Providing Bath Safety

• By Judith L. Seidmeyer
• Aug 11, 2008

 The issues and alternatives in helping patients safely bathe.

Most of us take bathing and bathing safety for granted, but there are millions of patients for whom this is either a luxury, or simply not an option. Fortunately, the HME/DME industry has more solutions than ever before to help address the bathing needs of clients with disabilities.
Traditionally, the issues for bathing individuals with disabilities have been numerous and varied. Issues such as the type of disability, the nature of the caregiving environment, the control or ownership of the home, and the financial resources available have dictated not only the alternative for home care, but also might have been the determining factor for transfer from a home environment to a nursing home or other permanent care facility.

Type of Disability
The type of disability is the most critical determinant for selecting bathing alternatives. Seniors, for example, might feel a little instability only when standing, and the use of a simple hand bar can suffice. Some individuals might be able to stand, but only for a short while.

However, there are also many individuals who are more severely disabled and might not be able to safely do transfers or walk-ins to address their bathing needs. Children with cerebral palsy can often be lifted into a tub for bathing, until they grow and become too heavy for parents or caregivers to safely lift them into the tub without risking accidents to either the CP patient or to the caregiver.

Likewise, high quads, amputees, individuals who require a reclined position, even some paraplegics? might not benefit from the equipment alternatives that have traditionally been available.

Caregiving Environment
The nature of the caregiving environment is another major factor in determining the most appropriate and safe bathing solution. Generally, most people, disabled or not, would prefer to remain in their own home setting rather than go to an institution to meet their daily living requirements.

Many aging Baby Boomers are currently either caring for their elderly parents and trying to keep them from being placed in nursing homes, or facing nursing home care for themselves, especially when they do not have the availability of a caregiver or an appropriate care environment. Two-story houses with a shower upstairs have driven many elderly and older individuals to either sell their homes or move to a nursing home. A mobile home, too, can present nearly unsolvable challenges for safe bathing care, or for re-model.

Unfortunately, for many individuals, their living environment has dictated that sponge bathing has been their only real, safe bathing alternative. Ask any physician or caregiver who sees the skin of an individual who has only had sponge baths. There will be skin breakdown, lesions, irritation, infections, and oftentimes odor. Sponge bathing is simply not a good alternative.

Home ownership, or the ability to do modifications, has oftentimes determined whether an individual with a disability could have the appropriate care environment and could have an alternative to sponge bathing.

Bath Modification Barriers
For untold hundreds of thousands of individuals with disabilities who live in apartments, rental homes, or in the homes of family members, the option to do any re-modeling for accessibility is precluded. And, oftentimes, the cost of a re-model and the impact on the resultant home value keep home owners from doing the full accessibility re-modeling necessary for safe bathing.

Fortunately, solutions such as portable wheelchair showers offer a solution to even the most difficult situation, and they require no re-modeling or huge expense. Portable wheelchair showers can be used by any individual in a wheelchair, in a sling, on a gurney, or in a reclining shower chair without requiring lifting or transferring. They require no modifications to the home, are lightweight and fold-up for storage.

Furthermore, bathing safety is not just an at-home issue. Many individuals with all types of disabilities still want to be active and travel. Travel and accommodations are an issue that HME/DME dealers have had limited opportunities to address, but portable options give providers additional opportunities to serve patient needs. Bathing safety and enhanced quality of life for individuals with disabilities is a nice advantage to offer, especially when enhanced profitability is part of that solution.

Summary
With these as just some of the issues faced by individuals with disabilities, the HME/DME industry has always been challenged to determine the best solution for each individual and situation.

To review some of the solutions, it is critical to keep in mind issues such as type of disability, the nature of the caregiving environment, and patients’ ability (or lack thereof) to modify their living environments. Bath safety options include:
• Safety bars, for the minimally disabled, but physically unstable individual.
• Bathtub modifiers, where an individual can be moved onto a bench, then slid into the tub.
• Walk-in bathtubs for those who can still stand and walk for short periods of time.
• Lifts and transfer devices, which can be used to transfer a patient into a tub or shower.
• Portable wheelchair showers, which can be used by any individual in a wheelchair, sling, gurney, or shower chair without lifting or transferring.
No one solution is going to be perfect for every situation, but by working with the occupational or physical therapists and the family, it is possible to find a safe bathing solution for nearly every individual with a disability — homeowner or not.

This article originally appeared in the August 2008 issue of HME Business.