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What's the problem with the bathroom?

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Bathrooms have been noted as one of the most problematic areas of the home for older adults (Gitlin, et al., 2001). The bathroom is where many activities of daily living are completed. Activities commonly performed in the bathroom include bathing, toileting, and grooming. Specific tasks required to complete these activities, such as transfers and operating controls, can be difficult in a typical bathroom.

As pointed out by one researcher, current bathtubs and showers have not been designed to meet the needs of people with various abilities and of various ages (Mullick, 2005). For instance, those who have difficulty ambulating may need space in the bathroom to maneuver with a walker or wheelchair. People with poor balance and endurance may need to sit rather than stand for long periods of time while bathing and grooming. When transferring in and out of the tub or shower and on and off the toilet, additional supports may be needed for the upper body. People may use existing fixtures in the bathroom to support them during transfers. These fixtures are often not designed to bear the weight of a person as they use the fixture for a support. Also the type of controls, the tools and supplies, and the distance from the water sources need to be accessible. People may have various abilities to reach and grasp, detect temperature and sensation and to complete grooming tasks.

Not only can the design of the bathroom be limiting in supporting people of various abilities, but it can also pose risks. Bathrooms can have slick surfaces which place people at greater risk of falls. People who fear falling may avoid bathing in the bathroom which makes them feel unsafe. Lighting may be inadequate for people who rely on their vision for stability during transfers. Low lighting can make it difficulty to see, as well as too much lighting which causes glare. These are just some examples of potential hazards in the bathroom.

Fortunately, the bathroom environment can be designed to facilitate performance of bathing, toileting and grooming activities. Grab bars, if secured and placed in an area of the bathroom that is useful to the person needing them, can be one way to support tub or toilet transfers. Sometime equipment such as a shower chair or bath bench can be used for persons who need to sit rather than stand while bathing. A roll-under sink can provide room for a wheel chair user to reach the sink controls from a forward position. A curbless shower can make the bathing space accessible to either a person who is ambulatory or someone using a wheeled mobility device (e.g. wheelchair, walker) to enter the shower.

Other bathroom modifications can be found in this article: http://atwiki.assistivetech.net/Bathroom_Accommodations

References

Gitlin, L. N., Mann, W., Machiko, T., And Marcus, S. M. Factors associated with home environmental problems among community-living older people. Disability and Rehabilitation, 23 (17), 777-787

Mullick, A. (2005). Bathing for older people With disabilities. Retrieved on November 6, 2006 from: http://www.ap.buffalo.edu/idea/Publications/Bathing%20for%20Older%20People.htm



Author: Dory Sabata
Affiliation: CATEA, Georgia Institutue of Technology
Email Address: dory.sabata@coa.gatech.edu
Web Site: http://www.catea.org