Most of us enjoy a relaxing soak in the bath and will therefore feel frustrated if this pleasure is taken away. It may become impossible to get in or out of the bath, or the bathroom itself may become difficult to get to, particularly if it is upstairs. However, in most cases these difficulties can be overcome using one or more of the many items of bathing equipment currently available, and/or by making a few alterations to the house.
Before considering building a downstairs bathroom for someone who cannot use the stairs, check that all other options have been considered. For example, it may be more practical and cheaper to install a stairlift or through-floor lift to provide easy access to the first floor.
The aim of this Information Sheet is to provide information on the type of equipment available to help with specific difficulties, and details about the useful features of some of the more popular items of bathing equipment.
The information contained in this document is strictly for information purposes only. There are hazards with all equipment and the suitability of any solution is totally dependent on the individual. It is strongly recommended to seek professional advice and assistance before you consider buying any type of equipment mentioned in this Information Sheet.
Where to get help and advice
Before making any decisions about buying equipment, or making alterations to your home, it is strongly recommended to contact an occupational therapist (OT). An OT is qualified to assess your daily living needs. The OT will advise on possible solutions and will arrange for the provision of suitable equipment to those who are eligible eg medical card holders. The OT can also advise on home modifications, where appropriate, and on grants that may be available to help with the cost.
You can contact the OT for your area through the Community Care section of your Health Service Executive area.
If you decide to buy equipment privately it is strongly recommended to seek the advice of an occupational therapist regarding the suitability of that equipment to your condition or situation. It is also recommended that you try out the equipment, if possible, before purchase.
You can arrange to visit a supplier’s showroom (if they have one). Contact details of suppliers can be found online and most will have a website with details of their products and services.
Sometimes suppliers organise exhibitions of different types of equipment in various locations around the country allowing people to see and try equipment. These exhibitions are often advertised in the local paper or on local radio. You can also request to be put on a supplier’s mailing list so you will be notified if there is an event being held in your area.
Some companies will give equipment for a try-out period before purchase. Enquiries should also be made about maintenance (if it will be required), maintenance contracts (if relevant) and whether a user manual is provided with the equipment (essential).
When purchasing from any supplier, it is important to remember that it is their business to sell. There may be several suppliers of that particular piece of equipment or different manufacturers of the same type of equipment, so always shop around.
Assessment
Depending on the type of equipment required, a qualified therapist will assess the individual and make a recommendation to the body responsible for the provision of the equipment or to the person or agency who has requested the assessment. Generally the following applies, but the assessment process and provision may vary in different parts of the country.
- Occupational therapists will assess for aids to daily living – these include wheelchairs, mobility aids, specialised chairs, bath, shower and toilet aids, stairlifts, hoists etc
- Physiotherapists will assess for movement, strength and balance training equipment, walking aids and exercise devices
- Speech and language therapists will assess for communication, speech therapy, and training aids
- Other relevant therapists and specialists may also be involved in carrying out assessments, depending on the equipment or appliance required.
All the different therapists described above are based in hospitals, community care areas, and with various voluntary agencies. For more information, contact the Community Care section of your Health Service Executive area or the relevant hospital department as appropriate.
Private Occupational Therapists
Occupational therapists in private practice can carry out assessments in the home or workplace, and if modifications are being considered, provide a report detailing the recommendations. It is important to ensure the therapist is experienced in relation to your particular needs. Make sure to discuss fees before engaging anyone’s services, and also check what the assessment fee includes (or does not include). The profession’s representative body, the Association of Occupational Therapists in Ireland (AOTI), keeps a list of contact details of member occupational therapists working in private practice in Ireland. This list is available from the AOTI (see Useful Addresses).
Private Physiotherapists
Physiotherapists can assess for movement, strength and balance training equipment, walking aids and exercise devices and recommend accordingly. If you wish to consult a physiotherapist you can go directly to your local chartered physiotherapist or ask your GP to refer you. It is important to ensure the therapist you consult is experienced in relation to your particular needs. Chartered physiotherapists work in hospitals and in the community where treatment is covered under the public health service. They also work in private practice and can be contacted through the profession’s representative body, the Irish Society of Chartered Physiotherapists (see Useful Addresses). Most will have their contact details and services online.
