Home bathing solutions and aids for the elderly

Why is bathing safety so important for older people? 

Everyone needs to take care of their hygiene on a regular basis, and that usually means having some sort of bath or shower routine to clean key areas of the body in order to maintain health. For those with limited mobility or dexterity, or for those who struggle to stand for long periods of time, bathing could pose a number of risks, as the bathroom is generally considered to be the most dangerous room in the house for older people.The Centers for Disease Control reports that around 21.8 million people aged 15+ sustained nonfatal injuries in 2008. According to more recent data from the National Accident Helpline, the bathroom is the 4th most likely place to be injured, with a 26% chance of injury. In addition, a wet floor has an 18% chance of causing an injury, and as the bathroom is the most likely place for wet floors, it is important to take steps so that older people feel safer at home by keeping bathrooms dry and safe with the necessary adaptations. Doing so can make a huge difference to an older person’s ability to manage their own hygiene practices, not to mention avoid a dangerous fall or accident that could lead to serious injuries.Daily personal care practices are also important for taking care of skin, as this tends to become thinner with age, which means older people are more likely to experience skin irritation and infections if they do not effectively manage their hygiene.Safety is always the number one priority, but during bathroom routines it is also highly important to preserve an older person’s dignity by ensuring they remain as independent as possible and have autonomy in how things are done. This can support their wellbeing, improve their quality of life, and bolster their mental health. By facilitating this, caregivers can help older people to avoid anxiety or depression developing due to a constant fear of falling.What bathing aids could help older people to stay safe and comfortable at home? No matter what your mobility needs may be, there is likely a home adaptation to help keep you safe and supported, and reduce your likelihood of falling. Some non-invasive bathing aids that can be added quickly and easily include: Grab RailsGrab rails (otherwise known as stability bars) are exactly what they sound like; rails added to the wall that an older person can easily hang onto if they lose their balance. These can make moving around safer and more comfortable. Those who struggle with balance or mobility can keep a hand on the rail throughout their daily activities to avoid any balance issues, as grab rails provide something sturdy to hold onto. For example, if a grab rail is installed beside the toilet, this can be used as a support for getting on and off of the toilet easily and safely. Grab rails can come in almost any combination of length, thickness and direction, meaning there will be an option for your home. They are usually mounted on the wall for added support, but you can also get suction options that may not require professional installation. Grab rails are often circular in shape, and can be fixed from wall-to-wall, wall-to-floor or floor-to-ceiling. They could also be fold-up bars that swing away when not needed. When installed, grab rails must be tested to ensure they can hold the weight of a person, and the positioning should be tailored to the space they are in and the needs of the user. This could mean a particular angle, height, length, material or finish. The World Health Organization recommends rails have at least 50 mm clearance from the wall to ensure there is enough space for hands to hold on, and the recommended circumference is 30-50 mm.If you are interested in installing grab rails in your bathroom, you can apply for a home assessment here, where someone from your local council will visit your home to assess your needs and determine whether this is the appropriate home adaptation for you.Non-Slip MatsNon-slip mats are easy to add to bathrooms as they typically only require the correct positioning and to be stuck to the floor with adhesive. A non-slip mat on the floor of the shower or bath can also be a great safety measure for older people who cannot easily correct their balance, and these can be stuck to the ground using suction cups. This provides a more stable surface to stand on while in the shower, and avoids accidental slips when repositioning your feet while bathing. Non-slip mats are thought to significantly reduce fall risk in wet bathrooms or slippery surfaces. These are useful for any older person to have regardless of their level of mobility, as they are usually inexpensive, simple to install, and easy to remove if needed.Shower or Bath Seats Showering and bathing are activities during which older people might feel most vulnerable due to the risk of slips and falls. For this reason, having a seat in the shower or a board across the bath can provide added comfort and stability when bathing. This is particularly helpful for those with fatigue or little stamina who struggle to stand for a long period of time. It can also be helpful for those who find it challenging to get in and out of a bathtub. A shower seat is usually a plastic chair designed to sit in the shower under the running water, giving you a place to rest while you clean yourself safely. This can help those who become easily fatigued, and who fear slipping in the shower. Shower seats are often foldable, meaning they can be brought out when needed and stowed away for when other members of the household are bathing and do not need this. Bath boards are a similar concept; a sturdy board that sits across the bath, creating a way for people to enjoy their bathing experience and get clean without sinking down into the bottom of the bathtub and worrying about getting out safely. This can be helpful for those with limited mobility, or who have recently recovered from surgery. For those with severely limited mobility who may risk drowning while bathing, a safe seat that keeps their head out of the water could be a crucial addition to their bathroom. 

