As older adults grow they may start experiencing poor balance and visual problems. Couple this with the taking of certain medications, and orthopaedic and neurological conditions and matters are made even worse. Family members often struggle to ensure that their elderly relatives are safe, especially in the bathroom. Making changes to the room could, however, offer some peace of mind to the caregivers and independence to the elderly.

As the different ailments pose various risks, Anthony Scerri, a lecturer in nursing at the Univeristy of Malta, says there is no single intervention that can reduce falls and injuries; one should make changes based on the individual needs of the person.

“It’s very important, and I cannot emphasise this enough, that any planned alteration in the bathroom has to be done following the advice of trained professionals, such as occupational therapists.

“‘Do-it-yourself’ alterations may not only lead to waste of money, but can be potentially dangerous,” he says.

Occupational therapists who visit the home, and the bathrooms to be altered, may come up with a number of proposals. Some of these can be quite easy to implement, while other suggestions may be slightly more complex.

“Occupational therapists may suggest increasing access to the bathroom by removing any furniture, rugs or mats that may be obstructing the doorway. Make sure that there is enough light, especially at night, in the corridor leading the bathroom and in the bathroom itself. Older persons may have visual difficulties and this may increase the risk of tripping and falling.”

Scerri also encourages the use of rubber non-slip mats, both on the floor next to the shower or bathtub and inside the shower and bathtub.

Do-it-yourself alterations may not only lead to waste of money, but can be potentially dangerous

“Non-slip adhesive strips can also be placed on the top of sink edges to guard against slippage.”

Grab bars, which offer support while showering or while getting in and out of the shower or bathtub can also be very effective, especially since many elderly persons seek to support their weight as they move around the bathroom.

Scerri warns not having the right bars can be very dangerous and result in accidents.

“Unfortunately, many older persons still use the towel bar for support. These are not designed to support the weight of a human person and can be a source of danger.

“Grab bars can also be attached to the toilet. Alternatively, a toilet frame or rail with armrests can be attached to the back of the toilet. Together with a toilet seat raise, they can aide an elderly person to sit down and get up safely.”

Keeping toiletries well within reach, without the need for excessive bending or stretching is also very effective, as is having a bathroom door that swings outwards.

“If a person falls against the door and it swings inwards, it may be difficult to reach the person inside. It is therefore preferable that the bathroom door swings outwards to allow access.”

Installing an emergency buzzer or phone accessible from the bathtub, toilet, or shower can be used to alert the household or others if the need for immediate help arises.

When planning any changes to the bathroom, keeping in mind who will be using the bathroom is crucial. If the elderly person has certain conditions such as dementia, specific safety precautions have to be taken.

“In such cases consider using plastic shower screens instead of glass, selecting a different colour toilet seat to the toilet, so the user can easily locate it and avoiding tiles with patterns and three dimensional representation of objects because these can cause visual confusion.

“All hot water outlets in sinks, showers, and tubs should have anti-scald devices − sometimes called thermostatic mixing valves − installed to prevent burns,” explains Scerri.

Choosing between a shower and a bathtub depends mainly on the physical abilities of the person yet Scerri says that in both the shower and the bathtub, one can install chairs or benches to facilitate bathing.

“If a person get tired standing in a shower, a shower chair can proof helpful. This needs to have rubber tips on its legs to avoid sliding. On the other hand, if making use of a bathtub, a bath transfer bench can be used to increase safety while getting in and out of the tub. This eliminates the need to stand on only one leg at any time while transferring.”

Although environmental adaptations at home can reduce the risk of falls, Scerri points out other modifiable risk factors should be taken care of. A simple way to do so is to engage in group or home-based exercise programmes to enhance balance and physical strength. He insists dialogue between caregivers and the elderly is crucial, especially when carrying out such changes, so as to respect the person’s autonomy, dignity, independence and self-determination.

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