For some, the bathroom represents a calming, utterly private escape. From grooming rituals like shaving to self-care activities like soaking in a bubble bath, bathroom activities can represent precious alone time. But problems with balance and mobility quickly turn this haven into a hazard.
“Bathrooms are particularly challenging from a safety and comfort perspective,” says Jamie Gold, a certified aging in place specialist and wellness design consultant in San Diego. “Older adults are most at risk of a slip and fall, and most often, seriously harmed by these accidents. The combination of brittle bones, poor balance and wet, brittle floor tile can be literally deadly.”
So what can you do when a loved one’s age or declining health raises their risk of bathroom injuries? Below, Gold and several health experts offer tips and tricks to create a safer, more accessible bathroom.
What to know before you start making changes to an aging loved one’s bathroom
Understand the varying levels of “accessibility”
Because no two seniors’ mobility is the same, accessibility will differ from person to person. If someone occasionally uses a cane for balance, installing grab bars might suffice. But for wheelchair users, accessibility requires a barrier-free entrance and a roll-in shower.
Also, keep in mind: If your loved one has a degenerative disease such as Parkinson’s, osteoarthritis or ALS, today’s accessible bathroom setup might no longer work in few months, making a bathroom remodel for seniors eventually inevitable.
Prepare to work as a team
Because of balance problems, some seniors might not be able to change ceiling lightbulbs or add non-slip stickers to the shower floor. “It is essential to have a family member who is able to help,” says Melissa Prestipino, a doctor of physical therapy and owner of Maize & Blue Rehab in Sparta, New Jersey.
But of course, just because a loved one has physical limitations does not necessarily mean they have cognitive limitations. Therefore, whenever possible, include your aging family member in the bathroom modification planning. “Independence gives seniors a sense of purpose,” reminds Yen Le, an occupational therapist at Marianjoy Rehabilitation Hospital in Wheaton, Illinois. She emphasizes that seniors do not want to feel like a burden.
“Independence gives seniors a sense of purpose.”
YEN LE, OCCUPATIONAL THERAPIST
Take inventory
Creating an accessible bathroom design for senior citizens can get expensive. Set yourself up for success by exploring other rooms for potential mobility aids. Maybe you already own high-watt lightbulbs that could brighten the bathroom. Maybe the non-slip floor mat in front of the kitchen sink could be moved in front of the toilet instead. There’s nothing wrong with making use of what you have in the house already.
As you make plans for an accessible bathroom, consider leaving room in the budget for accessibility features such as a transfer bench or sliding bathroom door that might become necessary in the future. Le also suggests looking for a medical equipment loan program in your area. A local physical therapist or occupational therapist can help point you in the right direction.
“Each person is going to have unique needs based on their endurance, strength, range of motion and the type of mobility aid they are using.”
— TAMZYN MATHER, OCCUPATIONAL THERAPIST AT NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL
Tips for creating an accessible bathroom, based on type
“Each person is going to have unique needs based on their endurance, strength, range of motion and the type of mobility aid they are using,” reminds Tamzyn Mather, an occupational therapist at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois.
Setting up a cane- or walker-accessible bathroom
Whether your loved one struggles to walk due to balance impairment, leg weakness or both, you can make a few small changes to improve the bathroom’s safety and accessibility.
- Remove tripping hazards. “It’s best to leave as much open space as possible to help seniors navigate,” says Prestipino. Tripping hazards might include throw rugs, trash cans and any decorative items on the floor.
- Add suction-cup grab bars or install permanent grab bars. Le recommends suction-cup bars with a safety indicator. She says to place one next to the shower entrance and another inside the shower, facing the faucet. Because suction cups must be placed over a completely flat surface, they might not be safe in a tiled shower. Sturdy bars drilled into the studs of the walls are the safest option for extra stability, says Prestipino.
- Place a non-slip mat in the shower. Iris M., who lives in Boston, Massachusetts, recalls her mother’s home health aide adding a non-slip mat to the base of the tub. This small change made a big difference in accessibility and comfort. “She appreciated these modifications,” Iris says of her mother, who recently died at the age of 100.
- Raise the toilet seat. Standing up from a low surface is difficult, reminds Mather. Elevating the toilet can make the transition easier. Raised toilet seats can be installed directly onto any standard toilet bowl.
- Add a frame around the toilet. Stand-alone toilet frames can be adjusted to fit snugly around any toilet. Because they offer handrails on either side of the toilet, they can greatly reduce the risk of falls.
“A lot of family members have grand plans to remodel their whole bathroom. They are pleasantly surprised that they can add something as simple as a transfer bench for safe bathing.”
