Bathrooms are one of the most hazardous places in the house considering the slippery and unforgiving surfaces that they have. This greatly increases the risk of fall-related injuries for the elderly in the house. But you can make the bathrooms in your house safer for the elderly. This article will outline different kinds of modifications that you can undertake in your bathroom so that they become safer and more comfortable for the elderly in your house.
Why do you require alterations in the bathroom for the elderly in the house?
More than one in every four persons above the age of 65 tend to experience a fall each year1. If falls do happen, most of them do not lead to a serious injury, except for a scraped knee or minor bruise. But the bathroom is one place in the house which is tricky in this aspect. Falling in the bathroom is a different situation altogether. Fall-related injuries can vary from minor scrapes, cuts, and bruises to a little more severe injuries, such as head contusions, broken bones (hip fractures being the most common), and even injuries related to the spinal cord.
Falls may occur due to various reasons, some of which we have highlighted below. However, the list may not be exhaustive, and we should be always vigilant for other potential fall risk factors.
- Risk of slipping: This is the single most prominent reason behind a bathroom fall and is caused by unexpectedly wet surfaces. In fact, it is generally seen that the user is very careful on a surface that is expectantly wet, however, if there is water spill in an area that is not supposed to be wet, it is highly risky for the user and more so, for the elderly.
- Risk of falling due to light headedness: Another major reason for bathroom falls among the elderly is because of light headedness that is felt immediately after getting up from bed. It is common for the elderly to get up frequently from the bed and use the bathroom; however, lack of proper blood circulation or conditions related to sub optimal blood pressure may result in blackouts, unsteady gait or just light headedness.
- Risk of Tripping: It is important to keep your bathroom floor as uncluttered as possible. Small stools (often meant for kids), loose cables, bathmats with ruffled up ends are some examples of hazardous situations which may lead to a fall. We should be careful to unclutter the bathroom floors for our elderly loved ones.
What accidents can happen in a Bathroom? Are you or a loved one susceptible to them?
Up to 80% of the cases of falls in the home are related to accidents in the bathroom. What makes this part of your house dangerous?
It is true that anyone can stumble and fall while in the bathroom but the risk of injuries increases for those who have poor muscle strength and balance. The risk increases even further if you have a history of falls. Most falls tend to occur while you are –
- Getting in and out of the shower or your bathtub;
- Using the toilet while sitting down and getting up; and
- Attempting to use sink tops, towel bars, or other objects to support balance while walking.
In addition to this, there are certain environmental hazards or features in the bathroom that add to the risk of falling. These hazards include shower chairs that not slip-resistant. Certain bathtubs that are difficult to step into and out of also add to this list. This situation is made further complicated by sliding shower doors that sometimes move unexpectedly while you are entering and exiting the bathtub.
The bathtub and shower floor surfaces are comparatively slippery as compared to the floor surface in the rest of the house. The floor tiles in the bathroom can be extremely slippery especially when they are wet. The elderly also face difficulty in getting up easily from toilets that are low in height. There are cases where they have tried to grip towel racks to take support and have experienced a fall since the towel racks were secured insufficiently.
How to Make a Toilet Elderly Friendly?
Let us first look at the alterations to be made to a toilet to make it elderly friendly. Having a toilet at a proper height can make a huge difference in terms of comfort and safety in the bathroom. Two of the most common options for achieving this are buying a seat extender or replacing the toilet with one that is at a proper height as per the user. If you are looking at a convenient and economical way, you should look at buying a seat extender (a raised toilet seat). Seat extenders are easily available at a local home health care store.
However, if you are remodeling your bathroom, it might be a good idea to consider replacing the existing toilet if it is not at a proper height. In that case, do keep in mind that the right toilet needs to be selected for the people who intend to use it and the height should be adjusted accordingly. Also, considering the person’s height and abilities, a handicap accessible toilet can create more issues than a toilet at a lower height.
In addition to adjusting the right height of the toilet, you might want to consider installing a toilet paper holder that is designed to make one-handed changing easier. You should ensure that the toilet paper holder is reachable from a sitting position. You might want to look at a toilet/bidet combination as an alternative if you are planning to replace the toilet. It can significantly improve hygiene for users.
Some other toilet solutions for the elderly can be:
#1 Toilet Seat with Bidet: A bidet, installed with a toilet seat, is a specialized fixture that can be used for a hand-free and toilet paper free cleaning experience on the toilet. Electric bidets often come with a toilet seat of their own and there is an option to heat or warm up the toilet seat before use, which is often useful in the winter when the seat is cold to the touch. The bidet can have the capability to adjust the pressure of water, the direction of water and the temperature of water in most premium models. It helps the elderly to maintain toilet hygiene in a very convenient manner and encourages self-use of toilets with minimal help from care givers.