If you decide to buy equipment privately it is strongly recommended to seek the advice of an appropriate therapist on the suitability of that equipment to your condition or situation. It is also recommended that you try out the equipment, if possible, before purchase.
Private Purchase – Applying for a VAT Refund
VAT paid on certain equipment which is privately purchased for use by a person with a disability can be reclaimed from Revenue. The relief applies to VAT on the purchase of goods which are aids and appliances designed to assist a disabled person to overcome a disability in the performance of their daily functions. Most aids to daily living and communication aids are included. Goods designed for leisure purposes are not. An invoice clearly stating the VAT content of the total amount paid must be included with the application. Contact Revenue’s Central Repayments Office to request Form VAT 61a (see Useful Addresses), or you can apply online for a VAT refund using eRepayments in Revenue’s myAccount service.
Housing Adaptation Grant for People with a Disability
The Housing Adaptation Grant for People with a Disability may be applied for to assist in the carrying out of works that are reasonably necessary for the purposes of making a house more suitable for the accommodation of a person with a disability (who is a member of the household). This scheme replaces what was previously known as the Disabled Person’s Housing Grant.
The types of works allowable under the new scheme can be varied and include the provision of access ramps, stairlifts, downstairs toilet facilities, accessible showers, adaptations to facilitate wheelchair access and extensions. In general, people who require grant aid for minor works eg ramps, grab rails, accessible showers and stairlifts, and who satisfy the means test provisions, should apply for assistance under the new Mobility Aids Grant Scheme, also administered by your local authority.
All applications for grant aid under the Housing Adaptation Grant Scheme are assessed on the basis of household means. The maximum grant available under this scheme is currently €30,000.
How to apply
The Housing Adaptation Grant for People with a Disability is administered by your local authority. All applications must include two written itemised quotations from contractors indicating the cost of the adapation. The local authority will decide whether it is necessary to refer the application to an Occupational Therapist. This decision is based on the report of the authority’s Inspector, the applicant’s General Practitioner, and the long term needs of the applicant. For full details of the Housing Adaptation Grant for People with a Disability, contact the Housing Department of your local authority.
Installing equipment in your bath
You will need to ensure that your bath is strong enough, of the right dimensions, and safe for the installation of bathing equipment.
You will need to consider:
- The length of the bath. Check whether the bath is long enough to use the equipment – especially if a bath board and seat combination is going to be used, and if you will want to straighten your legs in the bath, or if you are particularly tall. A 1700mm long bath allows room for most bath equipment.
- The width of the bath. If the bath is exceptionally wide or narrow, standard equipment may not fit into/on it.
- Built-in grab rails on the side of the bath. The positioning of these may hinder the use of equipment or entry and exit to the bath. The side flaps of some bath lifts can become stuck under the built-in grab rails. Some bath lifts come with sliders that fit to the grab rails and prevent the flaps getting caught.
- The material of the bath. Metal baths are strong enough to withstand most types of bathing equipment. Most acrylic baths are not strong enough to take wedge-in bath seats and, when free-standing bath seats and removable bath lifts are used, the weight should be distributed over as wide a base as possible. You should always check with the supplier of any bathing equipment if there are any limitations on the kind of bath they can be used in, and if necessary check with the manufacturer of your bath. If you are unsure what your bath is made of, see if a fridge magnet sticks to the side of the inside of the bath. If it does, it is probably made of enamelled metal. If the bath sounds like plastic when you tap it, then it is probably plastic/acrylic.
- Corner baths. Only a few items of equipment can be used in a corner bath, such as specific bath lifts and bath seats (check online product descriptions to see if they mention corner baths or contact the suppliers).
Equipment to help get in/out of the bath
There is a wide range of equipment, ranging from simple to sophisticated items that will help overcome this difficulty. The combination of a bath board, seat, grab rails and a slip-resistant mat may satisfy many peoples’ needs, others will need to consider a hoisting/lifting mechanism or an alternative type of bath. If the task is still difficult or unsafe, then it may be wise to think about showering.
To use bath boards and seats you will require reasonable grip and muscle strength to transfer on and off the board/seat. You should be able to maintain your balance whilst sitting and be able to bend at an angle of 90° at the hips. You will need to be able to bend further forwards if you wish to reach the bath controls or wash your lower limbs/feet without using a long handled sponge.
