Behind Closed Doors
By Linda Norton, MSCH, BSc OT, OT Reg (Ont)
Health Canada reports that one in three seniors will fall at least once in their lifetime, and 20% of injury-related deaths among seniors can be traced back to a fall. Health Canada also reports that bathrooms and stairs are particularly dangerous areas. Ensuring the safety and independence of everyone using your bathroom is an important objective. It’s important not only to consider the inhabitants of the home, but also daily visitors and guests who stay overnight.
Evaluate the bathroom
The best place to start is with a general review of the bathroom to identify any potential hazards. Use the checklist below as your guide.
Adapting for daytime guests
Even if no one in the household has mobility limitations, it is possible that someone with such limitations will visit. There are things you can do to ensure they remain safe and independent in your home. Take a moment and look at the bathroom from the point of view of a guest.
Aside from the basics of ensuring an extra roll of toilet paper is available, check that floor space is not cluttered. Although a basket of towels may look attractive, it can pose a tripping hazard for someone else.
Also consider how easy it is to rise from the toilet. Some homes have very low toilets, which makes standing up again difficult. If you think this poses a significant problem, consider purchasing or renting a spacer-style raised toilet seat that fits between the bowl and seat. Failing that, think about installing a grab bar near the toilet.
Unfortunately, towel racks are too often used as a grab bar. Towel racks are not stable enough to support someone should they start to lose their balance. When this happens, it is likely that the towel rack will pull away from the wall, putting the person at even greater risk of falling.
Expecting overnight guests?
For friends and family with mobility issues, lighting in the bathroom and on the pathway to the bathroom is critically important. At night in unfamiliar surroundings, lighting is especially important in helping your guests get to the bathroom safely. If you have pets, consider keeping them out of the area the guests are using. Animals are often curious and may get underfoot, creating a tripping hazard.
If your guests are regular visitors, talk with them about what would make them feel safer and more secure in your bathroom. If they feel a raised toilet seat would be helpful, most makes are easily installed and easily removable when your company leaves.
If they intend on taking a bath or shower, they may need a grab bar for stability. Suction grab bars and tub grab bars can be easily installed and removed when no longer needed. If a seat is needed in the bathtub or shower, look for one that can be easily dismantled. Some models fold or have legs that pull off, making the seat flat for storage.
Non-skid mats should be placed both inside and outside the tub and shower to help prevent slips and falls when stepping in and out. The mat outside the bath or shower should be removed as soon as possible, and any spills wiped up quickly.
When someone’s with you all the time
If a person with mobility limitations lives in the home, more permanent modifications may be appropriate. Grab bars can be installed into the walls as needed. Grab bars come in many shapes and sizes to promote function and safety, and complement any décor. In addition, a handheld shower is often a very helpful device.
Another thing to consider is renovating the bathroom to make the doors wider and the room more accessible. The tub could be modified or replaced with a walk-in shower.
Or, consider “tub cutting” to improve bathroom accessibility. This is a low-cost and quick alternative whereby a section of the bathtub wall is removed to create a step-in shower.
Some funding is available for renovations that improve the independence and safety of seniors or people with disabilities. The Canada Mortgage and Housing Corporation (CMHC) offers several funding programs, three of which are of particular interest:
• Residential Rehabilitation Assistance Program for Persons with Disabilities (RRAP – Disabilities). This program offers financial assistance for homeowners and landlords to make their properties more accessible to persons with disabilities. Modifications are intended to eliminate physical barriers and imminent safety risks and improve the ability to meet the demands of daily living within the home (http://www.cmhc-schl.gc.ca/en/co/prfinas/
• Home Adaptations for Seniors’ Independence (HASI). This program offers financial assistance for minor home adaptations that will help low-income seniors perform daily activities in their home independently and safely (http://www.cmhc-schl.gc.ca/en/co/prfinas/prfinas_004.cfm).
• Residential Rehabilitation Assistance Program (RRAP) – Secondary/Garden Suite. This program offers financial assistance for the creation of a secondary or garden suite for a low-income senior or adult with a disability—making it possible for them to live independently in their community, close to family and friends (http://www.cmhcschl.gc.ca/en/co/prfinas/prfinas_002.cfm).
Planning ahead is the key to reducing stress and the risks associated with travel for persons with limited mobility. Ensuring a wheelchair-accessible room is a good start (even if you don’t actually use a wheelchair) and it’s important to call the hotel directly to ensure it can meet the needs of the person with mobility limitations. Questions you might want to ask about the hotel room bathroom include:
• Where are the grab bars located?
• Is there space beside the toilet or only in front? (If there is no space to the side of the toilet, transfers may be more difficult for some people.)
• How high is the toilet? Is a raised toilet seat available if needed? Does this need to be reserved in advance?
• Is there a bathtub or shower in the room? Are grab bars available? Is a bath seat or bath bench available? If you have concerns about the ability of the hotel to meet your needs, consider packing a couple of essential pieces of equipment to ensure you have the devices you need.
Promoting safety and independence
Improving the safety of your bathroom is important, regardless of whether there is someone with a mobility limitation residing in the home or if people just occasionally visit.
By carefully evaluating your bathroom and considering other people’s needs, it is possible to identify potential hazards and eliminate them. Simple, low-cost solutions can often be identified and put into place, making “home sweet home” or a “home away from home” a safer, happier place to be.
Linda Norton, MSCH, BSc, OT, OT Reg (Ont), is the Rehabilitation Education Co-ordinator with Shoppers Home Health Care.