Other Simple Adaptations

There are many helpful home adaptations that could make a big difference to an older person’s safety and quality of life, such as: 

• Handheld shower heads – These offer a more convenient way for older adults to clean themselves without having to maneouver their body into certain positions under the flow of water – this way the water is always exactly where it needs to be. 
• Thermostat water settings – These are available to make temperature control easier and to avoid any mishaps with ice cold or scalding hot water. Controlling shower and bath temperatures can be tough for anyone, let alone an older person who may not be able to react quickly if the temperature becomes too hot or too cold. Older people tend to have thinner skin that can burn more easily than in younger people, so it is recommended to keep water temperature for bathing under 44°C (the NHS recommends 43°C) in order to prevent burns. A thermostat water setting device could help to maintain the desired temperature each time they shower.   
• A long-handled sponge – This can help to wash difficult-to-reach areas without overextending and causing injuries. These are relatively inexpensive and easy to get a hold of online or in pharmacies. For those living with arthritis, this can make washing a less painful experience. 
• Steps – Small steps can help to make reaching high shelves easier to reduce the need to reach or strain, such as mirror cabinets above the sink. 
• Raised toilet seats and commode chairs can make it easier to sit on the toilet by raising the height to a more convenient and comfortable level.

What longer-term solutions can be added at home? 

More permanent home adaptations can be added as a longer-term solution for mobility issues to enhance safety, comfort and independence. These will usually require professional installation, and for bathrooms, might include:

Walk-in Baths 

Walk-in baths can be a handy solution for any older person who finds it difficult to get into the bath, or worries about doing so. The high sides of a bath can lead to balance issues and falls, so having a specially designed bathtub with a watertight door allows older adults to easily step in and out by simply opening the door, with no need to step over a threshold. Many walk-in baths also have a seat, and are designed with anti-slip surfaces to offer maximum safety. This can create a relaxing bathing experience for older adults as it reduces any potential pain or strain associated with getting in and out of the bath. You could also consider adding a bath cushion to make this even more comfortable. The pros of a walk-in bath include improved safety, peace of mind and enhanced independence, while the cons might include the need for professional installation, longer fill and drain times, and cost – in the UK, it usually costs around £2,000 to have this installed through Age UK, but this depends on what other bathroom renovations may need to be done alongside, such as tiling or moving the bath to a different area of the room.Level-access Showers or Wet Rooms Similar to a walk-in bath, a level-access shower can remove the stress of safely stepping over a raised entryway to a shower. In traditional showers this could cause older people to lose their balance and fall, so a level-access shower makes it easy to enter and exit without having to step over anything. Another option offering the same level of safety is a wet room, which is a bathroom designed with non-slip flooring all over, and no shower door. This means the entirety of the floor is level, and older adults can access the shower area seamlessly without stepping over a raised threshold. Wet rooms also make it easy for people to take in their usual walking aids or wheelchairs, and may come with grab rails and fold-down shower seats for ease. The pros of a level-access shower or wet room include enhanced safety, easier access for caregiver assistance, and a modern design, while the cons might include the need for professional installation or a full bathroom refit, more water ending up on the floor after bathing, and a less enjoyable bathing experience for those who prefer relaxing in a bath.

Adjustable-height Basins 

For people who use wheelchairs, standard sink basin heights may not be suitable and could lead to injuries from stretching to reach. Adjustable height basins are a helpful adaptation that mean the sink can be easily raised or lowered to suit the needs of different people within the household. This can also be helpful for older adults who cannot stand up for a long time, and prefer to sit down while brushing their teeth, washing their face or styling their hair.

Who funds bathroom adaptations for older people? 