Bath boards
Bath boards are waterproof boards that fit across the top of the bath (the opposite end to the taps) to provide a secure area on which to sit. They are often combined with bath seats. They are designed to let you transfer onto the bath whilst sitting, which is safer than stepping into the bath. It is important to remember that you will still need to lift your legs over the bath rim whilst seated and some people find this difficult.
The bath board wedges between the side rims of the bath, providing a platform seated area over the bath. Once over the bath the user can either stay sitting on the board and wash using a hand-held shower spray, or can move from the bath board down onto a lower bath seat so that they can be nearer the bath water. It is recommended that a slip-resistant mat is also used.
Some boards are designed with integral handgrips which may be useful when moving onto and off the board. Some boards have a cut-away section or a dip at the front to make personal cleaning easier.
For maximum safety, the board must fit securely across the top of the bath. A standard board should not extend beyond the rims as it may tip when it takes the person’s weight. All have an adjustable fixing system, usually brackets on the underside, which braces the board against the sides of the bath. The board may be perforated or slatted, so that water drains away easily, and can be made of different materials, such as solid or padded plastic, wood or cork. In general, padded boards or seats will provide greater comfort and feel less cold.
Slatted or perforated boards will allow the water to drain away quickly, so that drying is easier and the board is less slippery to sit on. However, ensure that the holes are small as it has been known for male users to trap certain body parts.
Bath boards may sometimes also be called shower boards. Shower boards have greater width/depth than bath boards providing a greater area of support whilst sitting under a shower, whereas bath boards are narrower to provide more room if you wish to transfer down onto a bath seat. Bath boards can be used to sit on whilst showering.
Bath boards are available in different lengths. To get the right length, measure across the width of your bath, including the bath rims. If the board is too long it will stick out over the side of the bath and there is a chance it could tip up if you sit on the end. If the board is too short it will not have sufficient support.
The board must fit securely across the top of the bath. All have an adjustable fixing system, usually brackets on the underside, which braces the board against the sides of the bath. The angle of some brackets can also be altered to wedge the board against the inside rims of the bath. These should be checked on a regular basis, especially if the board is regularly removed for others to use the bath. The brackets are usually made of plastic and some may be held in position with wing nuts which people with weak or painful hands may find difficult to tighten. The brackets usually have slip-resistant covers to provide extra grip and to prevent marking the bath. These should be checked periodically as they may wear after long-term use.
Bath boards may not fit baths with irregular shaped sides, corner tiling etc. If this is a problem then a wall-mounted bath board may be an option.
To transfer into the bath you reverse towards the board and sit down on it before swinging your legs over the edge to place them on the floor of the bath. It is strongly advised to have grab rails fitted to the wall to hold whilst completing the transfer. Some people find it difficult to lift their legs over the bath rim whilst seated, but this can be helped by using a leg lifter.
Before purchasing a bath board check whether your bath is suitable for use with a bath board. Check that:
- The rims of the bath are level and at the same height on both sides of the bath
- The width of the bath rim should be at least 2.5cm (1 inch) on each side of the bath
- It is possible that some plastic baths may crack if weight is concentrated on specific areas of the bath, such as when using bath boards, bath seats or bath lifts. If you are unsure what your bath is made of see if a fridge magnet sticks to the side of the inside of the bath – then it is probably made of enamel. If it sounds plastic when you tap it then the bath is probably plastic. Note that acrylic is a type of plastic.
Transfer benches
A transfer bench is a four legged seat which spans over the outer edge of the bath. They usually have a back rest and a single arm/handle on the end inside the bath.
They are used in the same way as a shower/bath board, by reversing towards the bench, sitting down and swinging your legs over the edge to place them on the floor of the bath. Some people may find it easier to use than a board and it offers more support.
A transfer bench does not require support on the bath rim on the far side of the bath, so may be useful when this is not available.
Leg lifters
If you have difficulty lifting your legs over the bath rim when using a bath board or swivel chair, a leg lifter may help.
Manual leg lifters consist of a reinforced strap with a loop on the end. You hook your foot through the loop and then, with your arms, physically lift the loop (and thereby your leg) up to the edge of the bath rim and then down into the bath.