— YEN LE, AN OCCUPATIONAL THERAPIST AT MARIANJOY REHABILITATION HOSPITAL, WHEATON, ILLINOIS
- Get a shower chair or transfer bench. “A lot of family members have grand plans to remodel their whole bathroom,” says Le. “They are pleasantly surprised that they can add something as simple as a transfer bench for safe bathing.” She suggests buying a shower chair for walk-in showers or a transfer bench for bathtubs.
- Install a handheld showerhead. This makes it possible to shower in a seated position.
- Add a night light. Prevent trips and falls by ensuring that the bathroom is always lit. Add a night light, use brighter bulbs or simply leave the bathroom light on at all times.
Setting up an accessible bathroom for an older adult who has limited arm and hand mobility
While falls account for over 800,000 hospitalizations each year, according to the Centers for Disease Control and Prevention (CDC), they are not the only safety concern. Some aging adults also experience debilitating arm and hand weakness, which can cause issues such as dropped items or an inability to stabilize with grab bars.
Here, experts weigh in on boosting bathroom accessibility for those with limited upper-body mobility.
- Install motion-activated lights. Le says this also helps seniors who use walkers or canes. Motion-activated or voice-activated switches mean they won’t have to let go of mobility aids.
- Get a bidet. Bidet toilets or bidet toilet seats can help seniors who struggle to reach back or twist to clean hard-to-reach areas.
- Put a long-handled sponge in the shower. Mather suggests long-handled sponges or soap-on-a-rope as budget-friendly ways to help seniors bathe independently.
- Provide an electric toothbrush. These rotating or vibrating toothbrushes require less effort and fine motor skills than their manual counterparts, notes Mather.
- Put a cup next to the sink. Mather recommends ensuring there’s always a cup handy for water. This will allow an older adult to easily rinse their mouth while brushing their teeth.
- Keep wipes handy. Hand wipes and pre-moistened flushable wipes can both make hygiene easier for seniors with limited mobility, according to physical therapists Kathrina Prostka and Barbara Peraino, who both work at Marianjoy Rehabilitation Hospital.
- Try automatic dispensers. Both hand soap dispensers and toothpaste dispensers make daily tasks easier for seniors with limited hand or arm mobility.
- Consider new faucet controls. Make sure sink and shower controls are loose or lubricated enough for someone with hand weakness, says Prestipino.
Setting up a safe, accessible bathroom for those with vision loss
- Aim for a high-contrast color scheme. “If everything is bright white, it may be hard to see where the toilet, tub wall or shower start,” says Le. She suggests painting in high-contrast colors and avoiding high-gloss finishes, which create glare.
- Brighten the lights. Whether you add plug-in night lights or swap out soft white bulbs for daylight bulbs, a well-lit bathroom is safer and more accessible for those with vision loss.
- Get a magnified mirror. A magnified vanity mirror with built-in lights can help seniors see themselves better as they tend to daily hygiene tasks.
Setting up a wheelchair-accessible bathroom
“ADA guidelines are a good rule of thumb, but it’s more important to account for the individual’s abilities, height and even body size when considering home bathroom accessibility,” says Mather. ADA basics include:
- Wider doorways (a minimum of 32 inches of clearance).
- Door hardware that can be operated with one hand and that does not require wrist twisting.
- Lowered thresholds (no higher than 1/2 inch tall).
Prostka and Peraino, who are both wheelchair seating and positioning specialists, offer these tips and tricks to make your bathroom wheelchair-accessible:
- Consider removing or changing the door. If renovating the doorway is possible, choose a sliding barn door or pocket door to give as much clearance as possible for your loved one’s wheelchair. If that doesn’t work with your budget, consider swapping the door for a shower curtain or other sliding covering.
- Remove the threshold. Getting rid of the threshold of installing a threshold ramp will make it easier for someone in a wheelchair to roll into the bathroom.
- Rearrange the countertop. Place personal hygiene and grooming items toward the front, where they can be easily reached by someone sitting in a wheelchair.
- Get an angled mirror. Lowering the mirrors or investing in an angled mirror helps seniors sitting in wheelchairs see themselves without needing to lean forward or try to stand.
- Remove the cabinet door under the sink. If you’re unable to install a wheelchair-friendly sink vanity, the experts suggest removing the bottom cabinet door. This allows the wheelchair user’s legs to fit under the sink to better reach the flow of water. “Make sure to use pipe insulation to cover the hot water pipes to avoid burns,” warns Prostka. A faucet extension can also help bring the spray of the water closer to the front, says Peraino.
The bottom line on making a senior’s bathroom safer
It’s not possible to predict what the future holds for your aging loved one’s mobility. What caregivers can assume, however, is that seniors who want to age in place should prepare for additional safety and accessibility needs as they age. In the long-run, putting in the effort to create a safer, more accessible bathroom for them will be well worth the effort.
