Statistics show that many preventable accidents occur in bathrooms. Falls are the top culprit in this category. Wet floors and small spaces are only some of the causes for concern in a bathroom setting. Caregivers must recognize these obstacles before assisting someone they love in the restroom. Ignoring them can be a disaster for both caregiver and the one being cared for.
As an answer to the bathroom-transfer dilemma, many devices and maneuver methods are available to ensure a caregiver’s and their loved one’s safety. It is also important for a caregiver to recognize that nothing is more personal than assisting another with intimate cares. Respect and concern for their loved one’s emotional comfort are as important as their physical care.
At Home Base
Caregivers can establish a large amount of control over bathroom safety while in their own or a loved one’s home. There are two categories a caregiver should consider as preventive safety measures. The first is procedures and the second, products. Many potential problems can be addressed simply by home modification, approach tactics or the use of assistive devices.
Here are some general procedural tips to aid in the completion of a transfer:
- Do not pull on a person’s arms or under their shoulders.
- Use a gait belt secured around their waist for assistance.
- Explain each step of the transfer, then give physical assistance and verbal cues during the movement.
- Allow a loved one time to comprehend what’s expected and to follow through on their own time.
Whether the toilet or tub, there are guidelines caregivers can follow for each care performed in the bathroom. Proper transfer techniques can prevent more serious issues down the road, for all parties involved. Many of those discussed are targeted toward the senior population. However, the techniques could be practiced on any age group.
On a toilet, a raised seat or toilet safety frame is recommended to complete the transfer as safely as possible. First, make sure the person is in position, so both of the backs of their legs touch the toilet. Have their arms reach back to grasp a side grab bar, toilet or vanity for support. A caregiver should next assist them to a seated position. A note on toilet seats: If the person’s feet do not touch the floor when seated on the toilet, it is too high, and will put them at a higher risk for falls due to instability.
Many older homes have tubs with a shower attached, while others have a single shower stall. Each can pose different safety risks, especially after water has had its chance to saturate the area! The most transfer-friendly option is of course, a shower stall. If possible, a caregiver should consider replacing an existing tub with a stall and a shower chair. If not feasible, below are some tips for transfers in a tub.
- Position the person so that the backs of their legs touch the bathtub and are in line with the tub chair.
- If using a chair, have the person reach and grab the back of the tub chair.
- The other hand then grabs the side of the tub, or an assistive device
- The caregiver can slowly lower the person onto the side of the chair.
- Take the hand on the tub or other device, and place it on the shower chair.
- Lift the legs up one at a time and swing them into the tub.
- The person should be positioned in the center of the chair or stool.
- Reverse to transfer out of tub.
Some helpful products for this type of transfer include a bench with adjustable legs and a seat large enough for the person being assisted. The bench is made to straddle the outside of the tub/shower combo, and allows for help both in and outside the wet area.
To assist a loved one with greater flexibility and mobility, a simple tub chair can be placed inside for the person to transfer to. A chair with a handle, suction legs and a backrest may cost a little more, but increase the safety of a loved one while in the tub.
On Solid Ground
Another essential tool for a bathroom transfer is a non-skid bath mat. Standing on a wet, unsteady surface makes a loved one feel uneasy and scared, making transfers for a caregiver very difficult. A bath mat provides support and security for both. It is more difficult to assist someone who is not comfortable with a situation and tensing up. A caregiver should always make every effort to keep their loved one calm and collected during a transfer.
Grab bars are a must for any caregiver looking to make a loved one’s bathroom transfer-friendly. First, a grab bar (or more) is helpful for getting in and out of the tub, and can be placed on the surrounding walls or cabinets. Second, grab bars for in the tub offer support while standing to shower and rinse off, as well as transfer in and out. Here are some suggestions for grab bar placement, as suggested by an Internet article entitled “Bath Safety for Seniors”:
- A vertically placed U bar, fixed to the side wall at the base of the tub, ensures safe entry and exit.
- Horizontally placed support bars are appropriate for lowering or raising the body in the tub.
- Diagonally placed grab bars are not suggested as the hand may slip thus increasing the chances of a fall.
If a pre-established shower will not allow grab bar placement, a walker can be used for support in and out of a shower or tub. Towel bars are NOT enough support for transfers. They were made for supporting light towels and not a person’s full weight.
Using a towel bar may seem like a good “quick fix” but have disastrous consequences if it breaks under the pressure.
Also, make sure the grab bars stand out from the place they are attached to. Many people with special needs have a hard time seeing and distinguishing colors. A white bar placed on a beige shower/tub is asking for trouble.
Below are some other guidelines for general safety in the bathroom, not necessarily transfer-related, but that will make for easier transfers and a more positive experience. This information also comes from the article, “Bath Safety for Seniors”
- Use anti-skid material for the bathroom floor.
- Keep the floor clean and dry.
- Limit obstacles in the floor plan thus ensuring free movement in the area.
- Use non-slip strips in your tub or shower.
- Select impact-resistant shower and bathtub attachments.
- Put a bath mat with non-skid base next to the bathtub and shower.
- Install scald-prevention devices, these devices will keep a check on the water temperature.
- Electrical switches and plugs should always be kept away from water sources.
- Make sure all electrical outlets have ground fault circuit interrupters.
- Use door locks that can be unlocked from both sides.
When in Rome…
Do as the Romans? What if the Romans aren’t set up the way a caregiver needs them to be? It’s much easier to predict transfer hazards in a private home, but in public, there are many challenges a caregiver cannot control. Here are some ways to be an advocate for a loved one, in any situation, all while keeping them safe in a public restroom.
First, it’s obvious to choose restaurants and attractions with up-to-par handicap-friendly facilities. Even though most places today are up to code, that doesn’t mean the layout works in a caregiver’s favor. The best option is to have a loved one use the restroom before leaving, and in the event of a short outing, this works well.
However, there will be times a transfer does need to be performed in a public setting. Always wait for the handicap-accessible stall to be open, as it is the widest and most transfer-friendly. Allow the loved one full access to the grab bars, and a caregiver should assist as best as possible.
As before, a caregiver should use a gait belt for additional support and control. Always angle the wheelchair, if necessary, and lock the brakes. Ensure the person’s feet are flat on the floor and ready to support the body once standing. A caregiver should place their hands on the person’s hips or waist, and as they stand, give a lift for support. As they stand, help pivot onto the toilet help them get seated and ensure they are stable before moving further.
Whether on familiar territory or in the middle of a crowded public restroom, a caregiver can complete a successful transfer of a loved one with a few simple rules. First, is to ensure the caregiver’s safety by utilizing proper lifting techniques and transfer methods. An unsafe caregiver will only hurt themselves and the loved one they are caring for. They are then useless to do the task at hand.
Also, a caregiver must teach their loved one how to help themselves as much as possible, by lifting and using grab bars for assistance. When both parties are active in a transfer, aware of each other’s safety and respecting each other’s boundaries, both physical and emotional, bathroom transfers will become a routine well prepared for.
BY JENNIFER BRADLEY