Bath seats
Bath seats are often used in combination with a bath board, and provide a lower sitting platform halfway down for those people who wish to shower or sit near to, or in, the water. Bathing from the seat still means you will not experience the pleasure of lying in deep water or stretching out in the bath, although it may be possible to move down onto the bottom of the bath and move the seat out of the way until it is needed again for getting out. This is not recommended. Users need fairly strong arms to move themselves up and down between the board and seat. Bath seats are available with backrests and/or armrests and are available in different heights, the shorter the height, the more effort will be required to get out of the bath but the lower down in the water you sit. It is recommended that they are used in conjunction with a slip-resistant mat. Some seats have a cut-out section at the front to make personal cleaning easier. There are three types of bath seat: suspended, wedge and freestanding. If you have an acrylic bath you should consult the suppliers before buying a wedge type bath seat.
There are three types of bath seat:
- Suspended seats hang down from a framework which rests on the bath rim. The width of the frame can be adjusted to fit different sized baths. The ends of the frame are covered in a slip-resistant material to provide extra grip and to prevent damage to the bath. They can generally be used in metal or acrylic baths. Some have a backrest which gives full support but makes them difficult or impossible to use with a bath board.
- Wedge seats often have four hinged paddles which are attached to the metal seat frame and wedge firmly against the sides of the bath. The frame can be adjusted to ensure a firm grip against the bath sides. Most are only suitable for use in metal baths – some plastic or glass fibre baths may crack as the legs push against the sides of the bath.
- Free-standing bath seats have feet or suction pads which stand on the bottom of the bath. Some have adjustable side brackets which can be tightened to wedge against the side of the bath, reducing seat movement and providing the user with extra stability. They can generally be used in all baths, although those with larger bases to their legs are more suitable in acrylic baths than those with narrow legs as the weight is spread over a larger surface area.
Some bath seats have backrests, although these provide varying amounts of support. You are advised to check whether the model has a backrest or not. A high backrest will provide much more support than a low one, but if it protrudes above the bath rims the seat cannot be used in conjunction with a bath board. Padded backrests will provide more comfort if you are thin or in pain. Some seats have a cut-out section at the front to make personal cleaning easier. The term ‘bath seat’ is often used for bath stools.
Swivel seats
These seats rest across the rims of the bath and may be used in preference to a bath board as they provide a more supportive chair-type seat. They swivel to the left or right and many have a locking mechanism, which will secure the seat in a fixed position when the user is getting on and off. The person sits to wash usually using a hand-held shower spray. These seats do not lower you into the bath.
Combination boards and seats
These consist of a bath board attached to a bath seat and have the advantage of being more stable than two separate units. However, they can be rather bulky and heavy to remove from the bath.
Providing a support to pull on
Rails provide hand holds to help people get in and out of the bath independently or with minimal assistance. Some baths have small rails built in and provide a low level hand hold, but these may be too low to assist with getting in and out of the bath. They can also make positioning and securing equipment such as a bath board difficult. Conveniently placed grab rails positioned next to the bath will ensure that the person does not lean on a basin rim or towel rail for support.
Grab rails
Grab rails will give you secure anchor points with which to steady or manoeuvre yourself. Grab rails in a bathroom should have a ribbed or textured surface to give extra grip when wet. These can be attached to the wall, ceiling or floor next to the bath. Straight and angled rails are fixed to the wall to provide support when getting up and down in the bath. A floor to ceiling rail is fixed to the floor and the ceiling and can be helpful if a step is used to get in and out of the bath, however it may get in the way if a bath board is used. These rails should be fitted by experienced installers as they take a lot of weight and ceiling fixation can be complicated.
Bath-fixed rails
These clamp onto the side of the bath providing a vertical loop, which sticks up above the bath rim. Rails that attach solely to the bath itself, especially acrylic baths, are not recommended, as great care must be taken to ensure that the adjustable fixing mechanism, usually a screw system, is tight enough for the rail to remain secure, but not so tight that it damages the bath. Fixings should be checked on a regular basis and tightened when necessary.
Floor/bath fixed rails
These rails have fixing points which clamp onto the bath itself and on the floor next to the bath. This makes them more stable than those fixed only to the bath. Most are height adjustable. These rails can provide a handhold to assist you up from the bottom of the bath or from a bath seat. They can also help you to step into the bath. However, they will make it difficult to transfer your legs into the bath if you are going to do this whilst seated on a bath board.
