Why Older Adults Need Improved Shower and Bathtub Safety

By Sharon O'Brien

Many seniors use unsafe bathroom features even with safety features available

Shower and bathtub safety is a concern for older adults. One-third of people age 60 and older had difficulty getting into or out of a bathtub or shower, even with bathtub safety equipment installed, according to a study from the University of Michigan Health System.

How the Bathtub Safety Study was Conducted
U-M researchers videotaped fully-clothed study participants as they demonstrated how they normally climb in and out of a bathtub or shower in their homes. The videos showed whether participants used grab-bars, towel bars, shower curtains, glass doors, tub seats, and other parts of a bathtub to help themselves get in or out.

Researchers also evaluated the videotapes to determine the participants’ fluidity of movement, and whether they had difficulty negotiating their bathtub and shower environments.

All of the study participants were residents of congregate housing facilities and had no cognitive impairments. Yet one-third of the 89 participants “plopped” onto the bathtub seat, or hit the side of the bathtub or the shower threshold with their legs.

“We found that there are a lot of independently bathing older adults who have trouble or are unsafe getting into and out of the tub or shower stall,” said Susan L. Murphy, ScD, OTR, an occupational therapist and U-M research assistant professor, in a news release.

“For older adults, losing the ability to bathe is associated with having falls, fracturing bones, and even being admitted to a nursing home. It is important that we take steps to help to prevent bathing disability before it occurs.”

Key Shower and Bathtub Safety Areas
According to the researchers, common shower and bathtub safety issues included:

• Using a sliding glass shower door for stability or balance - This problem was observed in three-quarters of the older adults who use shower stalls with sliding glass doors.

“This is extremely unsafe because shower doors were not designed to support a person’s weight,” Murphy said. “This problem could be easily remedied by educating older adults not to use the door as a support, or possibly replacing it with a shower curtain, which was used only rarely by older adults in this study.” 

• Using unsafe shower and bathtub and bathtub features - While the majority of study participants used shower and bathtub safety equipment like grab bars when they were available, many used unsafe features in addition to the safe ones.

For example, 19 percent used unsafe bathtub features and more than 70 percent used unsafe shower features, including tub seats and towel bars. One study participant used a plastic lawn chair as a tub seat, which researchers found especially dangerous because of the curved tub floor.

How Can Shower and Bathtub Safety Be Improved?
Some shower and bathtub safety issues are easy to fix, according to researchers, by replacing shower doors with shower curtains and providing proper instruction about the built-in bathroom safety features (like grab bars designed for weight-bearing) to residents of senior housing facilities. The study researchers also recommended putting more attention toward improving bathroom design, and educating older adults about shower and bathtub safety.

“We think the results from this study demonstrate the need for healthcare professionals to become involved in helping to prevent bathing disability, instead of just treating people in the hospital after they have had a fall in the bathroom,” Murphy says.

“While bathrooms in senior housing facilities are designed to be safe, we have found that older adults often do not know the difference between a grab bar and a towel bar. They also have unsafe strategies of getting into and out of their shower or tub.

“Occupational therapists often see older adults for bathing problems and would be ideal to intervene with older adults before they start to lose the ability to bathe.”

Read the full study: Journal of the American Geriatrics Society, Aug. 2006, “Bath Transfers in Older Adult Congregate Housing Residents: Assessing the Person-Environment Interaction.”