It is well known that falls are dangerous for seniors and can even be fatal in some situations. This article shall highlight why falls occur in the bathroom and what can be done to stop falls from happening.
Top causes of falls in the bathroom
- Bathrooms are inherently dangerous because they are tiled surfaces that are slippery when wet. Moisture from the nearby shower or bathtub and splashing lead to an accumulation of water on the floor and lead to a slip.
- One usually undresses in this room and this may lead to a fall through misjudgment of one’s balance. When removing pants, some people choose to do this from standing rather than sitting and may trip over their own clothing or feet.
- Related to the topic of undressing, sneakers are usually removed in this room. Shoes increase the grip one has to the floor and improves stability. However, if shoes are removed, socks offer poor grip and contribute to sliding or falls. If socks are also removed, being barefoot poses similar problems as there is less grip compared to a rubber soled shoe.
- Those suffering with congestive heart failure (CHF), extensive coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), asthma and other complex health conditions may experience increased shortness of breath. A contributing factor to this is the humid and warm environment typical of a hot shower. If one has a difficult time breathing, and unable to get sufficient oxygen, one starts to fatigue easily and may even feel lightheaded. In these situations, one’s risk of falling increases. So while a prolonged warm shower may feel good on the skin, it may lead to a fall particularly if it affects one’s ability to get a full gulp of air.
- When one’s energy reserves are drained, a fall is more likely to occur. Standing in the shower can be energy consuming as one’s muscles must work to keep one upright and balanced. As well, bathing itself is a demanding activity in that one must physically scrub and clean themselves. Furthermore, getting in and out of the tub or shower can also be quite effortful.
Bath and shower transfers aids and safety equipment found in a senior’s bathroom
Many seniors use adaptive devices to increase their safety and independence within the bathroom. These tools all offer different advantages and disadvantages, but in a general they all act to improve safety with bathing, getting in and out of the shower/tub and help to conserve energy.
The only device that will help one safely get in and out of a bathtub where the user wishes to continue to soak in the bath water instead of showering. Electric powered and controlled with a remote.
Great for supporting one with transfers into and out of showers, bathtubs and moving around the bathroom. Need to have good strength for pulling and/or pushing depending on grab bar location.
A chair that slides from the toilet to the tub. The hole built into the device allows it to be used for toileting and personal hygiene without the need to transfer out of the chair.
The safest way to get into the bathtub to have a shower. Do not need to step over the tub edge. Simply sit on the bench, swing the feet inside the tub, and scoot over until one is in front of the shower head.
Similar to a regular tub transfer bench, except this one has a chair that slides into and out of the tub as needed. Great for conserving energy and boosting safety.
A bath chair that stays in showers or bathtubs and can be used for resting or showering from seated. Some models have a backrest while others also have armrests that can be used to push oneself into standing.
The smallest shower chair one can obtain. Ideal for small shower stalls where larger bath chairs cannot fit. Can be used to shower from a seated position. Ideal for slight standing balance issues.
Similar in role to a bath chair, but this secures against the tub edges with a clamp. Wider than a normal bath chair. Must still step over the tub edge to get into the tub. Cannot be used like a tub transfer bench.
A railing that secures against the tub edge with a clamp and is held there by pressure between two pads. Can be used to increase one’s stability by applying a downward force onto the device while stepping in or out of the tub.
A transfer pole is held in place by tension between the floor and ceiling. This device can be found near the toilet, bathtub or shower. It can be grasped by someone and used to help one get into standing from a low toilet, used to walk around a small bathroom and for support to step in or out of the shower.
Toilet safety aids that help the elderly with standing up
Getting on and off the toilet can be difficult especially when facing muscle weakness and general fatigue. Some people resort to using the nearby sink counters for support to get into standing or even moving from one part of the bathroom to another. This is extremely unsafe for several reasons:
- The counter can be wet as a result its close proximity to the sink, which may result in one’s hand slipping.
- There is nothing secure on the counter to grab and wrap one’s hand around for support. The counter itself not sufficient for keeping one from falling. If you don’t believe us, try to grab onto the counter and hold onto it real tight while relying on your hand for support as if you were falling and were using it for help. You will find that your hand will slide off the sink easily.