Tap-fixed rails
These clamp around the bath taps, fold down to rest on the bath rim and can be folded up against the wall when not required. When sitting in the bath, the rail will be directly in front of the person at about chest height. In this position it will provide stability whilst in the bath, but it may not be at an ideal level to help with sitting down or standing up from the base of the bath.
These rails are not always recommended as they clamp around the bath taps and are therefore only as strong as the tap fixtures. Taps are not designed to withstand a person’s body weight pulling against them. The rail should only have downward pressure applied so the weight is taken by the bath rim – it is not designed for you to pull on to sit down or stand up from the base of the bath.
Wall-fixed rails
Grab rails positioned beside a bath or shower can assist you with you transferring in and out of your bath or shower. However, the position and type of rail required will depend on your individual height, reach, strength and dexterity. It is therefore recommended that you have an assessment with an occupational therapist before having grab rails installed. Grab rails in a bathroom should have ribbed or textured surface to give extra grip when wet.
Rails can be attached to the wall alongside the bath to assist with stepping in and out of the bath, and to provide support when standing up from the bottom of the bath and lowering down. Wall-fixed rails used in the bathroom should have an anti-slip, coated finish; and all the fixation screws should be concealed. The wall itself must be strong enough to bear the load (it may be difficult to fix rails to some partition walls).
As general guidance, rails are available in three standard lengths: 30cm, 45cm and 60cm. Positioned on the wall horizontally, they will help with movement forwards and back, and side to side. Positioned vertically they will assist with up and down movements. When the user needs to get up from the bottom of the bath and has to shift his/her weight forwards before beginning to rise, a combination of a horizontal rail and a vertical rail (or a single rail positioned at an angle rising away from the users) may be needed.
For further information, see the Assist Ireland Information Sheet ‘Grab rails’.
Providing a lifting mechanism from the base to the rim of the bath
People who find it difficult to use a bath board or seat to move themselves up and down from the bottom of the bath may wish to try out a bath lift or hoist. Many are powered and can be operated either by the user for independent bathing; or by a carer to make the task of assisting someone easier and safer, and reducing the risk of back injury. If motor driven, the controls are air operated, usually on a handset, and are therefore safe if accidentally immersed. Although expensive, a hoist or lift may be more cost effective than installing a special bath or shower.
If you experience difficulty lifting your legs over the bath rim when in a seated position, some bath lifts can be raised higher than the top of the bath rim, which reduces how far you need to raise your legs to clear the bath rim.
A bath lift raises the person from underneath, a hoist lifts the person from above.
Removable bath lifts
These fit inside the bath and can lift the person from near the bottom of the bath up to the height of the bath rim. You must however, still be able to lift your legs over the bath rims if you wish to bathe independently. The majority of bath lifts have a seat and backrest unit made of either solid plastic or mesh fabric, and some have the option of a reclining mechanism to give a more relaxing bath.
Most seats have side flaps which drop down and rest on the rims on the bath to assist with getting on and off the seat. Some models have a swiveling seat or disc on the seat which helps the person to get on and off. Alternatively, a flexible transfer disc can be placed on top of the seat to provide a means of swiveling.
You will need to ensure that the bath lift of your choice raises to the height of the edge of your particular bath, to provide a smooth transfer over the rim of your bath. Some have adapters that can be added when used in deep baths – check with the supplier.
Lifts can be removed for relocation or to allow another member of the family to use the bath. However, their weight and the rubber suction pads can make them difficult to remove. Some models have detachable components making the bath lift easier and safer to handle.
Motor driven bath lifts
These use a rechargeable battery to power the lifting motor. The battery must be recharged regularly. Some have a safety system which will not allow the seat to lower to the bottom of the bath if there is not enough remaining battery power to raise the seat fully to the top again. Some have an emergency stop mechanism.
Powered lifts are controlled by a handset which is waterproof and is safe if accidentally immersed in the water. Some handsets can be attached to the side of the bath with suckers so that they are always conveniently positioned. Most handsets have press buttons to control the movement. Some are marked so that they can be used by a bather with sight loss. Rocker or toggle switches are sometimes available and are particularly helpful for a person with weak or painful hands.
