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Elder Care News
Bathing Problems Common in Older Adults Can Be
Prevented
Study finds safety problems among many who bathe
without help
B
Katie Gazella, U-M Health System
 September
14, 2006 - Getting in and out of the bathtub or shower can be a perilous
journey for older adults, including those as young as 60, even when they
have bathrooms already equipped with safety features, according to
research by the University of Michigan Health System.
Researchers videotaped people ages 60 and older who
demonstrated (while fully clothed) how they normally climbed in and out
of the shower or tub. One-third of the 89 participants in the study had
difficulty, such as plopping onto a tub seat or hitting the side of the
tub or the shower threshold with their legs.
“We found that there are a lot of independently
bathing older adults who have trouble or are unsafe getting into and out
of the tub or shower stall,” says lead author Susan L. Murphy, ScD, OTR,
an occupational therapist and research assistant professor with the
University of Michigan Medical School’s Division of Geriatric Medicine,
part of the Department of Internal Medicine. The study appears in the
Journal of the American Geriatrics Society.
“For older adults, losing the ability to bathe is
associated with having falls, fracturing bones, and even being admitted
to a nursing home. It is important that we take steps to help to prevent
bathing disability before it occurs,” Murphy says.
One of the major problem areas the researchers
found involved sliding glass doors in showers. Three-quarters of
participants who used shower stalls with sliding glass doors tried to
utilize the door for stability or balance.
“This is extremely unsafe because shower doors were
not designed to support a person’s weight,” Murphy says. “This problem
could be easily remedied by educating older adults not to use the door
as a support or possibly replacing it with a shower curtain, which was
used only rarely by older adults in this study.”
Participants in the study were residents of two
congregate housing facilities and had no cognitive impairment. They were
videotaped as they demonstrated how they used their environment while
getting into and out of the shower or tub – that is, whether they used
grab-bars, towel bars, shower curtains, glass doors, tub seats, and
other parts of the tub to assist themselves.
The videotapes were also evaluated for the
participants’ fluidity of movement and whether they had difficulty
negotiating the environment. While the majority of people using both
tubs and shower stalls used safe environmental features such as grab
bars, many used unsafe features in addition to the safe ones.
Nineteen percent of participants using a tub were
evaluated as using unsafe features, and more than 70 percent of those
with shower stalls used unsafe features, such as the glass door, towel
bar or a tub seat.
One participant had a plastic lawn chair as a tub
seat, a particularly dangerous improvisation given curved shape of the
tub floor.
Some safety problems researchers observed can be
fixed easily with, for instance, the installation of a shower curtain in
place of a door, and proper instruction about built-in bathroom safety
features (such as grab bars designed for weight-bearing) for new
residents of senior housing facilities. A focus on better designs of
bathrooms in senior housing facilities was also suggested by the
researchers.
“We think the results from this study demonstrate
the need for healthcare professionals to become involved in helping to
prevent bathing disability, instead of just treating people in the
hospital after they have had a fall in the bathroom,” Murphy says.
“While bathrooms in senior housing facilities are
designed to be safe, we have found that older adults often do not know
the difference between a grab bar and a towel bar. They also have unsafe
strategies of getting into and out of their shower or tub. Occupational
therapists often see older adults for bathing problems and would be
ideal to intervene with older adults before they start to lose the
ability to bathe.”
In addition to Murphy, the authors on the paper
were Neil B. Alexander, M.D., professor in the Division of Geriatric
Medicine, Department of Internal Medicine, and director of the Geriatric
Research, Education, and Clinical Center, VA Ann Arbor Health Care
System; Linda V. Nyquist, Ph.D., senior research associate-social
sciences, Institute of Gerontology; and Debra M. Strasburg, M.S., P.T.,
research physical therapist, VA Ann Arbor Health Care System.
The research was supported in part by grants from
the AARP Andrus Foundation, the Department of Veterans Affairs Office of
Research & Development, and the National Institute on Aging (NIA) Claude
Pepper Older Adults Independence Center. Murphy is a recipient of a K01
Mentored Research Scientist Development Award from the National Center
for Medical Rehabilitation Research, and Alexander is a recipient of a
K24 Mid-Career Investigator Award in Patient-Oriented Research from NIA.
Citation: Journal of the American Geriatrics
Society, Aug. 2006, “Bath Transfers in Older Adult Congregate Housing
Residents: Assessing the Person-Environment Interaction.”
Links:
University of Michigan Health System
U-M Medical School’s Division of
Geriatric Medicine
U-M Medical School’s
Department of Internal Medicine.
Journal of the American Geriatrics Society.
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