This way, you will not have to keep getting up to gather what you need.
If you are unable to get into the bath tub or shower stall, a sponge bath may be an option. Again, set yourself up in a chair with everything you need to get bathed and dressed. A bedside table may be helpful, and can wheel out of the way when you are finished.
One other approach is to use no-rinse shampoo and bathing cloths. The shampoo comes in a device that looks like a shower cap. The cap is applied to the head and then massaged, just like washing your hair, working up a lather. No rinsing is required, just dry and style. The no-rinse bath cloths come in a package that can be heated in the microwave. Remember to use several disposable cloths for your bath so that you are always working with a clean cloth.
Bathrooms have many slippery surfaces, especially when wet. Taking the time to identify your needs and look for solutions will help prevent falls and other injuries. If you find bathing difficult, ask your doctor to refer you to an occupational therapist for an assessment to ensure you get the most appropriate equipment. And ask for help at home from a care provider who can assist you with bathing and dressing.
Linda Norton, MSCH, BSc, OT, OT Reg (Ont), is the Rehabilitation Education Co-ordinator with Shoppers Home Health Care.