Safe Bathing

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mobility aid safe bath

Bathing allows us to maintain social standards of cleanliness and refreshes and relaxes the body and mind. For the frail elderly, however, the need for cleanliness is often carefully weighed against the risks of accidents while bathing. For the caregiver, bathing an elderly loved one also has emotional and physical stresses including preparing the bath, standing nearby for emergencies, and having to towel dry an embarrassed parent. So what can a caregiver do to ensure a loved one’s bath-time safety? A high-risk activity Bath-time accidents are associated with two factors: 

(1) Design,the tub and bathroom  

(2) Bather frailty. In the first case, bathrooms often have little room to maneuver, particularly around the tub. And tub design often ignores the mobility challenges of the less agile. 

Fortunately, new inventions, such as tubs with doors, walk-in tubsfor stepping are available. These option is worth exploring. In the second case, elderly persons’ frailties are often complicated by medication side effects (e.g. dizziness), reduced physical ability (e.g. arthritis) or diminished eye sight. 

These frailties may be exaggerated when the elderly, in an effort to maintain privacy, refuse bathing assistance from caregivers. In many cases, older adults tend to be too confident and over-exert themselves to maintain their independence and compensate for their loss of capabilities. This over-confidence and lack of help often results in personal injury.

Individual solutions when bathing is a concern, a caregiver can consult with a health professional, who will conduct a proper assessment of the elderly person’s abilities and environment. These assessment services are available from a government-funded or private agency. Some caregivers may balk at the idea of paying privately; however, the increased safety and peace of mind are well worth the investment! 

Nonetheless, most bath-time accidents occur for one of five main reasons. Below are the main reasons and some helpful solutions for ensuring your loved one’s safety: 

1. Balance

Many elderly have poor balance. For support in the bathroom, they often hang onto the sinks, fixtures, shower doors, soap holders - any of which may break loose and cause an accident. As these products are not designed for support, they may force the person to turn and twist the bodies, thus exposing them to the risk of falling. Transfer Benches ease transfers in and out of tub. They generally remain partly inside and partly outside the tub, and a person sits on the part outside the tub and slides his or her body inside the tub. Bath seats rest in the tub. They must have proper non-slip legs to ensure stability, and preferably have a back for additional support. Bath lifts raise and lower the elderly into and out of the tub. They must be installed properly to ensure safety. 

2. Toileting 

The area in and around the toilet is a frequent site of slips and falls. Slippery floors near the toilet and the tub often cause falls when the elderly are sitting on the toilet or entering and exiting the bathtub or shower. Floor mats, if used, must be secured to the floor. Bathmats must be non-skid and have suction-cup-like backing, or they will loosen and slip. Bath patches are inexpensive small, non-skid pieces that are permanently glued to the tub surface. Boating shoes are used by some elderly in the tub and shower. Caregivers can use sneakers in the bathroom. Hand rails or grab bars provide weight support and allow a person to maneuver easily. 

3. Standing 

Standing, reaching and over-exertion happen for three reasons: 

(1) stretching for supplies and controls that are not within easy reach, 

(2) trying to reach various parts of the body, and 

(3) challenging reaching capabilities because of physical limitations. Preparation is important. The caregiver should lay everything out to minimize reaching. For example, have bath towels at arm height close to the tub, or use soap-on-a-rope to avoid unnecessary reaching if the soap falls. Hand-held showers allow an elderly person to shower while sitting down on a bath bench. Hand-held showers are also easy for caregivers to use, and they can easily replace the need for a bath. 

4. Privacy 

The elderly often find privacy during bathing to be a problem. Family caregivers may find the level of intimacy difficult to manage. Paid caregivers acknowledge that bathing assumes trust between them and their clients; however, this trust can be difficult to achieve when there is little consistency in caregivers. Frank discussion about bathing between the elderly person and the caregiver is important. Does the person prefer a family member to assist, or would she or he like it better if a stranger helped? Would the person prefer someone of the same sex or the opposite sex? Washing private parts may be dealt with in various ways, such as the caregiver handing a soaped washcloth to the elderly person or placing a wash cloth may over the genitals. Some elderly prefer wearing a towel around the waist while showering. It doesn’t matter if the towel gets wet; remaining casual is important. Hiring a caregiver to give a bath regularly may be worth the expense. It would provide continuity and eliminate the need to repeatedly write down the particulars of bathing (e.g., what shampoo to use, in what order to do things etc.) to new caregivers. 

5. Other considerations

Poor lighting may cause tripping or overextending, especially when an elderly person removes their eyeglasses before bathing. Additional light in the bathroom may be helpful; however, glare must be avoided. Light-coloured walls in the bathroom and a transparent curtain may also help. Opening faucets and adjusting water temperature are troublesome activities for many elderly. Those lacking sensation in the hands can also easily misjudge the temperature and get scalded. Installing anti-scalding devices or automatically setting the water temperature will reduce the risk of burns. Cognitive impairment such as Alzheimer disease may cause a person to refuse a bath. Being calm, explaining step by step what will happen, and promising a special treat after the bath may ease this task.

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