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Personal Care – Bathing

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Introduction

Caring for oneself through bathing is a very personal activity, often undertaken alone. Yet age-related frailty and/or disability may require a person to need help from relatives and carers to wash and bathe. The domestic bathroom can sometimes be a hazardous space. Getting in and out of a bath can be difficult for people with limited mobility whilst the risk of slipping on a wet floor may induce fear of using showers and become a barrier to regular washing.

Insights

Difficulties accessing the bathroom

There may be a number of physical difficulties that people encounter that prevents them accessing the bathroom with ease and comfort. These include:

Visual impairments making it difficult to see, especially in an environment where domestic aesthetic dictates a ‘white on white’ effect, such as a white bath surrounded by white tiles.

Cognitive impairments may effect a person’s management of bathing, forgetting they are running a bath or assessing the correct temperature. In addition difficulty with eye-hand co-ordination may cause a person to misjudge where support is and become at risk of falling.

Physical impairments may take one or multiple forms and may affect balance, increasing the risk of slipping or falling, joint mobility in hands making taps difficult to operate as well as reach, and grip capabilities for other objects in the bathroom. In addition, impaired joint mobility in hips and knees make bending difficult and impaired tactile receptors make judging temperature difficult.

Many people may not experience a single impairment but multiple difficulties such as visual impairments coupled with impaired joint mobility in hands and hips. Hence, design of the bathroom should incorporate a holistic approach to the needs and safety of people.

Other considerations

As well as consideration for personal hygiene, the design of the bathroom has to also incorporate wider domestic hygiene concerns such as cleaning the area after use. In addition, the bathroom’s extreme environment demands that certain materials are more favourable in use.

Cleaning: As the domestic space where we clean ourselves, the bathroom also requires frequent cleaning. Such tasks can be difficult for people with mobility impairments such as difficulty bending, and/or restricted reach or grip to clean the bath, shower tray and WC pan.

Materials: The domestic bathroom can be considered an extreme domestic environment in which furnishings and accessories are required to withstand steam and damp. In addition, as an environment where slips and falls can be of greater risk, anti-slip prevention may be considered. This will make some materials more favourable then others.

Space: Many UK bathrooms are very small, making space a premium. Issues such as storage and the sharing the space with a partner or carer should therefore be an important consideration in bathroom design. This includes the needs of a carer in aiding a person to bathe and/or shower.

Aspiration: Many people aspire to have an aesthetically pleasing bathroom, so that designs for assistance should not ‘stand out’ as a retro fitted afterthought. Incorporating products for assistance and safety should be integrated into the overall design of the environment.

Inclusive design for bathrooms

Understanding the needs of older and disabled people in maintaining personal hygiene can highlight major factors for all people’s needs.

The space of the bathroom needs to be ergonomically accessible, not only for people to take care of their own personal needs but also that of carers. In addition, the cleaning of the bathroom space after use must also be considered from an accessible and ergonomic perspective.

The complexity of tasks in maintaining personal hygiene should also be considered. Using the bathroom will require a number of activities including undressing, turning taps on and off, regulating temperature, climbing in and out of baths or walking in and out of showers, using soaps and shampoos, rinsing, drying and getting dressed. Each activity will itself incorporate a range of motions and movements, decisions and choices, which need to be considered as part of a holistic activity.

Due to the dual nature of the bathroom environment (from dry to wet), it is important that functionality is kept simple and easy to use in both circumstances.

Although it may currently go against aesthetic desire, a form of colour contrast between bath, wall, shower cubicle and floor, may make the bathroom more accessible to people with visual impairments.

It is important that design solutions do not stigmatise a person’s home and therefore the person themselves.

Images

Videos

Quotes


‘I prefer a bath and time on my own to soak’

‘I find the walk-in shower too small and the step too deep’

‘I am hoping to have a downstairs shower and toilet put in… I am disabled and need a shower opposed to a bath, as I can’t sit down comfortably and have difficulty getting in and out’.

‘There is something primal about the need to be looking in the mirror…’

‘I keep things in the bedroom and bring them in (to the bathroom). There’s no storage…’

‘The bathtub is quite luxurious, it is one of those old-fashioned ones on a pedestal and it gets deeper’.

‘Things deteriorate with age, they shrink, crack etc. and then you have all the problems with water. I would like to have a room that is very clean and dedicated to bathing, not bring the bathing to the rest of the house’

‘What is good is to learn from the past… the idea of having the toilet with a small basin in a separate room… and then another room with all the bathing and pampering.’

‘I don’t use the bathtub anymore – because I’ve got arthritic knees and I can just about get in the bathtub – it’s very hard, but to get out is impossible.’

‘Getting up from the toilet is hard too. Toilets are now a bit too low for me. What can I do – my knees don’t bend! But you can’t stop using a toilet’.

‘See if I take a shower I leave the door open as I live here by myself… if I don’t the whole bathroom is completely fogged up, unusable and full of moisture’.

‘I went to Bali once and … the bathtub was like a small pool and the shower was in the middle of the space… light and beautiful flowers everywhere – beautiful. Oh yeah that is definitely the way to live. In this country you concentrate on how to keep it warm and dry.’


Case studies

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Safe & Sensual

A design study aimed at making the bathroom a safer and more relaxing place for everyone by enhancing the experience of showering.

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Watergate: an accessible bath for older people

This project addressed the challenge of designing an accessible bath that can be used easily and safely by older and less able people.

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Indulgent bathing: new narratives for old people in the bathroom

This design study explored what luxury and indulgence in the bathroom might mean for people over the age of 50.

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Indulgent bathing: beauty and ageing in the bathroom

This project put indulgence and luxury at the heart of bathroom design for older people with new concepts for the toilet and shower, basin and mirror.

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