Bathing For Older People - Part V

Findings

Bathing Dependence


Bathing dependence varies greatly between people and their physical conditions. Ability to bathe independently did not depend on any one factor. For example, a 63 year old female with left sided paralysis, hip replacement and arthritis in the sacroiliac was dependent upon being bathed, while an 85-year-old woman with arthritis, impaired vision and shortness of breath bathed independently. Several persons, in spite of as many as seven disabling conditions bathed independently. All three mobility-impaired persons bathed independently. An 80-year-old who lived independently in her own home was dependent on being bathed. While another person who had difficulties living independently, bathed on her own.


Bathing dependence generally resulted from illness and/or injury. For example, a 90-year-old mother's dependence was due to falls in the home, and an 80-year-old woman's dependence resulted from a physical injury. No individual was completely dependent on being bathed. They all offered various levels of assistance. For example, one person who required help with soaping, rinsing and drying, transferred on her own. Another person who only needed help in transferring in and out, bathed mostly on her own. Bathing dependence was both physiological and psychological. For example, one person phoned her daughter before and after her bath. Another person has her care-provider remain present in the bath area at all time. A 90-year old mother made sure that her daughter stood outside the closed bathroom door. People's ability to bathe on their own depended on age, severity of disabling condition(s) and their willingness to do so.


Mechanical and Physical Difficulties


Bathing difficulties vary significantly. The most common problem was maintaining balance when bathing and making transfers. Those unable to make safe transfers had abandoned tub-oriented bathing. Other problems were largely due to inadequate reach, poor grasp and low level of thermal sensitivity. Many individuals indicated that because of their inability to "reach low," using controls from the outside of the tub was impossible. Opening faucets and adjusting water temperature are troublesome for many. Those who lack sensation in the hands frequently misjudged the water temperature and got scalded. Low level of illumination made it difficult for bathers to see controls and accessories. In the absence of auxiliary heating, people felt cold while bathing. Inadequate storage caused lying around of articles. This made it impossible to keep the bath space organized. The size of the bathing space presented diametrically opposite problems. Small size restricts movement of wheelchair users and those providing care. Excessively large space makes controls and accessories inaccessible, and wheelchair users become fatigued from wheeling around in an attempt to reach for accessories.