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Monday, April 6th, 2009 at 10:03 pm

Handicapped baths require an Electrical Safety Inspection

Bathroom Safety Tips & Medical Equipment Supply for Home Health Care

Home bathrooms often need adaptation if an elderly person wants to stay at home and remain independent.

Medical equipment supply stores offer products to help ensure bathroom access and safety.
Bath & Shower

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Too often falls occur as people get in or out of the tub. Simple, readily available home medical equipment will prevent the broken bones the elderly and infirm invariably suffer after such falls every day.
Most caregivers and patients are aware of commode frames, bath chairs, tub transfer boards and transfer benches and they are indispensable medical equipment supply aids for many elderly patients, but don’t forget these simple measures:
·   Clamp on bathtub rails are an inexpensive way to prevent falls (modern materials also make them antibacterial and easy to clean).
·   Non-slip suction mats or rubber silicone appliqués in the tub are indispensable & will help prevent falls.
·   Non-skid bath mats on the floor beside the tub & toilet provide firm footing when exiting.
·   These appliqués & mats are generally available at home medical equipment supply stores.
The University of Missouri Extension Physical Therapy Education department laid out the following recommendations when more extensive alterations may be needed:
Safety bars
Grab bars around the bathtub are necessary home medical equipment for safety. These bars should be institutional-grade, and installed according to the manufacturer’s directions for firm, solid support. These bars may require a handyman to install but under no circumstance should towel rods or improperly installed grab bars be used as bathtub aids. They will not support a person who loses balance.
Different types of bars and poles are available from plumbing supply companies (see listing at end). The type, number and positioning of supports depend on:
·   The wall space around the tub
·   The wall structure
·   The plumbing arrangements; and
·   The disability, if any, of the person(s) using the tub.
Two types of grab bars usually are needed at the tub for the ambulant older person:
·   For use in getting in and out of the tub from a standing position;
·   For use when lowering or raising the body to or from a seated position in the tub.
U-shaped bars are available in 12- to 40-inch lengths. They may be secured vertically or horizontally to a wall.
A vertically placed U-bar, attached to the side wall at the foot of the tub, allows safe entry and exit. (The foot of the tub is the end where the water faucets and drain are located). This vertical bar should be about 32 inches long, and placed near the outer tub edge.
Horizontally placed support bars are best for lowering or raising the body to or from the seated position in the tub.

A 12- to 15-inch bar may be placed at the foot end of the tub and a longer one along the back wall.

Horizontal bars.

Diagonally placed grab bars are not recommended because the hand may slide and if footing is not secure, falls are more likely.

Diagonal bar.

If the tub is free-standing at both ends (as in many older homes) and the end wall is too far for grab bar placement, a vertically placed pole (see Figure 3) on the access side of the tub may be used. This pole should be about 1-1/2-inch diameter and extend from floor to ceiling. Position it between 1 foot 3 inches to 1 foot 6 inches from the end of the tub and close enough to the access side to reach from a seated position. It also can be used to grasp with one hand while operating the water controls.
Figure 3
Vertical bar.

Angle bars from the back wall (behind the tub) to the floor, with wall posts, may be used when one or both tub ends are enclosed by a wall. This is useful for persons needing to use both hands to enter/exit the tub, or if other people with varying dysfunction’s also use the tub.
Figure 4
Angle bars.

Tub seats
A variety of portable seats, chairs and benches are available if sitting on the bathtub floor is difficult or impossible.
One seat has side flanges that adjust to fit any shape and size tub.
Inside-the-tub chairs with backs for greater comfort are available.
An inside/outside transfer bench with adjustable legs allows the bather to sit on the bench that extends outside the tub then slide to the inside of the tub.

Transfer bench.

Any chair or bench must have non-slip rubber tips on the legs and be safe and comfortable.
When using these seats in the tub, a hand-held shower head is almost a necessity to direct the water where needed.
Figure 6
Flexible Hand held shower

Showers
An angle bar attached to two walls provides support while standing to shower, or as an aid to sitting and rising if using a bath bench or chair.
Figure 7
Angle bar.

If the shower floor is slippery, nonslip suction mats or rubber silicone treads should be used.
A non-skid bath mat on the floor outside the shower is a necessity.
Toilets
The standard 15- to 17-inch height of toilet seats creates a problem for many people, especially those with arthritis, hip, knee or back problems. Elevating the toilet seat from 5- to 7- inches will give better leverage in regaining a standing position.
Medical equipment stores provide several types of removable and permanently fixed raised toilet seats available from supply companies (see list at end of guide).
Two examples are
· A molded plastic seat (see Figure is the simplest way to increase seat height by about 4 inches.

Figure 8 (left)
Molded plastic eleveated toilet seat.
Figure 9 (right)
Adjustable raised toilet seat.
· An adjustable seat (see Figure 9) will add from 3 to 6 inches of height.
For a more permanent raised toilet, a plumber can put the stool on a wooden platform made to fit the toilet bowl base (see Figure 10)
If building a new bathroom, consider a wall-hung toilet (see Figure 11) that can be hung at any height.

Figure 10 (left)
Raised toilet base.
Figure 11 (right)
Wall hung toilet.
Special feature
A special medical equipment supply unit (portable bidet or sitz bath) for cleaning the perineal area without hands or paper may be attached to any standard toilet bowl (see Figure 12). It is an electrically powered unit with a mechanism for spray washing with warm water and drying with a flow of warm air. This promotes independence for persons with very limited hand/arm functions (see list at end of guide).
Figure 12
Portable bidet or sitz bath.

Grab bars
Grab bars around the toilets are for safety. Many types are available. The choice will depend on 1) available wall space near the toilet; 2) nearness to other fixtures in the room; and 3) needs of people in the household.
Basic types of toilet support bars include
· Wall-mounted on a side wall (see Figure 13).
Figure 13
Side and back mounted bars.

· Wall-mounted on the back wall behind the toilet.
· Wall/floor mounted (see Figure 14).
Figure 14
Wall/floor mounted.

· Free-standing (see Figure 15).
Figure 15
Free standing.

· Floor model (see Figure 16)
Figure 16
Free standing.

· Slip-over guard rails (see Figure 17)
Figure 17
Slipover.

Other safety features
A single-lever mixing faucet (see Figure 18) can control temperature and flow of water better than dual controls. All hot water in the older person’s home should be controlled thermostatically to a maximum temperature of 120 degrees to avoid burns.
Figure 18
Single lever faucet.

Get Professional Help for Safety
· If you have a physical limitation, weakness or unsteadiness, we recommend you consult a physical therapist or the Housing Specialist in your local MU Extension center to help you select and recommend placement of grab bars and other accessories for safety in the bathroom.
· If you are unsure of your wall structure or do not have proper tools or skills we suggest you hire a carpenter to install and/or make the new adaptations.

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