Once there was a woman who was stuck inside her bathtub for three days before help arrived to get her out. She couldn’t get herself out of the tub! She lived on the third-floor apartment of a Boston triple-decker.

Fortunately, it was summertime and she was able to stay hydrated. There were towels nearby for warmth and cover.

When I showed up sometime later, to do a home safety visit she wanted every possible safety feature for her bathroom. She lived through a traumatic experience that she didn’t want to repeat.

Aging in place is a PROACTIVE process of anticipating change.

Here are some bathroom essentials to consider for your safe home. 

Toilet height

We all use the toilet. Toilets, like chairs, are a one-size-fits-all scenario. For uses who are unusually short, unusually tall, or unusually wide the standard toilet size may not be appropriate. The standard toilet height is 13 inches. A comfort height toilet is around 17 inches high. Very short people do not benefit from a higher toilet seat. Very tall people do. Those of average height may benefit from a higher toilet seat to make it easier to stand up when they have medical conditions.

Height can be temporarily added to a toilet for someone with back, hip, knee injury, pain, or surgery creating medical and mobility challenges. Toilet height can be raised with an add-on seat insert, like those available at http://www.carex.com.  Note if your toilet is round or elongated before purchasing. Just like that, raise the lid and plop it in place. It can also be easily removed for use by others. 

Adapt a Toilet

A commode over the toilet is a simple, no tools way of adding height and handles to a toilet. The legs adjust easily, in the same way a walker’s height adjusts. Just measure to be sure it fits in the available space. There’s a bottomless bucket, also called a splash guard, that comes with every commode, for use over a toilet. Always use a commode liner for ease of cleanup and odor containment. Find an example of commode liners on the Shop/Products page of this website.

Commodes

I’ve seen someone put a commode in the living room next to their recliner chair with a floor-to-ceiling grab pole there for support when moving between the chair and commode. The pole needs a solid ceiling surface and a solid floor to get the required friction fit for secure installation of the pole. This is a convenient setup for someone with limited mobility, at home alone.

A commode at the bedside is useful for someone who gets up at night and is unsafe to walk to the bathroom. For that application, one can use a commode with a bucket and handle. Use a commode liner which is a plastic bag that fits inside the commode for easier cleanup. Make sure there is toilet paper and hand sanitizer or wet wipes nearby. Place the bedside commode close to the bed so that walking around in the nighttime is minimized. 

Toileting if you are 5’4” or taller

In my experience, some people cannot stand up from a toilet unless they are using grab bars or handles. Some folks that are tall, weak, or confused can get themselves off a toilet only if there is a grab bar in front of them, enabling a forward weight shift toward standing.

In tight spaces use a floor-to-ceiling pole with adjustable height handles that provide a hand hold for transfers to the tub, shower, and toilet when properly placed.

People 5’4″ and under have less trouble standing from an average toilet because the height fits them better. 

What does bariatric mean?

Commodes come in bariatric styles which have higher than average (300#) weight capacity. They are useful for obese users or those with weakness or neuropathy. A drop arm commode is an option for someone who cannot stand up fully, such as a leg amputee. The handles fold down and out of the way so the user can scoot across the top surface without standing tall.

A flat-top bariatric drop arm commode enables the user to lift one hip at a time, while seated, for improved hygiene with wiping, without standing. Those are useful for someone who is non-weight-bearing or an amputee.

“Short arm syndrome”

For those with “short arm syndrome” or inability to reach behind for wiping look into a bidet attachment. The Tushy bidet (hellotushy.com) is a low-cost add-on bidet.

In other countries a handheld hose is mounted next to every public and private toilet. The is similar to a kitchen sink sprayer. It’s easy to install and effective. 

If you want features in addition to room temperature water spray like warm water, air dryer, remote control those upgrades are available with high end bidets.

Toilet hygiene

There are portable urinals and portable bidet bottles that are discreet and handy for many users.

There are toilet “wands” that extend the reach of the user into tough to access places.

Wet wipes are helpful when you are cleaning someone else’s tushy. For the sake of the environment, please dispose of those in the trash versus flushing them down the pipes. Wiping somebody else’s rear end is an act of love. 

Protection Products

There are numerous personal protection products for toileting on the market. No one product or combination of products is ideal for every situation. Trial and error is required.

Briefs (diapers with side tapes) are what’s commonly used in nursing facilities since they are easiest for caregivers to put on and take off at bed level, without removing pants and shoes.

“Pullups” are elasticized waist incontinence products (Depends, Always) that are sometimes paired with a removal insert pad so that only the smaller removable pad needs changing during the average day.

Any product that fits too loosely can leak. Any product that fits too tightly can cause skin breakdown. Monitor skin carefully if using protection products. Skin breakdown happens quickly and progresses quickly. Change soiled products ASAP. Use barrier cream for skin protection.

Bathtubs

Then there’s the bathtub! Formerly considered the only way to bathe ~bathtubs have evolved. Tubs evolved into spas and then home jacuzzis. Bathroom renovation trends favor free-standing, spa-like immersion tubs that look beautiful but do not support Aging in Place.

Many folks have trouble stepping over the edge of a traditional bathtub. The thought of which causes fear of falling and anxiety about using the wet and slippery tub.

There’s no need to tear a tub out and replace it with one of those walk-in tubs advertised in senior magazines. It seems obvious – that’s a bad idea! Sitting in that kind of tub, wet and naked, waiting for the water to drain out before opening the little side door, seems ludicrous. There is usually no need to spend a lot of money on expensive bathroom renovations. 

How to Retrofit a bathtub

Now tubs are being made into walk-in showers with a conversion kit that takes up the same footprint as a tub (ezable.com).

You can place a tub seat or a tub bench into the tub for a seated shower. This is important for someone unsafe to stand in the wet area. The bench-style is good for someone heavy, weak, or mobility impaired. Two of the tub bench’s legs remain outside the tub wall.  

Remember to adjust the height of the tub seat to fit the height of the user. To use this bench first sit down on the outside edge of the bench, facing out. Then undress, get your legs in over the tub edge, slide over on the bench and inside to face the faucet. That way you never have to stand up in the wet area.Sit on a facecloth to make turning easier. Reverse the procedure to get out safely.

Adapt a tub

You will need to make a couple of slits in the plastic shower curtain liner so it can be tucked in around the legs of the tub bench. This simple trick keeps the water spray inside the tub. A tub bench is useful for someone who is a large size, recovering from surgery, partial weight-bearing, weak, or has poor balance, endurance, or vision.

There’s also a conversion kit to cut a piece out of the sidewall of the tub making it easier to get heavy or weak legs in and out of the tub.

There are hundreds of varieties of tub seats. I favor the type with a flat (not concave) seat, usually rectangular and made of white plastic, without handles. Look for adjustable legs with rubber-tipped feet.

Don’t forget the non-skid tub mat for the inside bottom of the tub. A mat is preferable to decals which are hard to clean and cover less area. A contrasting color tub mat is useful for someone with low vision.

This adapted tub has a variety of safety features