As chargers have to be plugged into the mains this activity should be carried out away from the bathroom. On some models the handset only has to be removed and plugged into the charger; others have large batteries which have to be removed for charging.Manual/Hydraulic bath lifts
Manual lifts are operated hydraulically using the weight of the person to lower the lift and the buoyancy of the water to help to raise the lift. The motor driven versions are usually powered by a rechargeable battery located behind the backrest or in the handset. This must be removed and recharged regularly.Inflatable bath lifts
A few bath lifts use air pressure. User’s may find the seat unit, particularly if it has no backrest, less stable. Therefore, they may be inappropriate for someone with balance difficulties.
Wall/floor-fixed bath lifts
These lifts are also called band lifts. They consist of a fabric band on a roller connected to the wall. The band pulls out, runs across the bath rims and slots into a floor-mounted bracket. A battery or mains-powered motor gently rotates the roller ‘letting out’ the band, lowering the user into the bath. The roller is rotated in the reverse direction to lift the user up. Their advantage is that they lower the user right down to the bottom of the bath and give them the freedom to lie back and soak. In addition, they are relatively discrete. These lifts are not suitable for everyone, as they provide no trunk or back support, and users must adjust their position on the band at intervals during ascent and descent to keep themselves central. The bather therefore needs to have good sitting balance in order to use these lifts safely.
Bath hoists
A hoist is usually a strong metal frame which may be static (fixed) or mobile. The frame has a lifting mechanism operated manually or powered by electricity. From the frame, or lifting arm/boom, is suspended a sling (on a spreader bar) or a chair, to support and carry a person as they are moved from one place or position to another.
Bath hoists fully support you as the user as they mechanically lift/lower you in/out of the bath. They will usually require the assistance of a carer.
Floor-fixed bath hoists
Floor-fixed bath hoists may be powered or mechanically operated. They have a seat (or slings) attached to a vertical column which usually slots into a base plate at the side or the end of the bath. The height of the column can be adjusted and the seat swivels to enable the person to transfer onto it from outside the bath. The seat is then raised so that it clears the bath rim and is lowered down into the bath.
Manual hoists are operated by a winding handle designed to be operated by a carer, although it may be possible for the bather to use some models independently. Powered hoists use either mains electricity that will require a power point outside the bathroom or a rechargeable battery that will need regular charging. The controls may be operated independently by the bather using a handset.
Hoists which provide a sling support
Although a few of the floor-fixed bath hoists have the option of using slings, most people who need the additional support gained from a sling will use a mobile or ceiling track hoist. It is better to use mesh slings in the bath as they allow the water to drain away easily.
A small mobile hoist can be used for many handling tasks in and around the home. However, if the person needs to be moved from one place to another, it is better to use an overhead track hoist or a sanichair because a mobile hoist can be heavy and difficult to manoeuvre, especially in confined spaces such as bathrooms; and the occupant can feel particularly vulnerable in transit. The hoist legs must fit under the bath to position the bather. This will require a minimum space of 11cm under the bath, and the side panel will need to be removed or have a hole cut into it. Storage space for the hoist also needs to be considered.
Battery-powered hoists are easier to operate than manual hoists, as the motor takes the person’s weight, but remember that the battery needs to be charged regularly.
Overhead or ceiling track hoists are ideal in a domestic situation because, if the layout of the house permits, a straight, jointed or curved track can be fixed so that a person can transfer in the sling from the bed and into the bathroom where they can use the toilet and the bath or shower. It may be possible to do these manoeuvres independently or with minimal assistance. However, structural alterations may be necessary such as strengthening the ceiling, or adapting the top of the doorframe to take the track. It is more expensive to install, but it requires less space and less effort from the carer.
Providing an alternative type of bath
When planning to replace a bath consider:
- the available space
- the level of disruption in terms of both noise and mess whilst work is in progress, and the time the bathroom will be out of action
- the volume of water required to fill the new bath and compare this to the capacity of the current bath. Does the hot water tank have sufficient capacity?
- aftercare of equipment, particularly servicing and maintenance if the bath has moving parts
- the long term prospects of the bather. If the person’s ability is likely to deteriorate a level access shower might be a better option
- other household members.
