As we age, falls become more and more likely. Our balance, vision, and sensation decrease which leads to an increased risk of falling.
And one-third of these falls occur in the bathroom with bathroom falls being twice as likely to result in an injury.
In the living room, a fall may be onto a carpeted floor or near a soft chair. But in the bathroom, there are many hard and sharp surfaces that an older adult could land on: toilets, counters, tubs, sinks, and more.
The average person uses the bathroom 6-7 times per day, and that number may be higher for older adults with incontinence or urgency. That also doesn't include the times we go in to bathe, brush our teeth, style our hair, or just wash our hands.
A bathroom is one of the most frequented areas of the home we all use daily and unfortunately also a place we are most likely to experience a fall. Put those together and the bathroom is the first place we recommend you evaluate for fall risk.
Implementing Fall Prevention Strategies
The good news though is that implementing home modifications can greatly reduce the risk of falls in the bathroom. In fact, more than 20-30% of falls are preventable.
By making bathroom safety a priority and using fall prevention strategies you can support aging at home for you or your loved one.
That's why The Americans with Disabilities Act (ADA) has developed a set of standards for the height of certain surfaces within the bathroom to accommodate a variety of needs.
These needs can include leg weakness, balance, and wheelchair accessibility, which are important factors as we consider the ways to prevent falls.
To minimize falls and support aging at home, it is important to consider a few key areas of the bathroom:
- Shower safety
- Toilet seat height
- ADA sink height
- Having a wheelchair accessible bathroom
Shower safety is often a concern for everyone - regardless of age. The ground is slippery and the surfaces are hard. For many of us, it’s easy to understand why older adults can become increasingly fearful of showering and resort to only bathing at the sink.
However, there are some fall prevention strategies that can be put into place to reduce the risk of falls and allow older adults to shower with confidence. These strategies include:
- Using a shower chair or tub transfer bench
- Installing grab bars
- Using a nonslip bathmat or nonslip shower strips
- Improve lighting within the shower
- Install a hand-held or adjustable height shower head
Depending on your home shower, many different shower chairs are available. These include shower chairs with back support, armrests, and padding. There are also tub transfer benches that are placed over the tub threshold so that you or your aging parent do not have to step over the tub.
And if more positioning features are needed, there are specialized shower chairs that can provide side body supports, head support, seat belts, tilt in space, and much more. Often these specialized chairs will need to be rolled directly into the shower and will require modifications of the home shower to remove the threshold.
Or you can consider installing grab bars.
Grab bars are number one on the list of fall prevention strategies for showers - due to their effectiveness of supporting better control and balance. However, knowing where to properly place grab bars can be difficult.
We always recommend that you have a home safety expert to access the shower and make suggestions about grab bar placement. If done incorrectly, grab bar installation can actually be counterproductive - leading to a greater fall risk.
Shower safety is essential not only for independence but also for peace of mind. If you or your loved one are at risk of falling, consider making some changes to the shower to support aging in place - and get in contact with Jukebox Health. Our clinical team would be happy to assist you in grab bar installation.
Toilet Seat Height
Getting up from the toilet gets harder as we age (and that is not a place we want to need help). The simple change of raising the toilet seat height can increase independence, allowing many older adults to toilet without fear or risk of falling.
The ADA recommends the toilet seat height be at least 17 to 19 inches to accommodate wheelchair access. However, if leg weakness is an issue, but you or your aging parent are still able to ambulate, then a higher toilet seat height may be appropriate for fall prevention. If you think wheelchair access may be needed in the future, consider an elevated toilet seat or bedside commode placed over the toilet so that it can be easily removed if mobility needs change.
ADA Sink Height
Accessing the bathroom sink is important for washing your hands, brushing your teeth, shaving your face, and so much more. Not being able to access the sink can decrease an older adult’s independence throughout the entire day.
To improve this aspect of the bathroom, the ADA sink height recommendations are:
- Make sure the top of the sink is no higher than 34 inches
- Ensure that knee clearance under the sink or counter is at least 27 inches high, 30 inches wide, and 19 inches deep
If a wheelchair is safer for fall prevention, cabinets under the sink can limit wheelchair access significantly. Installing a pedestal sink or wall-mounted sink can also allow an older adult to age in place when mobility becomes difficult or exhausting.
Wheelchair Accessible Bathroom
Along with the shower, toilet height, and ADA sink height, it is essential to assess the overall accessibility of the bathroom. If you cannot enter the bathroom in the first place, nothing else will matter.
When mobility becomes difficult and a wheelchair is the best option for fall prevention, having a wheelchair accessible bathroom can make all the difference.
Here are some things to consider when assessing your bathroom accessibility:
- Entryways: The ADA recommends at least 32-inch door openings. This should be measured from the narrowest points, which is likely from the inside of an open door to the opposite door frame (not door frame to door frame).
- Inside spaces: Once inside the bathroom, consider if a wheelchair can navigate within the room. The ADA recommends at least 30 inches by 48 inches of clear floor or ground space. Also take into consideration any cabinets, shelves, rugs, or toilet paper holders that might get in the way of a wheelchair.
The Importance of Fall Prevention in the Bathroom
Lastly, it's important to note that fall prevention must occur before the fall occurs. Being proactive about implementing fall prevention strategies can mean the difference between successfully aging at home and needing significant care.
Depending on your or your loved one's individual needs, some or all of these adaptations may be important for fall prevention. If you need help deciding which would be most beneficial, give Jukebox Health a call.