Sometimes the smallest room in the house — the bathroom — can cause the greatest risk.
One in four people over age 65 falls each year, according to the Centers for Disease Control and Prevention (CDC). Bathrooms are a prime place for injuries, with falls causing about 80% of bathroom injuries.
“For seniors aging in place, the bathroom can be one of the most dangerous rooms in the house,” says Peter Ross, CEO and co-founder of Senior Helpers, an in-home senior care provider that operates in Cook, Will, and DuPage counties.
“Wet conditions, slick tile, and a wide assortment of hard surfaces to land on, such as the edge of the sink, toilet, or tub, can make the simple act of practicing good hygiene into a frightening and harrowing experience,” says Ross, who is a member of the Home Care Association of America board of directors and the Healthcare Leadership Council.
When an older adult has physical conditions that limit their abilities, bathroom safety may be fraught with other issues as well.
Bathroom safety modifications
About 5 million Americans over age 65 living in their own homes lack equipment that helps them bathe and use the toilet safely, according to an estimate in a 2021 JAMA Internal Medicine article.
The National Institute on Aging recommends fall-proofing your bathroom by mounting grab bars near toilets and on the inside and outside of the tub and shower. Place nonskid mats, strips, or carpet on all surfaces that might get wet, and remember to turn on nightlights.
One can also use nightlights with sensors that turn the nightlight on when the room is dark. Shower stools or a walk-in tub may be helpful too, Ross says, as well as other home modifications.
Privacy in the bathroom
The bathroom is a place for vulnerable activities, such as toileting, showering, and bathing. This makes privacy vital, in addition to bathroom safety.
Many older adults resist bathing if they need supervision, so ensuring they have as much privacy as possible may help alleviate their fears, Ross says.
Sometimes, because of already established dynamics, being bathed by a professionally trained in-home caregiver can ease embarrassment. Also, if embarrassment is an issue, caregivers can keep a towel over the individual’s private areas while bathing.
Though some people may need assistance getting on or off the toilet, once they’re in a safe position, it’s important to give them private time. When it comes to any necessary clean-ups, a caregiver could minimize embarrassment by cleaning up messes discretely, thoroughly, and promptly.
Bathing every day is not necessary, nor is stepping into a shower or bathtub. “Using washcloths to wash themselves is perfectly fine, but it’s important to remember that bathing should start at the face and head and move down, with special attention paid to the private areas, as they tend to get dirtiest,” Ross says.
While cleanliness is important, showering a few times a week is fine. “Most Americans are used to showering every day, but outside of things like heavy sweating or activities that involve dirt and grime, it’s not strictly necessary for good health,” Ross says. “For seniors, at a minimum bathing twice a week will help them avoid skin breakdowns and infections.”
If an older adult is recovering from surgery or a wound, a professional in-home care provider may be better suited to handle bathing time.
“Wounds and incisions heal more slowly, even haltingly,” says James Dan, MD, a geriatric clinical adviser and member of the Senior Helpers board. Because of this, meticulous skincare is a must, he says.
If an older adult lives on their own, make sure their bathroom is clean. If they have limited eyesight or smell, it may be difficult for them to clean thoroughly on their own.
“Exposure to a living situation rife with infectious agents is simply dangerous, and attention must be paid to ensuring a clean living situation,” Dan says.
A soothing space
If an older adult is resistant to bathing, allowing them to choose their bathing time gives them more control over the situation. “This is especially important for seniors with dementia, as trying to force them into something is a huge stressor for people suffering from memory issues,” Ross says.
To create a soothing space — which could encourage people with dementia to take a bath or shower — play relaxing music, be sure the temperature of the space is warm, and have a plush robe and slippers ready.
“Think about how relaxing a bath is for you, or how refreshing a shower can be, and consider that older adults also deserve that same respite,” Ross says.
Bathroom safety is important. Keeping bathing safe and soothing can prevent a fall from happening and keep an aging loved one clean and comfortable.