#2 Toilet Safety Frame with Arms: For patients with advanced osteoarthritis or any other musculoskeletal condition which significantly impairs mobility, sitting down on the toilet seat itself is an activity that may be difficult and will be fraught with fall risk. The toilet safety frame is often constructed with anodized aluminum for safety and durability and attaches to the toilet body to provide support and comfort. The high arm rests help to distribute you weight while you are seated on the toilet and also helps to lift yourself up from the seat. Most premium models can be adjusted in both height and width to suit your bathroom and your height.
How to Make a Bathroom Elderly Friendly?
The bath area tends to be more slippery and hence more dangerous for the elderly. You can make the following alterations to the bathroom to make it elderly friendly.
The Location of the Bathroom in your house
It is advisable that at least one full bathroom should be present on the main level of your house which has other commonly used areas like the kitchen, bedroom, laundry room, etc. In case your house does not have a bathroom on the main floor, you may look at the option of remodeling a bit to add an additional bathroom on the floor. You can also install an elevator or a chair lift that can make reaching the other levels a little easier.
Ensuring that there is adequate space to move around
If you are planning to remodel your bathroom, do keep in mind that space will be a greater issue as you age. As you transition from mid-life to elderly or senior, you should consider the space that would be occupied by assistive devices like canes, wheelchairs, or walkers. In an ideal scenario, you should have plenty of clear space that can accommodate someone using a wheelchair around the toilet, shower stalls, bathtubs, and areas around the closets and cabinets in the bathroom.
Grab Bars in Bathrooms
Installing grab bars in the bathroom can significantly and economically increase safety for the elderly. They can also be quite helpful in bedrooms, hallways, or other places in the house where the elderly might need standing or walking assistance. At the toilet, grab bars can assist the elderly with sitting and standing. In the shower or the bathtub, they can help the elderly to stand (or stay standing) and safely get in and out of the shower.
Typically when people think of grab bars, they think of products that look like they belong in a hospital. However, you can find grab bars that are not cold or metallic but come in a variety of colors and styles to match your taste and the decor of the surroundings.
If you are thinking about remodeling your bathroom, you might like to install bracing in walls around the tub, shower, shower seat, and the toilet. This can be done even when you do not plan on installing grab bars at that time. You should get the walls prepared to support grab bars when you feel you are ready and prevent any additional remodeling that might be required later. Typically, grab bars are required to support a weight of 250-300 pounds. For best results, grab bars should possess a texture that enables easy gripping.
Bathtubs and Showers
Most homes in America have bathrooms that are not designed keeping accessibility in mind. This turns out to be a huge safety concern for people who wish to age in place. You can do several things to a standard tub that can make it safer for an elderly person. Installing grab bars, shower seats, and applying an anti-slip coating to the bathtub floor are some of the reasonably priced options that you can consider.
You can also modify the bathtub to create a safer way to enter the tub. This can turn out to be more inexpensive than replacing the tub. If you are planning to replace a tub, you might want to look at the wide variety of walk-in tubs in the market that can replace your existing tub.
For showers, one of the most accessible options is a roll-in shower. A Roll-in shower is a shower stall that has a curb-less entrance and opening (or door) is a minimum of 36 inches wide. This allows easy access to a wheelchair that might be required at some point and helps those who walk into the shower a lot of room to maneuver.
Adjustable Shower Heads
An adjustable Shower Head can move to suit the height and position that is most comfortable for a user. It is a great way to add accessibility to a bathroom. It can be combined with a hand-held shower head to create an even more functional experience for the elderly. You can also add a shower seat to make it much easier to bathe while bringing in an increased level of safety.
Shower Seats can relieve the strain experienced by the elderly when standing for extended periods of time. These seats help a person to safely shower and reduce the chances of them experiencing a fall. There are many kinds of shower stools, shower chairs, retractable or foldable seats, and built-in seats.
For the purpose of overall usability and bathing safety of the elderly, you should ideally have the tub and the shower water controls closer to the entry-point. This enables the user to reach for them from outside the shower/bathtub area. You should also install lever handle faucets. For the sake of comfort and convenience, have a shelf installed int eh shower/tub area to keep the soap, shampoo, and towels. Install or purchase a tub or shower seat. You should have the water pressure controlled and install anti-scald controls. It would be a good idea to have water pressure controlled for the sink as well. If your shower stall does not have a light, get it installed for convenience.
Sliding Transfer Shower Chair
This is shower aid / bath aid that can be installed on your bathtub. Made of sturdy rims of aluminum, the structure consists of two track-like rims which straddle one wall of the bathtub and a seat which moves on this track, in and out of the bathtub. You re supposed to seat on the chair, while it being outside the bathtub, and slide yourself into the bathtub using the rails. For added safety, the feet of the structure have rubberized tips for better hold on wet ground, and both ends of the track are equipped with hand railings so that the user gets more support.