Baths with a built-in seat
These have a seat built into the moulding of the bath so that the bather does not have to sit on the bottom of the bath. They have no transfer system and, like a bath seat, the user must have fairly strong arms to move him/herself up and down. Many have cut away sides and a small corner ledge for users to perch on whilst transferring their legs into the bath.
Baths with a built-in transfer mechanism
These baths have lifting seats incorporated into the structure of the bath so that there is no need for the person to get up or be helped up from the bottom of the bath. The seat raises and lowers; all but a few seats have a fixed moulded backrest which makes reclining back in the bath difficult. Some seats incorporate a legrest to lift the legs over the bath rim. When the seat has been raised above the bath rim, it can be swivelled outwards, either manually or automatically, for easier transfer. The height of the seat edge is important, especially for people who need to brace their knees in order to stand upright, or who need a level transfer from a wheelchair seat. A few systems have the facility to raise and lower the seat outside the bath.
The lifting mechanism is either manual or mains powered. The lift can be controlled by the bather or a helper using a handset. If the system is electrically powered, a safe air switch is used.
Multi-adjustable baths
These are high-level baths that enable the bather to transfer directly onto a bathing platform. The bath side or sides are then raised so that bathing can commence. The platform can also be used as a drying/changing table in some situations. As well as making transfers easier, this style of bath can ease back strain for a carer.
Walk-in baths
These baths have a door in the side or front that you can step through to walk into/out of the bath. Although there are no high sides to negotiate, there is a low step beneath the door. Full length baths with a door are available, but will then require you to be able to sit down/get up from the bottom of the bath. A bath board and seat might also be required.
Walk in baths are also available with an integral seat moulded into the shape. These tend to be shorter in length, therefore reducing legroom, and may well be too cramped if you experience stiffness in the hips and knees. Those that are square take up less room in the bathroom, but if the door is outward opening, space will be needed to accommodate the swing.
The bath has to be empty before you enter it and then filled when you close the door. When exiting, the water needs to be drained before you open the door. This filling and drainage causes a delay during which you may become chilled, so consider keeping the bathroom well heated during use.
Check the height of the internal seat to make sure you are able to lower yourself down and stand up from it with ease. The moulded seat is supportive, but will limit your ability to recline. If you are unsteady on your feet, make sure the taps, plug and door controls can be reached from the seated position if you plan to bathe independently.
Check the height of the internal seat to make sure the user is able to lower down and stand up from it with ease; and, if they are unsteady on their feet, make sure the taps; plug and door controls can be reached from the seated position if independent bathing is planned.
Adjustable-height baths
The height of these baths can be adjusted, either mechanically or electrically. They are designed to reduce the need for a carer to bend over the bath if the person needs assistance. The bather may be able to step into the bath at its lowest level and then be raised to a convenient height. However, remember that the water usually needs to drain away before the bather can get out. These baths are not often used in a domestic setting.
Support, comfort and positioning in the bath
Care must be taken when using any bath cushion or insert that they will not slip accidentally. Check all fixing mechanisms regularly and replace when they are looking worn or broken.
Cushions for comfort
Plastic covered foam cushions can be used to line the bath to improve comfort for someone who is frail; or to increase the safety of a bather who has involuntary movements. Shaped cushion inserts are also available for some of the moulded plastic bath seats and lifts.
Mouldable body supports
These are large waterproof mouldable cushions which are filled with polystyrene beads. They are available in different shapes to support various parts of the body. They will conform to the shape of the bather and this shape can be semi-permanently fixed, when the air inside is removed using a pump. They are secured to the side of the bath with suckers.
Head supports
Head cushions improve comfort when lying back in the bath. They are fixed to the bath with suction pads. If head control is poor, swimming flotation aids can be used to support the head of the user above water.
Pressure relief cushions
It should be remembered that anyone who needs pressure care should be provided with it across the range of daily living activities, ie not only as a pressure cushion for the wheelchair, but also in bed, in the bath and on the commode or toilet. Bath cushions should have a waterproof outer cover, and a heavy inner substance which enables the cushion to remain submerged.
Safety equipment
Bath thermometers
These can be used to check the temperature of bath water before use. They are particularly useful if the bather has reduced skin sensation and needs an objective way to determine temperatures.
