In a bid to boost resident satisfaction and stay competitive, seniors housing operators are focusing more attention on resident bathing. But creating aesthetically pleasing, spa-like bathing areas isn’t their only priority. Safety for residents and staff during lifting and transferring to and from bathing areas is paramount, as is ensuring that health and safety risks are minimized throughout the entire bathing process.
This safety-first approach is prudent, especially considering more injuries occur during lifting, handling and transferring than any other resident care activity. According to Bureau of Labor statistics, heavy lifting contributes to more than 200,000 occupational injuries each year, most of which affect nursing aides, orderlies and other frontline caregivers. When lifts and transfers are combined with bathing — and the slick, wet surfaces that accompany it — the risks become even greater. In fact, bathing areas are where most musculoskeletal and head injuries typically occur in every home environment, the Centers for Disease Control and Prevention reports.
A growing array of innovative equipment and solutions is helping assisted living operators better manage those risks, while significantly improving the overall lifting, transferring and bathing experience for residents and staff alike.
“Quite simply, the technology is better and the market has demanded that bathing and lift systems evolve with the times,” says David Anderson, national sales manager for Apollo Bath.
Lighten the load
As more assisted living residents require assistance before, during and after bathing, having the right equipment available (and readily accessible) is imperative. More than ever, safety lies in the details, notes Derek Newbould, associate business manager for Invacare Continuing Care.
With lifts, new-and-improved features are making facilities take notice. “New lift safety features include anti-entrapment sensors, which automatically stop the lift if it meets any resistance while it’s being lowered,” Newbould says. Emergency up-and-down functions are another added safety feature, he adds, as are wider base openings that accommodate wider wheelchairs and make lifts more versatile.
Whenever possible, the best way to minimize risks is to avoid transfers altogether. In assisted living, where some residents prefer a beauty shop approach to shampooing, adjustable sinks can allow many non-ambulatory residents to stay in their wheelchairs while their hair is washed. “Because the number of transfers is reduced, the opportunity for transfer- and lifting-related work injuries for facility staff is also reduced,” says Dave Shusterich, president of Accessible Systems LLC, referring to the benefits of the company’s Adjust-a-Sink adjustable height shampoo bowl.
Adjustability extends to other bathing fixtures, as well. With bathing areas often cramped, especially when wheelchairs or lift equipment are present, having sinks and other bathroom fixtures that can be adjusted for each resident’s needs can make maneuvering and bathing simpler and safer, says Gary Nowitz, president, North America, of Pressalit Care Inc.
“Adjustability allows you to cost-effectively customize a bathroom set-up to each resident’s unique needs,” Nowitz says. Pressalit Care’s flexible bathroom design system is built upon a system of horizontal and vertical aluminum wall tracks that allow bathroom fixtures to be easily height-adjusted and repositioned. They also allow support arms, shower chairs and other aids to be added or removed without the need for tools. Not only does fixture flexibility enhance resident independence and simplify care processes for staff, it allows bathing areas to be adapted in connection with progressive illness or for different users.
To further enhance resident independence, Pressalit Care’s Matrix line of sinks and washbasins can be raised or lowered to standing- or wheelchair-height, and moved side to side, as needed. “They also have integrated grab bar, so a person can easily grab on and steady themselves with one hand, while washing with the other,” Nowitz continues. For European-style wet room spaces, residents can be placed on shower seats attached to the wall track and then safely moved directly to the shower area. Adjustable shower seats feature high shower chair backs and independently adjustable arm rests that can be safely lifted out of the way when not in use.
Some facilities are installing ceiling lifts in bathing areas, which can reduce transfer and overall bathing times. They also eliminate the need for hunting down mobile lifts — a headache that sometimes leads caregivers to cut corners and attempt the dangerous task of manually lifting and transferring residents.
Some resident care products also can pull double-duty, making them more cost-effective and user-friendly. The EHOB WAFFLE Mattress Overlay, for example, is a pressure redistribution product with built-in hand wells that make it easier for staff to transfer and position residents who need more assistance. The product, which costs a healthcare facility roughly $30 and is designed to be discharged with the resident to and from other care settings, allows staff members to grab the hand wells to safely “log roll” the resident on his or her side if a bed bath is needed. Once the resident is positioned on the side, a wedge can be placed to lend additional support while bathing takes place.
Caregivers may also use the WAFFLE product to safely pull up residents and transfer them to a wheelchair or bedside chair. “This mattress lives under the patient, so there’s no need to go looking for lifting equipment that’s located down the hallway in another part of the facility,” says Kurt Vetters, VP of corporate accounts for EHOB Inc. The resident can be transferred with their own WAFFLE to the bathing area. When accompanied by a gait belt and an appropriate shower chair, this process allows for easier positioning and transferring during and after the bath or shower. “The material can be dried easily and the WAFFLE then goes with the patient back to their room,” Vetters explains.
Baths get a boost
Today, assisted living operators have access to innovative, feature-rich bathing units that emphasize resident and employee safety. Easy access, side-entry baths with built-in transfer devices are just one example. In the past, getting residents into the bath required a separate piece of equipment that lifted them up and over the sides of the bathing unit.
“Today, we offer spas with integrated transfer systems that [negate the need] for independent transfers,” says Lee Penner, owner of Penner Patient Care. To further enhance resident and staff safety, the integrated transfer systems on Penner Manufacturing’s bathing units transfer residents in and out of the spa at wheelchair-height.
Temperature control is easier than ever, too. “Virtually every bathing system on the market comes equipped with thermoscopic/thermostatic mixing valves to ensure residents will not be subjected to water that’s too hot,” assures Anderson of Apollo Bath.
Enhanced infection control and prevention is another key benefit of many bathing systems today. Backflow preventers that reduce the likelihood of water entering the air line when the air blower is turned off aid the process, as do smaller-diameter air lines that allow disinfectants, fresh water and air to do their job better by making greater contact with the surfaces of the lines, Penner explains.
Pipeless baths powered by pipeless jets also make disinfection a snap, Newbould says. Invacare’s TheraPure tubs meet demanding hospital-grade requirements of NSF International’s Protocol P182, allowing removal of up to 99.9% of bacteria after each bath, he says. For added safety, TheraPure tub seats “are positioned at wheelchair height to make transfers easy from both wheelchairs and lifts.”
Integrated cleaning and disinfection systems that automatically flush whirlpool and air spa lines also are prevalent. Apollo offers a germicidal ultraviolet system with its whirlpool bathing systems, exposing cycling bath water to UV light. [Editor’s note: Even with the presence of a UV system, bathing units must be thoroughly cleaned and disinfected after each use.]
Comfort and convenience count, too. Units with autofill features and water reservoirs that keep water warm and ready for the next resident can further shave valuable minutes off each bath, assures Penner. “This is all part of making the bathing areas more comfortable and homelike, and less institutional,” he says. “When bathing is something that residents look forward to, that makes giving a bath more positive and efficient for the caregiver.”