Keeping Seniors Safe in Their Own Homes: Part 1 Bathroom Safety

VickyRN, MSN, DNP, RN

Accidents are the ninth leading cause of injury-related deaths among the older population. Older women have a higher rate of injuries than any adult female age group. Seniors aged 85 years and older have the highest death rate of all from injuries and accidents. In the United States, unintentional falls are the most common cause of injury and accidental death in those over the age of 65.

Falls are a major health concern for the older person, with serious implications for medical as well as financial outcomes. Indeed, slips and falls are a major cause of disability and account for more than 70 percent of the total injury-related health cost among the senior population. The odds of falling in any year after the age of 65 are about one in three. Clearly, decreasing the risk of falling among older adults is a public health priority.

Since most falls occur in the home, a nurse walk-through visit is imperative to identify risk factors and recommend appropriate actions. The home safety survey should begin in the bathroom, since most falls occur there. The high likelihood of falling and striking one's head on the hard surface of a tub or toilet substantially increases the seriousness of the fall. Particular attention should be paid to the following aspects:

Lighting

A small light should be on in the bathroom at all times. Since older adults tend to have urinary frequency and nocturia, the nightlight in the bathroom can make night trips to the bathroom safer.

Faucets

Lever-shaped faucet handles are easier to use than round ones, especially with stiff arthritic hands. Older people can risk injury by releasing too much hot water as they struggle to turn a round faucet handle. Color coding the faucet handles makes it easier to differentiate hot from cold than the small letters alone.

Tubs and shower stalls

Nonslip surfaces are essential for tubs and shower floors. Nonskid mats, appliques, or textured strips with a gritty surface should be added to bathtubs and all surfaces that may get wet. The strips are considered safer than bath mats, and only cost a few dollars. A portable, hand-held shower head should be installed for convenience. A liquid soap dispenser should be mounted on the bathtub wall, to avoid reaching for or tripping over a bar of slippery soap. A padded bath or shower seat offers a place to sit when showering and, for tub bathers, a resting point before transferring out of the tub. Because a drop in blood pressure may follow bathing, the seat alongside the tub is beneficial for to elder to rest when drying. The nurse should also determine if the elder can get into or out of the bathtub or shower easily.

Water temperature

The water temperature should be carefully regulated in order to prevent scalding or burning. The hot water temperature should be set centrally at no greater than 110 degrees F.

Grab bars and/or safety rails

Grab bars should be mounted securely on a reinforced wall, on both the inside and outside of the tub and shower and beside the toilet. These bars offer support during transfers and a source of stabilization when bathing. A simple towel rack will not do. The grab bars need to be strong enough to hold a person's weight, especially when unbalanced and about to fall.

Floor surface

Towels, clothing, hair dryers, and other clutter should not be left on the bathroom floor. The most common hazard for falls is tripping over objects on the floor. Scatter rugs and unsecured floor mats should not be used. Leaks should be corrected to avoid creating slippery floors. Tiles should be matte or textured in finish to help prevent slips and falls.

Toilets

Grab bars or support frames aid in the difficult task of sitting down and rising from a toilet seat. Because the low height of toilet seats makes them difficult for many older people to use, a raised seat attachment could prove useful. A raised toilet seat that sits atop the bowl is inexpensive and requires no installation. These toilet adapters sell for $40 to $50 in medical supply stores.

Electrical appliances

Bathrooms are a particularly dangerous place to use electrical appliances, such as hair dryers, space heaters, and radios. An elder can accidentally slip and pull an electrical appliance into the tub, posing a risk for electrocution. A ground fault circuit interrupter (GFCI) should be installed in bathroom outlets. This is a safety device that helps prevent shocks when electrical appliances get wet.

Older adults thrive much better in the familiar surroundings of their own home, rather than in an assisted living facility or a nursing home. This series of articles will offer tips on helping seniors live safely at home, with less risk of accident or injury.

References

A Housing Safety Checklist

'Elderizing' Your Home How to Make Any Residence Safer for the Senior Set

Home Safety for the Elderly