Water temperature indicators
These devices change colour to indicate water temperature. Some people may find them simpler and easier to read than a bath thermometer.
Water level indicators
Bath temperature indicators show when the temperature of the bath is above a safe level by changing colour or giving a reading of the water temperature.
Some are preset within a safe range, which is usually 34-37oC for the bath. When the temperature of the water goes higher than this, they may emit a warning such as a change of colour or sound an alarm.
Some can also sound an alarm to warn of a dangerous water level which could lead to flooding.
Bath mats and anti-slip materials
Mats which are secured with suckers to the bottom of the bath, self-adhesive strips and spray-on slip-resistant material will all help to prevent a person from slipping in a wet bath. Before every use the mat should be checked to ensure it is securely fixed.
Taps
Bath taps should not be used as a support to pull up on when getting out of the bath. Most will not be strong enough to withstand a person’s weight. Strategically positioned grab rails should be used instead.
Tap turners
If you experience difficulty turning your taps on and/or off due to a weak or painful grip, you may wish to consider trying tap turners. These fit onto the top of your existing taps. Most are designed for a particular type of tap (e.g. for cross or bar head taps or for round heads). They are usually colour coded red or blue for hot and cold taps.
Alternatively you could replace your taps with lever taps. These are easier to turn as the lever can be pushed/pulled to operate the tap. On most the lever only needs to turn a quarter of the way around the tap to go from off to fully on.
Long-handled bathing aids
There are long handled washing and personal care equipment and hand and foot care aids available, designed to help make it easier to reach parts of your body when washing with less stretching or bending.
This equipment can be used for washing your feet, back or other hard to reach areas of the body such as between the toes. It may be best to use this equipment whilst seated in your bath, to help avoid any potential difficulty with your balance when reaching with the equipment.
Useful publications
- Building for Everyone
Publication which examines buildings and the external environment to achieve equality and inclusiveness for everyone. Available from:
National Disability Authority
25 Clyde Road
Dublin 4
Tel: 01-608 0400
Email: nda@nda.ie
Website: www.nda.ie
Useful addresses
- Association of Occupational Therapists of Ireland (AOTI)
Office 1 & 2
1st Floor
Haymarket House
Smithfield
Dublin 7
Tel: 01-874 8136
Email: info@aoti.ie
Website: www.aoti.ie
- Irish Society of Chartered Physiotherapists (ISCP)
Royal College of Surgeons
St Stephen’s Green
Dublin 2
Ph: 01-402 2148
Email: info@iscp.ie
Website: www.iscp.ie
- VAT (Unregistered) Repayments Section
FREEPOST
Central Repayments Office
M: TEK II Building
Armagh Road
Monaghan
Tel: 047 621 000
LoCall: 1890 60 60 61
Email: cromon@revenue.ie
Website: www.revenue.ie
- Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
Liffey Valley Shopping Centre
Quarryvale
Clondalkin
Dublin 22
Tel: 01-620 8731
- Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
Mahon Point Shopping Centre
Mahon
Cork
Tel: 021-431 3033
- Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
Red Car Park (Level 2M)
Dundrum Town Centre
Dundrum
Dublin 14
Tel: 01-298 7982
- Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
Blanchardstown Shopping Centre
Red Car Park – Marks and Spencers Entrance
Blanchardstown
Dublin 15
Tel: 01-821 1911
- Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
Whitewater Shopping Centre
Green Car Park
Cutlery Road
Newbridge
Co Kildare
Tel: 045-450736
- Irish Wheelchair Association (IWA)
Áras Chúchulainn
Blackheath Drive
Clontarf
Dublin 3
Tel: 01-818 6400
Email: info@iwa.ie
Website: www.iwa.ie
- Disabled Living Foundation (DLF) (UK charity providing advice and information and a comprehensive up-to-date database of disability equipment available in the UK)
England
Tel: 0044 207 289 6111
Email: info@dlf.org.uk
Website: www.dlf.org.uk
- Research Institute for Disabled Consumers (RIDC) (independent research body in UK which produces guides for older and disabled consumers based on professional research – formerly known as RICA)
England
Tel: 0044 207 427 2460
Email: info@ridc.org.uk
Website: www.ridc.org.uk
