Safely Assisting in the Bathroom
Learn Easy Techniques to Help Prevent Falls
Safely maneuvering in the bathroom can be difficult for seniors. Bathrooms are filled with hard surfaces and floors and space is often cramped. Provide the senior's bathroom with appropriate safety equipment such as a raised toilet seat, toilet safety frame and grab bars.
Learning proper transfer technique can also help prevent many falls that occur in the bathroom. The following are techniques for safe transfer on and off the toilet, as well as in and out of the tub and shower.
A raised toilet seat or a toilet safety frame is highly recommended for safely completing this transfer.
Make sure the senior is in position so that the backs of both legs touch the toilet.
The senior's arms reach back to grasp the toilet, grab bar, or sturdy vanity for support.
Assist in slowly lowering the senior to a sitting position.
Reverse to stand up.
If the senior's feet do not touch the floor when sitting on the raised toilet seat, then the seat is too high and should not be used.
Many falls occur in the shower and tub. If you are assisting a senior or anyone who has difficulty with mobility and transfers, an adjustable-height shower chair or stool is recommended. A transfer bench (a bench with legs that straddle the tub and allows for sitting inside the tub/shower) is recommended for those who have more difficulty with transfers, or for someone who is uncomfortable or fearful using a chair or stool.
In order to effectively use the chair, stool, or bench it is helpful to have a shower curtain instead of solid shower doors. Curtains provide more room when lifting legs up and swinging them into the tub. A hand-held shower is recommended to avoid the shower spraying directly into the face of the person being bathed.
Position the chair two-thirds of the way toward the back of the tub. Adjust the height of the chair so that the person's feet are touching the floor on the outside of the tub while they are sitting on the side of the chair or stool inside the tub (the back of a chair faces the back of the tub so it can be used for support on transfer). It is recommended that several "dry runs" be completed prior to the actual shower.
Position the senior so that the backs of her legs are touching the tub and she is in line with the chair inside.
If using a chair, the senior reaches back with a hand for the backrest of the chair.
The other hand grabs the side of the tub, or a walker or cane.
Slowly lower the senior onto the side of the chair.
Take the hand from the tub or walker and place it on the shower chair or stool.
Lift the legs up one at a time and swing them into the tub.
The senior should be positioned in the center of the chair or stool.
Reverse to transfer out of tub.
A tub bar that clamps onto the tub wall provides a secure surface for transfers, especially if using a shower stool (without a backrest). One hand grabs the bar while the other holds the cane, walker, or side of the tub. Position the clamp bar to the rear side of the tub behind the seat or stool.
A walk-in shower provides a difficult challenge to caregivers in safely assisting a senior. There is often not as much room for swinging legs in and out through the narrow doorway. A hand held shower and a shower bench are recommended equipment.
Position the bench so that the bulk of the bench is within the shower stall and two of the bench's legs reach over the threshold of the shower.
The senior should back up until the bench is felt on the back of both legs.
Position one hand on the back of the bench and the other on a walker or cane.
Slowly lower the senior onto the edge of the bench.
Scoot the person to the opposite side of the bench until there is enough room to swing the legs into the shower.
Another option is to install a vertical grab bar positioned near the shower entrance and a horizontal one under the controls at a height of 36 inches. With this set up the senior can step into the shower stall holding the bars and then sit on the shower chair or stool.
Some seniors may have shower stalls too small to use the techniques described above. Often homes are outfitted with fiberglass or plastic prefabricated shower stalls where grab bars cannot be installed. If the senior in your care has sufficient mobility skills to allow them to step over the height of the shower threshold, using a walker to step in and out of the shower may be appropriate.
Position the walker at the edge of the shower threshold and have the senior step within the walker frame.
Lift the walker frame into the shower stall and position firmly in the shower.
Have the senior step over the threshold into the shower.
Once in the shower stall, the caregiver can position a seat for the senior and remove the walker.
Reverse to transfer out.
Once again, as with all transfers, make sure to explain each step of the procedure clearly in advance, and give plenty of time for response and completion.
Finally, there are a few general guidelines that apply when assisting in the completion of any transfer:
When assisting in the transfer of a senior, never pull on her arms or under her shoulders.
Use a gait belt secured around her waist to assist her.
Explain each step of the transfer and allow the senior to complete it slowly.
Give physical assistance and verbal cues to the senior during the transfer.
Allow time for the senior to respond and follow through.
If you are having difficulty with transfers and mobility issues, consult a physical therapist or occupational therapist to evaluate your situation and provide treatment and recommendations.