Few phrases cause shivers in the senior living environment more than, “It’s bath time.” And that feeling of dread doesn’t just pertain to residents — it goes for staff members, too, especially when the bathing activity takes place in a public area instead of the privacy of a resident’s quarters.
Although necessary for personal hygiene, assisted bathing carries a heavy stigma for residents, especially the most physically and mentally vulnerable ones. The indignity of being undressed, exposed to cold air and being precariously transferred into the tub can be a severe cause of stress for residents. Likewise, staff are subjected to what is an awkward, uncomfortable and physically demanding process.
But bathing doesn’t have to be that way. With the right approach, environment and products, it can be a pleasant experience for both residents and staff, bathing specialists say.
Hillary Marshall, Joerns Healthcare’s global product manager, patient lifting and repositioning, understands the negative associations with bathing and says they can be minimized with thoughtful and compassionate measures.
“If a resident requires assistance undressing, staff may help with this task in the resident’s room,” she says. “But if the bathing area is not in the resident’s living quarters, the resident may feel uncomfortable wearing a robe or covering when passing through common living areas because it doesn’t provide a level of discretion. Instead, residents can receive the assistance they need in the bathing suite with a sit-to-stand lift, on which caregivers can easily undress and dress the resident in the bathing suite, preserving the resident’s dignity.”
Even residents who don’t normally need assistance transferring may feel nervous when entering and exiting a shower or bathing area, and that anxiety could create a safety hazard in and of itself, Marshall says. When residents are concerned about their safety, dignity or comfort, it can cause anxiety, she notes.
“They can be especially nervous during transfers, so it’s important to reassure them in a comforting tone and keep them at the caregiver’s eye level, or below, as much as possible so they feel secure,” Marshall says. “So it is important to understand residents’ insecurities as well as their physical capabilities. The sling of a sit-to-stand lift fitted around a nervous resident offers the feeling of security and confidence, reassuring the resident, offering greater control and elevating the dignity level.”
A sit-to-stand resident handling lift may be a solution for residents who have some trunk control and weight-bearing ability, Marshall says. Sit-to-stand lifts safely raise residents from a sitting position to a standing position on the lift’s foot pad. The lift then can be repositioned near a shower chair or other seat, and it then can lower the resident. Because sit-to-stand lifts are active lifts — meaning the resident actively participates in their usage — they can encourage or prolong mobility and independence in performing activities of daily living.
“In a bathing environment, safety issues are often related to the abundance of wet surfaces, as these slick surfaces could cause the resident to slip and fall and sustain injury,” Marshall says.
To be sure, “the right bathing solution makes all the difference for the safety and wellbeing of senior residents,” adds Greg Wells, director of marketing and communications for Bestbath. “The residents have various abilities, and this should be taken into account to provide the appropriate bathing solution,” he says.
Gary Nowitz, president of Pressalit North America, notes that considerable attention should be given to residents with special needs — those who are profoundly disabled — including quadriplegics and people suffering from severe degenerative diseases.
“While these individuals are not generally bathed in a conventional tub, they do require regular bath- ing and share many of the same worries and concerns as do typical elderly residents,” he says. “Height-adjustable, wall-mounted nursing benches have come into vogue as an ideal means of addressing the bathing requirements of people with profound disabilities.”
From pain to pleasure
Under the right circumstances, residents can learn to love bathing, finding it a relaxing and soothing experience. The key to making bathing more desirable, says David Anderson, national sales manager for Apollo Bath, is to let bath time be the resident’s idea.
“Don’t force the issue,” he says. “Provide the bath at the time that the resident would normally bathe. If the resident is used to a shower and you are introducing them to a tub bath, give them a shower in the bath the first two times so they get used to it. Once they are familiar with the bathing system, add water and then engage the whirlpool to give them a nice, relaxing spa bath.” Penner Patient Care advises facilities on how to design the optimal bathing area. President Lee Penner says with the right amenities it can turn into a marketing tool. For instance, changing the color from a bright white to a low-key dark tone instantly transforms the area from institutional to a resort-style spa. “Color is very important,” he says. “We offer 21 colors in granite to match the décor.”
Taking the resident’s mind off the stressful aspects is another way to encourage relaxation and enjoyment, Penner adds.
“TVs are a great way to increase the enjoyment of the bath,” he says. “Some facilities put together 15-minute DVDs of the resident’s life, which definitely takes the attention away from the bath and toward the screen.”