Bathroom adaptations can be arranged and paid for privately through many companies within the UK, but for those who need funding or financial support to cover part or all of these adaptations, there are a few options available. 

• Local authorities – For minor home adaptations costing under £1,000 (such as grab rails), your local authority in England will often install these free of charge with no means testing required. Similar help will be provided in Scotland for minor adaptations costing less than £1,500. In Wales and Northern Ireland the amount you pay will depend on your circumstances. You can apply for a home assessment here.
• Disabled Facilities Grant (DFG) – DFGs are provided by local councils, and can cover up to £30,000 in England, £36,000 in Wales, and £35,000 in Northern Ireland for essential home modifications to enhance safety and independence for disabled people in their home. This grant is no longer available in Scotland, but there may be other options available to you via Disability Information Scotland. For DFGs, eligible adaptations include installing level-access showers, walk-in baths, and adjustable-height basins. To apply for a Disabled Facilities Grant, you will need to undertake a means-tested assessment whereby an occupational therapist will determine what the necessary adaptations may be to improve your independence.
• VAT relief – Disabled people or those living with a long-term illness will not be charged VAT on products designed or adapted for their personal or domestic use, including the installation of home adaptations, repairs, maintenance, spare parts or accessories. This covers things like adjustable beds, stair lifts, wheelchairs, alarms and more, but it only applies to disabled people who qualify – if you are older but not disabled, VAT relief will not apply to you. 
• Charities – Some charities in the UK offer grants to help those who need home adaptations. The Turn2us Grants Search is a great place to find out about grants you could be eligible for, as they list grants from registered charitable organisations across the UK who give money to help people who need adaptations to improve their independence. You can learn more here. 
• Home Improvement Agencies (HIAs) – While not a direct source of funding, you may find additional support available through HIAs. These not-for-profit organisations help older and disabled people to assess their home for their needs, plan and arrange adaptations, and can assist with things like grant applications, planning applications and finding contractors. Every year they help around 20,000 people being discharged from hospital, assist with around 30,000 Disabled Facilities Grants, and provide support to around 40,000 self-funders. 

How can home caregivers help with bathing? 

As well as bathroom aids and adaptive devices, having visiting care or live-in care is another way to ensure your loved one’s safety at home, with the added benefit of making personal care tasks less strenuous and having someone around if any accidents do occur. Home care can also offer specialist care for particular health conditions, provide companionship to avoid loneliness, and help with things like housekeeping and running errands. If safety at home is a particular concern for you, having a home caregiver can offer peace of mind that there is always someone around to help if needed, and to oversee personal care tasks while prioritising dignity, promoting confidence at home, and encouraging independence where possible.  Home care can help with a number of things that bathing solutions and home adaptations cannot, such as:

• Removing clutter from the bathroom area to avoid falls
• Mopping up wet floor patches to avoid accidental slips 
• Checking water temperature is comfortable before bathing 
• Putting down non-slip mats and ensuring they remain flat with no upturned corners 
• Assisting with undressing and washing areas that are difficult to reach
• Being a source of comfort when transferring in and out of the bath or shower, when an older person might feel more anxious and vulnerable 

At Home Instead, we understand that starting to receive help with personal care can bring up feelings of embarrassment, shame and anxiety if, for example, you have to undress in front of a carer when you have always taken care of yourself. Rest assured that our Care Professionals are expertly trained in providing compassionate personal care that makes your dignity a top priority. We tailor your care to ensure you feel as comfortable as possible, which might mean avoiding embarrassment by starting with simple companionship in the home to help if anything goes wrong. Over time, we can work to build trust and provide further help if needed. We encourage older adults to do as much as they are able to on their own with the help of bathroom adaptations to promote their independence, and can adapt our level of support as needs change over time. Many families assume that when an older loved one can no longer take care of their own personal care needs, they may need to be moved to a care home for their safety. This is not always the case; some simple home adaptations could make their home just as safe as a care home, with the added benefit of having their regular comforts and family nearby.Our experienced, supportive Care Professionals can provide the help needed to manage personal care tasks safely at home, where they feel most at ease. To discuss your options, reach out to your local Home Instead office.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.