By Anna Hazard
Getting into, out of, and maneuvering inside the shower or tub is one of the most common causes for falls, accidents, and injuries suffered while in the bathroom. This is particularly dangerous for seniors (who often may have balancing issues as well as greater liability for injury due to more fragile bones & lack of musculature) as well as those who have other mobility issues.
The Center for Disease Control and Prevention cites that around 1/3rd of all senior injuries happen within the shower or bath. Thus remodeling the bathing area (whether for a shower or bath tub) should be one of the highest priorities when it comes to making a home more accessible, safer, and aging in place friendly.
Here are a selection of general tips & recommendations applicable for improving safety & accessibility in both shower and bath tub style bathing areas
Bath or Shower Entrance
In general, having the bathing area blocked off by a glass door (either sliding or swing out) instead of a normal shower curtain can provide much needed stability in the area while giving a solid surface for the user to brace themselves against in case they should lose their balance.
In addition, the bathing area should have an anti-slip coating preferably with built-in antibacterial properties (as the moist & warm conditions found within most bathrooms can easily lead to the proliferation of bacterial colonies).
Tub or Shower Flooring
If the tub or shower floor has a properly textured bottom to help prevent slipping, then it may not be necessary to install additional mats or treads inside (which have the potential of peeling or sliding off unlike a more permanent texture molded directly into the bottom).
Otherwise, heavy duty safety treads meant specifically for the bath and other wet areas are a necessity to prevent the area from becoming a falling hazard. These items are also known as shower strips, circles, or bath tub decals, and are water resistant self-adhesive strips meant to be applied to the flooring of bath tubs & showers.
The faucet controls for the tub or shower should be installed near the entrance so that they are easily accessible to the user before entering the area. This would allow the user to test & set the water temperature before having to directly stand within the spray itself as well as allowing a helper to assist with faucet control while remaining outside of the tub or shower.
In general, off-setting the controls toward the room improves access by reducing the need to bend and stretch. For an enclosed tub or shower, the controls should be placed on the wall around 33" above the finished floor for easiest access. In addition, the faucet should have a hand spray with at least a 60" hose to allow an assistant to help someone with bathing.
The control dials themselves should be easy to grasp and manipulate. Lever and loop handles are easier to grasp (especially for weakened or arthritic hands) over rounded or smoother knobs. In general, a single control (instead of separate hot and cold controls) tends to be easier to use and adjust the water to an exact preferred temperature.
Hot and cold water controls (either separate dials or placed on the sides of a single control) should always be easily identified with bright red and blue indicators (in addition to text and graphics which may be harder to see without glasses or contacts within the bathing area).
Anti-scald devices should be present within the faucet (with control valves that are either pressure balanced, thermostatic mixing, or a combination of both) in order to prevent scalding due to changes in water pressure or temperature. This would include capping the maximum water temperature distributed by the water heater system itself.
The Department of Energy generally recommends that maximum water temperature be set to not exceed 120°Fahrenheit in order to help prevent scalding. A maximum of 140°Fahrenheit can be used in households where residents have suppressed immune systems or chronic respiratory disease as well as in regions susceptible to legionnaire's disease (where the risk of infection is deemed more dangerous than the risk of scalding).
Otherwise, appliances such as dishwashers that require water temperatures of 130°- 140°should come with their own heater boosters.
Seating & Shelving
Whether shower or tub style, the main bathroom should have a bathing area large enough to encompass seating for those with limited mobility or who may have trouble standing for an extended amount of time as well as those who may have difficulties rising from a seated position at the bottom of the tub.
This can either be built directly into the structure of the tub/shower or it can be a removable and free standing item (the latter which is more popular for smaller locations or in bathrooms being shared amongst those with varying ages and abilities). For those that have enough space and money in their remodeling, a built-in seating configuration with enough space left over for removable items leaves the most options open for future needs.
Variations of removable bathing seating includes ones that either adhere to the bottom with suction cups for better stability, those that temporarily attach to the sides of the tub, or ones that are permanently wall mounted but can be folded out of the way for normal use.
Fancier bath lifts with seating that can be raised and lowered to comfortable positions for sitting, cleaning, and entering/exiting the bathing area are another option for those with more limited mobility or severe health problems. In all cases, care should be taken that the placement of the seating does not make entering and exiting the shower more difficult or cumbersome.
Otherwise, shelving should be installed or lowered within the bathing area so that soap, shampoo, towels, and other necessitates can be easily reached while sitting or standing without having to overly stretch or bend (which are maneuvers that often cause falling within the tub or shower). Specialized shelving units that can also double as grab bars that are strong enough to support the entire weight of the potential user are another beneficial option.
View the Rest of the Series
Part 1 - Introduction
Part 2 - Exterior
Part 3 - Landscaping & Gardens
Part 4 - Patio, Porch, & Deck
Part 5 - Garage & Carports
Part 6 - Entrances, Exits, & Thresholds
Part 7 - Exterior Steps & Ramps
Part 8 - Threshold Lighting & Windows
Part 9 - Interior Doors & Halls
Part 10 - Interior Steps & Staircases
Part 11 - Interior Stairlifts
Part 12 - Interior Elevators
Part 13 - Interior Lighting
Part 14 - General Interior Flooring
Part 15 - Interior Flooring Comparisons
Part 16 - HVAC & Energy Efficiency
Part 17 - Power, Communications, & Other Interior Systems
Part 18 - Living Room
Part 19 - Kitchen Layout, HVAC, & Electrical Systems
Part 20 - Kitchen Lighting, Flooring, and Sink Faucets
Part 21 - Kitchen Countertops & Cabinets
Part 22 - Kitchen Refrigerators, Freezers, and Dishwashers
Part 23 - Kitchen Ovens, Ranges, Stovetops, and Cooktops
Part 24 - Kitchen Microwaves, Blenders, & Food Processors
Part 25 - Miscellaneous Kitchen Items
Part 26 - Dining Room Layout, Tables, & Other Furniture
Part 27 - Dining Room Flooring, Lighting, & Meal Serving Equipment
Part 28 - Bedroom Layout & Closets
Part 29 - Accessible Beds
Part 30 - Bedroom Furniture, Electronics, & Other Accessories
Part 31 - Bedroom Flooring
Part 32 - Bedroom Lighting
Part 33 - Bathroom General Layout
Part 34 - Bathroom General Tips for Showers & Tubs
Part 35 - Bathroom Accessible Tubs
Part 36 - Bathroom Accessible Showers
Part 37 - Bathroom Accessible Toilets
Part 38 - Bathroom Sinks & Vanities
Part 39 - Bathroom Cabinets & Shelving
Part 40 - Bathroom Grab Bars
Part 41 - Bathroom Flooring
Part 42 - Bathroom Lighting
Part 43 - Bathroom Ableware - Toilet Aids & General Accessibility
Part 44 - Bathroom Ableware - Shower, Bathing, & Grooming Aids
Part 45 - Laundry Room Location, Layout, & Spacing