How to do it... Bathing areas

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When it comes to coordinating and arranging resident living spaces, there may be no bigger challenge for providers and designers than bathing and bath areas. Preserving independence while also keeping spaces fully functional are two key considerations they must keep in mind. Neglecting to make bathing areas roomy enough or free from common hazards could bring problems for individual residents, or the caregivers who assist them. Improper planning also could lead to insurance and legal trouble. The advice and tips below lend valuable insight for anyone working with resident bathing areas.

1) The most valuable asset any bathroom has is space, especially when considering that those with special needs have limited mobility, says Rob Buete, president of Safety Tubs®.
"Wider doorways, more floor space and easy-access bathing all contribute to bathrooms designed for those who need personal assistance," Buete says. "Taking wider doorways into special consideration, this feature would allow for easier wheelchair access and will also provide plenty of space to bring special equipment in and out."
Remember to leave enough space to allow transferring residents from either side of a tub, add experts with ARJO, a maker of bathing systems.
In addition, the room door should be opposite the head of the tub, to make transfers easier. This is a perfect example where advance planning can prevent logistical nightmares later.

2) Special care should be taken to use measurements and bathing systems appropriate for residents with the lowest mobility level, recommend designers from ARJO.
"This ensures that adequate space is available to facilitate every type of shower/bath assisting requirement," they say.

3) Using a layout that keeps items in a bathing area extremely orderly is helpful.
"It is advisable that all other appliances and storage space be completely clear of the bathtub," Buete says. "This includes the toilet, cabinetry, sinks and movable objects. When the bathtub space is clear of clutter, it is much easier to get the person being bathed in and out of the tub." Distractions caused by items being knocked over or obstructions, even for a moment, could lead to falls in bathing areas.

4) To help preserve residents' dignity, space should be planned to allow dressing and undressing in bathing and bathroom areas.

5) To ease the use of mobile lifts, mobile walking devices and wheelchairs, the doorway into the shower or bathroom must not have a threshold.
"If this is not possible, choose a threshold of the depressible rubber type," ARJO experts advise.

6) The slope of the floor must not exceed 1:50 (one inch rise per every 50 linear feet), they add. A steeper incline could cause mobile equipment to roll, creating dangerous situations.

7) In addition, the floor must be made of a slip-resistant material – and be free of bumps. There should be no stops between levels.

8) Walk-in shower areas and bathing units are becoming more popular when it comes to senior care.
"Eliminate the dangers of stepping into a bathtub or slipping in the shower and consider a walk-in bathtub," Buete says. "Bathers simply walk in, sit down, secure the door latch and enjoy the comfort and safety of bathing on their own."
Built-in safety bars, slip-resistant flooring and watertight seals should be part of the plan.

9) In fact, there can never be enough grab bars in bathroom and bathing areas, Buete feels. Go beyond putting them near just bathtubs and toilets, he says. Consider places such as above waist-high towel bars, empty walls, cabinet sides and any "other space where a safety bar can be properly anchored."

10) As always, you should keep ergonomics and worker health issues in mind. That means using a height-adjustable bathing unit, if possible, to ease the strain on caregivers' backs.
Too often, the sole focus is put on resident comfort and maneuverability. Remember that if workers can't move freely and safely, the situation can be unsafe for all involved.

Mistakes to avoid
- Not leaving enough space around bathing units to accommodate current – and future – residents' needs.

- Too few grab bars.

- Trying to put too much equipment or too many items in a bathing area.

- Allowing different levels, lips or thresholds in flooring areas. These multiply the likelihood of falls, strained backs or other dangerous situations.