- Some people will rationalize that they will hold onto the sink bowl, but this can be wet and slippery. Once again it is not a secure object that you can wrap your hand around.
So let’s discuss the alternatives for toilet transfers. A toilet safety rail (also known as a versaframe) can be helpful. This bolts onto the toilet (same spot where the toilet seat is secured) and can be used to push off the armrests to get into standing. These arms are right beside the user and there is no need to reach awkwardly for them.
Not all toilets will be able to accommodate a toilet safety rail. Sometimes the bolts will not fit the versaframe and at other times they have been removed / misplaced when the original seat was removed to install a raised toilet seat. In these cases one can consider using a stand alone bathroom safety rail. This is essentially a aluminum frame that wraps around one’s toilet to provide a stable base from which the user can push on to get into standing. It should be noted that this is a wider device compared to a versaframe. Also the armrests cannot be adjusted usually, where as traditional toilet safety rails can be widened and raised for larger individuals.
Usually a safety frame, whether it is secured to the toilet or stands around it, is used in combination with other senior aids to make toilet transfers more safe. For example, a raised toilet seat can increase the overall height of the toilet. This means that one does not have to sit down as far and is sitting a little bit taller already when they are prepared to stand. As a result, standing is significantly easier.
Sometimes these two devices are not utilized or compatible depending on the toilet. An alternative is a 3 in 1 commode that can be placed over the toilet bowl. The advantage to this safety aid is that it has both of the necessary features of a toilet safety frame and a raised seat within one convenient device. For instance, it has armrests and the commode itself has height adjustable feet to increase the height of the sitting surface to make standing easier. The aid comes with a chute through which the stools or urine pass to reach the toilet bowl. Also, the commode can be interchanged to hold a pale and be used at the bedside if someone has difficulty ambulating longer distances to a bathroom. While this devices offers numerous advantages, it is not visually appealing, quite bulky and large. Also, having this aid stationed near the bedside means odors after voiding tend to linger. After each use, it is recommended that it be cleaned to immediately to minimize odors. One helpful suggestion is to purchase absorbent commode liners which can be sealed immediately after voiding and replaced easily. They make cleanup very easy, quick and minimize any nasty smells from lingering in the room.
Lastly, some people opt for grab bars along the wall near the toilet. Depending on the placement of the grab bars, one can either pull themselves into standing or use them to pushed off of to accomplish the same thing.
Preventing seniors from falling at the bathroom sink
Standing at the sink for an extended period of time while brushing teeth, shaving or washing one’s face can be dangerous. The risk of having a fall at the sink is especially high for those with poor standing endurance, tolerance or balance. One useful strategy is to use a tall perch stool so one can sit at the sink while brushing their teeth and engaging in their personal hygiene. This is a useful energy conservation technique and can prevent falls.
How to make a small bathroom senior friendly
As one ages there is usually a need for mobility devices to support one’s balance and walking. Most often a walker is needed, however not all bathrooms are spacious and able to accommodate these mobility aids. Some doorways may be narrow and prevent walkers from passing through. Also some bathrooms are small and this can act as a barrier to safely navigating inside as it prevents turning with the walker. In these cases many people abandon the walker outside in the hallway and use the counters or sink for support to get to the toilet or shower. This places one at high risk of falls and injury as they attempt to ambulate with less than optimal support.
A better option would be to install expandable hinges to increase the usable width of the doorway. When using this accessory, doors move completely out of the way from the door frame and allow use of the entire width of the doorway. In comparison, a regular hinge prevents the door from moving away from the frame and decreases the width of the doorway by 1 to 2 inches.
Another strategy is to install grab bars that are within reach of each other to facilitate the user moving from one part of the bathroom to another until they get to their destination such as the toilet, shower, sink and/or doorway. You need to get a hold one grab bar before letting go of the grab bar held by the other hand. Doing this ensures that you always have some form of support as you move around the bathroom and decreases your risk of falling.