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By Jennifer Bradley, Staff Writer
Statistics show that many
preventable accidents occur in bathrooms. Falls are the
top culprit in this category. Wet floors and small
spaces are only some of the causes for concern in a
bathroom setting. Caregivers must recognize these
obstacles before assisting someone they love in the
restroom. Ignoring them can be a disaster for both
caregiver and the one being cared for.
As an answer to the
bathroom-transfer dilemma, many devices and maneuver
methods are available to ensure a caregiver’s and their
loved one’s safety. It is also important for a caregiver
to recognize that nothing is more personal than
assisting another with intimate cares. Respect and
concern for their loved one’s emotional comfort are as
important as their physical care.
At Home Base
Caregivers can establish a large
amount of control over bathroom safety while in their
own or a loved one’s home. There are two categories a
caregiver should consider as preventive safety measures.
The first is procedures and the second, products. Many
potential problems can be addressed simply by home
modification, approach tactics or the use of assistive
devices.
Here are some general procedural
tips to aid in the completion of a transfer:
- Do not pull on a person’s
arms or under their shoulders.
- Use a gait belt secured
around their waist for assistance.
- Explain each step of the
transfer, then give physical assistance and verbal
cues during the movement.
- Allow a loved one time to
comprehend what’s expected and to follow through on
their own time.
Bathroom Specifics
Whether the toilet or tub, there
are guidelines caregivers can follow for each care
performed in the bathroom. Proper transfer techniques
can prevent more serious issues down the road, for all
parties involved. Many of those discussed are targeted
toward the senior population. However, the techniques
could be practiced on any age group.
On a toilet, a raised seat or
toilet safety frame is recommended to complete the
transfer as safely as possible. First, make sure the
person is in position, so both of the backs of their
legs touch the toilet. Have their arms reach back to
grasp a side grab bar, toilet or vanity for support. A
caregiver should next assist them to a seated position.
A note on toilet seats: If the person’s feet do not
touch the floor when seated on the toilet, it is too
high, and will put them at a higher risk for falls due
to instability.
Many older homes have tubs with
a shower attached, while others have a single shower
stall. Each can pose different safety risks, especially
after water has had its chance to saturate the area! The
most transfer-friendly option is of course, a shower
stall. If possible, a caregiver should consider
replacing an existing tub with a stall and a shower
chair. If not feasible, below are some tips for
transfers in a tub.
- Position the person so that
the backs of their legs touch the bathtub and are in
line with the tub chair.
- If using a chair, have the
person reach and grab the back of the tub chair.
- The other hand then grabs
the side of the tub, or an assistive device
- The caregiver can slowly
lower the person onto the side of the chair.
- Take the hand on the tub or
other device, and place it on the shower chair.
- Lift the legs up one at a
time and swing them into the tub.
- The person should be
positioned in the center of the chair or stool.
- Reverse to transfer out of
tub.
Some helpful products for this
type of transfer include a bench with adjustable legs
and a seat large enough for the person being assisted.
The bench is made to straddle the outside of the
tub/shower combo, and allows for help both in and
outside the wet area.
To assist a loved one with
greater flexibility and mobility, a simple tub chair can
be placed inside for the person to transfer to. A chair
with a handle, suction legs and a backrest may cost a
little more, but increase the safety of a loved one
while in the tub.
On Solid Ground
Another essential tool for a
bathroom transfer is a non-skid bath mat. Standing on a
wet, unsteady surface makes a loved one feel uneasy and
scared, making transfers for a caregiver very difficult.
A bath mat provides support and security for both. It is
more difficult to assist someone who is not comfortable
with a situation and tensing up. A caregiver should
always make every effort to keep their loved one calm
and collected during a transfer.
Grab bars are a must for any
caregiver looking to make a loved one’s bathroom
transfer-friendly. First, a grab bar (or more) is
helpful for getting in and out of the tub, and can be
placed on the surrounding walls or cabinets. Second,
grab bars for in the tub offer support while standing to
shower and rinse off, as well as transfer in and out.
Here are some suggestions for grab bar placement,
as suggested by an Internet article entitled “Bath
Safety for Seniors”:
- A vertically placed U bar,
fixed to the side wall at the base of the tub,
ensures safe entry and exit.
- Horizontally placed support
bars are appropriate for lowering or raising the
body in the tub.
- Diagonally placed grab bars
are not suggested as the hand may slip thus
increasing the chances of a fall.
If a pre-established shower will
not allow grab bar placement, a walker can be used for
support in and out of a shower or tub. www.agedcarer.com
informs caregivers that towel bars are NOT enough
support for transfers. They were made for supporting
light towels and not a person’s full weight.
Using a towel bar may seem like
a good “quick fix” but have disastrous consequences if
it breaks under the pressure.
Also, make sure the grab bars
stand out from the place they are attached to. Many
people with special needs have a hard time seeing and
distinguishing colors. A white bar placed on a beige
shower/tub is asking for trouble.
Below are some other guidelines
for general safety in the bathroom, not necessarily
transfer-related, but that will make for easier
transfers and a more positive experience. This
information also comes from the article, “Bath Safety
for Seniors”
- Use anti-skid material for
the bathroom floor.
- Keep the floor clean and
dry.
- Limit obstacles in the
floor plan thus ensuring free movement in the area.
- Use non-slip strips in your
tub or shower.
- Select impact-resistant
shower and bathtub attachments.
- Put a bath mat with
non-skid base next to the bathtub and shower.
- Install scald-prevention
devices, these devices will keep a check on the
water temperature.
- Electrical switches and
plugs should always be kept away from water sources.
- Make sure all electrical
outlets have ground fault circuit interrupters.
- Use door locks that can be
unlocked from both sides.
When in Rome...
Do as the Romans? What if the
Romans aren’t set up the way a caregiver needs them to
be? It’s much easier to predict transfer hazards in a
private home, but in public, there are many challenges a
caregiver cannot control. Here are some ways to be an
advocate for a loved one, in any situation, all while
keeping them safe in a public restroom.
First, it’s obvious to choose
restaurants and attractions with up-to-par
handicap-friendly facilities. Even though most places
today are up to code, that doesn’t mean the layout works
in a caregiver’s favor. The best option is to have a
loved one use the restroom before leaving, and in the
event of a short outing, this works well.
However, there will be times a
transfer does need to be performed in a public setting.
Always wait for the handicap-accessible stall to be
open, as it is the widest and most transfer-friendly.
Allow the loved one full access to the grab bars, and a
caregiver should assist as best as possible.
As before, a caregiver should
use a gaitbelt for additional support and control.
Always angle the wheelchair, if necessary, and lock the
brakes. Ensure the person’s feet are flat on the floor
and ready to support the body once standing. A caregiver
should place their hands on the person’s hips or waist,
and as they stand, give a lift for support. As they
stand, help pivot onto the toilet help them get seated
and ensure they are stable before moving further.
Whether on familiar territory or
in the middle of a crowded public restroom, a caregiver
can complete a successful transfer of a loved one with a
few simple rules. First, is to ensure the caregiver’s
safety by utilizing proper lifting techniques and
transfer methods. An unsafe caregiver will only hurt
themselves and the loved one they are caring for. They
are then useless to do the task at hand.
Also, a caregiver must teach
their loved one how to help themselves as much as
possible, by lifting and using grab bars for assistance.
When both parties are active in a transfer, aware of
each other’s safety and respecting each other’s
boundaries, both physical and emotional, bathroom
transfers will become a routine well prepared for.
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