Bathing For Older People - Part Iii

Safety problems among the aged are generally due to the loss of physical capabilities and poor design of bathing equipment. In order to compensate for loss of capabilities, the elderly tend to over-exert themselves. This seriously affects their security and personal well-being. For example, the elderly have difficulty bending over and kneeling down. They are unable to access parts of their body when standing, and some even when sitting. Many attempt to challenge their capabilities to access difficult areas and injure themselves. The elderly are constrained by limited reach and poor grip strength. They feel exerted by the poor design and location of controls. They have problems reaching fixtures and grasping them. Many receive injuries from applying excessive force. Poor balance affects stabilization. This escalates their chances of slippage and falling when entering and exiting the bathtub or shower.

Current Design

Review of available bathtubs and showers suggests that safety was never the major issue in their design. Historically, the development of bathing equipment has been more of chance than conscious design. Institutional equipment has undergone a significant evolution because assisted bathing is very difficult for care-providers but, the design of common household bathtub/showers has remained virtually unchanged. The earliest known bathtub dates back to the Minoan dynasty in 1700 BC, and its form is almost identical to the bathtub forms that are in use today. The present day bathtubs are much like the Minoan tub, the only difference being they are made of manmade materials and have flowing hot and cold water. Showers are relatively new. The earliest showers were developed for medicinal purposes (e.g. water cure or rain bath) in the early 1800s. Showers became common with the introduction of indoor plumbing. Their design has remained virtually unchanged since the end of the First World War.

There are many problems with the present designs of bathtubs and showers. First, these products are outdated and they fail to meet the physical needs of the aging population. Adaptive fixtures and equipment are "Band-Aid" solutions to complex problems not satisfied by conventional showers and tubs. They highlight failures in conventional design and unresolved problems. Grab bars make up for the absence of adequate support and the need for greater physical security in the bath area. Bath mats overcome the danger of the slippery floor surfaces. They reflect the need for safer footing. Bath seats are a reminder of people's inability to stand while bathing. They point the need for alternative ways of bathing.

Second, bathtubs and showers are ability-specific products. They conform only to the functional capabilities and physical needs of young, able-bodied individuals, and place considerable physical and mental demands on the elderly, the children and those with disabilities. For example, the positioning of controls and accessories often requires standing and a wide range of motion. Bathtubs and showers require good balance when transferring in and out of them.

Third, the design of bathtub/showers does not reflect a lifespan perspective. Conceptually, children begin to bathe on their own by the time they are 6 to 7 years old. They continue to do so as grownups until they are about 50-60 years old. Beyond this age, they begin to inherit equipment-related dependence, followed by people-oriented dependence, and finally dependence on both. Bathtubs and showers do not meet the changing needs of people. They are not responsive to adaptation as people's functional capabilities and physical conditions undergo age-related changes. For example, when unable to stand and bathe, people sit down while bathing. The loss of reach from a person's restricted movement makes controls and accessories inaccessible. Thus for much of their lives, people either bathe in unsafe conditions or they are dependent on assistance.