Planning a bathroom routine with a disability

Before any planning can be done, a proper assessment of the bathroom tasks needs to be completed.

The bathroom routine will vary depending on the individual’s preferences, but also their mobility level. Tasks will be broken down into small actions, such as cleaning teeth, washing face, using the toilet, drying off after bathing and so on. The more the tasks are broken down, the more planning that can be done to enable each of these. Each tasks will have different motor skills and muscle strength to execute.

 

In order to understand the tasks, the OT may wish to do a live run through with their client and note these down. Their family or carer may be involved as well to explore what activities they will need to assist with.

During home assessments (there may be multiple visits in some cases), the OT will meet with the client and their family, and start to develop the daily and weekly plan. They’ll likely take photos of the space, measure up spaces, doorway and distances. The OT will create many notes that they later go through and tidy up into a report and ultimately a plan. 

The OTs will often do multiple home assessments in a day when it’s busy, so the demand on creating clear organised notes is high. 

 

Each bathroom is different in its dimensions and layouts, so getting an accurate set of specifications will be really important when determining which solution is best for their needs. 

The schedule is something that provides a sense of control and reliability for families navigating a mobility impairment. A schedule usually pertains to the morning and night routines – other trips to the bathrooms are less dependendable, although even these may start to present as patterns for carers.

The schedule for bathroom use isn’t only useful for the individual to have confidence in their day routine, but also helps the rest of the household plan their own bathroom use accordingly. It’s understandable that a mobility impaired person’s bathroom routine may take longer than others in the household, so scheduling this at a time where the other family members aren’t left having to rush is optimal. The OT and family will often work together to agree on a time that works best for the mobility impaired individual and the rest of the household.

An occupational therapist is a crucial part of a successful bathroom plan. Their expertise is in helping mobility impaired people find ways to enjoy and perform everyday tasks.

One of the biggest concerns of mobility impaired individuals and their immediate family is the interactions during bathroom use. There’s no denying that showering and toileting are intensely private moments in the day, and the introduction of family members or carers to the equation here can be a real hurdle for many.

If the individual with the mobility impairment has the communication ability to have direct involvement in the development of their daily care plans, it’s important to allow them to lead the discussion and decision making process. One of the biggest considerations here is that of the involvement of families. Some individuals are happy to rely upon family members for bathroom use, whilst others prefer a professional carer that has no other relationship with them beyond support. It’s not uncommon for individuals to receiver a combination of family member and professional support across the week, providing family members with a reprieve for some days (or times in the day).

 

Ultimately the combination of outside care and family will come down to the preferences of the individual, the willingness of family to support with the bathroom and what’s actually safest for everyone – there are instances in which family members are willing but not physically able to provide support like lifting.

Beyond the support received from another person, its the equipment used to support a mobility impaired person in the bathroom that can make a huge difference in their enjoyment.

In fact, ‘independence’ as an objective of the bathroom routine is heavily dependent on the quality of the support equipment available. The occupational therapist will work with families to find the combination of equipment that will best support bathroom use. Sometimes this will be equipment in the form of permanent fixtures that need to be installed. The drawback of such equipment is that any member of the household will need to work around it – ramps, hoists, grab bars and affixed chairs.

 

A preferable alternative that many OTs are starting to opt for is the Showerbuddy transfer system range – professional grade equipment that offers all the support for toileting, showering and transfers without making any destructive modification to the bathroom. For bathrooms with a bathtub or shower with an edge, the transfer range provides a bridge across the edge which the seated user can be shifted across into an in-shower base. This can be removed if needed and switched into a different bathroom – something a permanent installation can not provide.