Step Stool with Handle
Step stools are platforms that are typically about 9 inches high and have a handle to support yourself. It will also have curved rubber tipped feet which expand the support base of the device and add to the stability. While they can be used to access higher shelves safely, or to get in and out of your bed, these devices are very helpful in allowing you to safely get in and out of your bathtub. As your feet will likely be wet after a shower – or the bathtub floor may be slippery when you get into it, the non-slip rubberized layer on the step stool goes a long way to help you get support on firm ground. The handle will help you to stabilize yourself once you are on the platform.
Handheld Shower Heads
Often in elderly patients with Alzheimer’s or Dementia, it is a harrowing experience to stand in the shower and take a bath. Patients with dementia may find the activity of showering as disorienting and confusing – and they may dread the rain of water on their heads and skin, because water cannot be seen. Installing a handheld shower head means equipping your elderly loved one with more confidence in the shower – letting her have better control on the water and improving the bathing experience to a great degree.
In order to ensure greater usability, consider a sink that is wheelchair accessible. This kind of sink is generally hung on the wall and thus provide space for your knees or the wheelchair underneath a panel that covers the pipe and also protects the user’s legs.
One of the most useful things to make the bathroom more accessible is installing lever handle faucets. The market also has faucets that are pedal-controlled. Both of these options allow users of almost all abilities to turn the faucets on and off more easily. They are quite helpful to users who are suffering from ailments like arthritis or other issues with gripping or bending their hands. To ensure the safety of the users, consider having the water pressure controlled, and also install anti-scald controls to prevent burns.
Cabinets and Counters
There is always a requirement of more storage space in your bathroom. If you are planning to remodel your bathroom, you would like to include as much storage space as you can. You can consider installing adjustable height (or varying height) countertops that have a provision for roll-under access in front of the sink and main countertop which makes accessing the mirror and countertop quite easy.
You should install a contrasting edge color on the countertops. This is especially useful for the elderly who are experiencing diminishing eyesight or balance issues. They would feel more at ease and this will reduce the probability of accidents.
Having plenty of counter space not only helps you cut down on the clutter but also helps in preparing the bathroom area for space needs in the future while caring for someone. You should avoid having any sharp edges in the bathroom, especially at the counters and cabinets. Ensure that the edges of the counter are rounded. This helps in preventing cuts and bruises in case someone falls against them.
A medicine cabinet should be handy in case someone gets hurt inside the bathroom. You should be able to reach it while you are sitting down. This could turn out to be particularly helpful if the elderly cannot get around very easily, or are using a wheelchair.
Having a mirror that can tilt up and down makes using it much easier. This becomes more practical if someone intends to use it in a sitting position or has a diminished stature.
As obvious as it sounds, slippery surfaces are one of the primary reasons behind bathroom accidents. The bathroom should always be made free of slippery walking surfaces. This is quite essential from the safety perspective, especially in the areas directly inside and outside of the shower and the bathtub area. You should consider using anti-skid tiles for the flooring and shower stalls. If you have a bathtub, consider putting an anti-skid coating at the bottom of the tub to avoid any falls.
It comes as a surprise to a lot of people that throw rugs turn out to be one of the major causes of users tripping and falling in the bathroom. It is recommended that you remove rugs from your bathroom as much as possible. If you still feel the need for a rug in the bathroom, buy a rug that has a low pile and secure it with anti-slip rug tape that is easily available at most major home improvement stores.
One of the most inexpensive ways to make your bathroom fall proof is to add non-slip bathmats on the floor, outside the bathtub, below the toilet and basin, wherever there is a chance of water spillage. They not only reduce the risk of slipping but can also absorb crucial impact if the elderly fall on the floor.
Motion Sensor Lights
Motion sensor lights are a great way to reduce fall risk for the elderly, in the bathroom. Often the elderly may not be turning on lights, thinking that they do not need them, or it may just not be convenient for them – however, dim areas always increase the risk of falls. Installing motion sensor lights in your bathroom remarkably increases the convenience of the elderly, who do not have to explicitly switch on the lights. Not to mention, that motion sensor lights reduce your electricity bill as well.
What other modifications would make the bathroom more comfortable and accessible to the elderly?
You should ensure that the bathroom door can be unlocked from the outside, just in case the elderly are injured and stuck inside the bathroom. You should replace the doorknob with a lever handle. In order to have greater accessibility, the bathroom door should open out and not inwards. Pocket doors also have the tendency to increase the space inside your bathroom. Another addition that you can look at is a phone. Cordless phones are an easy addon to your bathroom. These phones should be reachable from the toilet and the shower/bathtub area.
Bathrooms tend to be one of the major places where the elderly have accidents. As per a study by the Centers for Disease Control and Prevention (CDC) conducted in 2011, close to 200,000 Americans come to the emergency departments to get treated for bathroom-related injuries on an annual basis.
Modifying the layout of the bathroom can lead to a more comfortable and convenient experience for the elderly. This can also prevent injuries and visits to the emergency room. You should decide on the alterations that you plan after consultation with the elderly and try to understand the different challenges that they are facing while using the bathroom. This will make the whole experience comfortable and safe for them.