Jan 15, 2012

Hazard in the Home

By Monica Heltemes

Monica Heltemes
Did you know that for elderly persons, there is a structural hazard in their home that they encounter daily?

What do you think it is?

The bathroom. It is the riskiest room in the home.

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According to the Centers for Disease Control and Prevention, every year about 235,000 people over age 15 visit emergency rooms because of injuries suffered in the bathroom, and almost 14 percent are hospitalized.

More than a third of the injuries happen while bathing or showering. More than 14 percent occur while using the toilet. Injuries increase with age, peaking after 85, the researchers found.

So what can be done to improve bathroom safety for older persons and more specifically, for persons with dementia?

Add Supports – Grab bars by the toilet and in the shower or tub area are important. Make sure the supports are installed properly, to ensure their stability when used. For those who sit in the bottom of the tub, there are rails available that clamp-on to the side of the tub. Also, consider a raised toilet seat and/or safety frame that provides “arms” directly around the toilet. The Home Depot is offering free workshops this month to learn how to install grab bars and raised toilet seats. See www.homedepot.com/workshops.

Reduce the risk of slipping – The very nature of showers and baths with water everywhere, makes this task inherently risky. Steps you can take to minimize the risk include:
  • A non-skid surface inside the shower or bath, such as a rubber mat or non-skid, stick on strips that can be applied to the floor of the shower or tub.
  • A bath mat with a non-skid back outside the shower or bath to step onto when exiting.
  • A towel set-up beforehand and readily accessible from the shower or bath. A hook right by the shower with a towel here may work well for those who may forget beforehand to set out a towel.
  • Drying off feet well or slipping into sturdy slippers before stepping onto the tile.
  • Consider a bath chair to sit on while washing the feet or if balance is unsteady.

Special considerations for those with memory loss – As mentioned previously, persons with dementia may forget to set-up needed supplies before entering a shower or bath. Then there is the risk of slipping when they step out to get what is needed from the cupboard, sink, etc. Some strategies to avoid this include:
  • Placing a towel on a hook or shelf that is right by the shower or bathtub, as mentioned previously.
  • A tub or shower wall organizer that will hold needed shampoo, soap, washcloth, etc.
  • A hook in the bathroom for their robe.

If the person is having more difficulty finding the bathroom, missing the toilet, forgetting to flush, forgetting toilet paper, or other oversights:
  1. Try to organize the bedroom so that the bathroom is in plain sight from the bed, for the person who has trouble finding the bathroom or having accidents in the night.
  2. Have a nightlight in place for nighttime trips to the bathroom.
  3. Hang a sign on the bathroom with a photograph of a toilet and the word “Bathroom” or whatever the person calls it (I had one patient who called it the “pit”!)

White toilet seats, flush handles, towel bars, and grab bars on white backgrounds can be difficult for persons with dementia to distinguish, as their perception of objects in their environment diminishes. 

Try to make the items they are missing stand out, to increase the odds they may see it.

For instance, a wood colored toilet seat against a white toilet base will stand out more. Similarly, you can take black or red electrical tape and wind it around grab bars and on the toilet flusher. I have definitely noted increased use of the grab bar when this strategy was employed.

Last, try a dark-colored towel hanging on the rod against a white wall (or a white towel against a dark-colored wall). Note these same modifications work well for those with visual impairments.

See if you can encourage the person to bring along a cordless phone when showering, if they are doing this task alone, just in case of emergency. A reminder note on the wall may help. Or if the person has a lifeline system, speak to the manufacturer to see if it can be worn while in the shower. Often times they can.

These are some bathroom safety tips that occupational therapists teach to our clients. I hope they are helpful to improve the safety for the person you care for or maybe even yourself!

I would like to know if you would appreciate more home safety and/or self-care tips related to persons with dementia? A few of my OT colleagues and I have wondered, would a book about tips to increase safety and daily functioning of persons with memory loss be of interest? Or do you already find what you are looking for through current books on the market?

Thanks in advance!

Monica Heltemes is a practicing occupational therapist and owner of MindStart™. MindStart designs hobby-style items, such as games and puzzles, specifically for persons with memory loss. They keep persons with dementia active, while giving support to caregivers, and are quick and easy to use. Visit MindStart (Activities for Persons with Memory Loss) to learn more.

More Insight and Advice for Caregivers
Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,261 articles with more than 402,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Monica Heltemes, the Alzheimer's Reading Room