Welcome to Bringing Parents Home. We are here to help you with the transition of bringing your elderly parents into your home.
A resource for caregivers & families
Home Improvement

Bathroom Preparation

Bathroom doorknob vs. lever: the first consideration in safety is the ease of the elderly parent getting in and out of any room, and using a lever vs. a knob to open the door is one small but very important change you can make. It’s easy to change out a doorknob for a lever; normally a Phillips screwdriver is the only tool needed. Please refer to our DIY section for helpful tips.

A remote door opener is extremely helpful when your parent uses a cane, crutches, walker or wheelchair and is easy to install. Backing up to an open a door is very dangerous. A remote door opener gives your parent freedom, independence, privacy and safety.

To learn more about uControll door openers, visit our products section.

A vanity base bathroom sink
 makes getting close to the sink for washing and other care needs a hardship.

Removing the vanity and installing an ADA (American Disability Act) approved sink will allow access to the sink from a wheelchair or sitting on a walker. From a sitting position, it is helpful to tip the vanity mirror forward by as little as 5-10 degrees. Please review our DIY section for tips on doing this.

On any sink, using a single lever faucet will make turning on the water easy and selecting the correct temperature safe.

The new automatic water faucets are a great invention for the bathroom. The cost can be as low as $50.00 for a faucet adapter, to $100.00 and up for a complete auto-sensing faucet. The installation can easily be done by a home handyman. These faucets will turn on as soon as hands are placed under the faucet.

One of the benefits is that the temperature is pre-set so there is no need for adjusting to keep the temperature safe. However, if your hot water line takes time to get the hot water to the faucet there will be the usual delay in obtaining warm water.

Many times a simple drain plug (with or without a chain) will do a much better job at holding water than the built in drain plugs. Plus it may be easier to use than the built in raising rods by the elderly. Oftentimes the built in drain plug systems will collect hair and other particles, causing a slow drain.

Especially important in the bathroom is the placement of frequent and convenient handrails. Be careful not to confuse handrails with bath towel rods. Safety is very important in the bathroom; there is so much activity in such a small space that it is easy to overlook the types of activity, and the position of handrails to make the activities safe and easy to stand, sit, get back up, move/spin around without losing balance. It’s not aesthetically pleasing, but the more handrails, the safer.

Simply do a walk-through of the bathroom and imagine limited activity and where you would need an extra support or assistance to sit down, get up and especially move safely in a wet area. Mounting handrails to be a sturdy and safe support is extremely important. Please read the included instructions by the handrail manufacturers. You may want to look at our review of the various types of anchors available in our “How To” section.

We think the larger and fluffier the towels, the better. But when you are aging, weight and size of a towel can be a hindrance and a hazard. It’s hard to lift your arms up and over your head. A heavy towel will require a lot of energy to use. If you have to steady yourself while standing, you only have one hand to use in drying yourself off. While looking for lightweight quick drying towels, consider the lightweight towels back packers use. They are lightweight, absorb a lot of moisture for their weight, and are quick to dry.

A conventional toilet seat can be a dangerous situation. Using an elevated seat with side railings will provide a convenient and safe situation. Transporting from a wheelchair will require a seat height that matches the wheelchair. Having convenient handrails for transferring are critical in maintaining a safe situation.

Another necessity is convenient access to toilet paper. The toilet paper holder needs to be easy to reach without stretching or bending. Also, as the situation may warrant, you will need space for a caregiver to assist with transfers and cleaning. Bathing can be an especially hazardous situation. There are a number of considerations to take into account in regards to providing a safe and easy to use environment.

Based on the activity level today and what may transpire in months to come, what starts out as an easy to use transfer seat in a conventional tub may over time evolve into the need for a roll in chair shower situation. Walk in tubs are very well promoted on TV, but in an assisted living environment they are difficult to use based on the height of the opening, the need of the patient to be mobile and the length of time it takes to fill and drain.

With any bathing needs, it is very difficult for a caregiver to assist in any way. In most bath situations, direct observation is the best safeguard. However, most patients want privacy in bathing, so it is extremely important to have fall prevention aids and a fall or safety alarm to signal for help. You can use a wireless doorbell for an inexpensive call button. Simply inserting it in a plastic bag and hanging where it is easy to reach is a help to you and your parent.

Kleenex or similar disposable towels are a nice adjunct to normal hand towels. Another nice to have product are flushable, single use moist towels. Frequently there may be a need for more hygiene cleaning, and using disposable items is more convenient for both caregiver and patient.

For ambulatory parents, constipation is a frequent side effect of the medications used and plugging the toilet is often a side effect, so it is important to have a good toilet plunger available and easy to use. One caution is the embarrassment the parent may feel when/if this happens; they will wear themselves out trying to clear the plugged toilet. Depending on the condition of the parent, the energy used to clear a plugged toilet could cause fatigue and create a very unsafe condition. So monitoring the parent is required.

Controlling the ambient temperature in a bathroom is more critical than you can imagine. Due to many of the elderly illnesses, parents can have a difficult time in regulating their body temperature. They are more aware of and affected by drafts and temperature. Having a heater in a bathroom to warm up the temperature sounds like a nice idea, but the draft / breeze will actually cool the parent off and create a much more difficult situation.

Easy and convenient access to toiletries is extremely important in avoiding hazardous and unsafe conditions. Bending over can be unsafe if there are any middle ear or balance issues. Additionally, not being able to find care products (medications, face and hand towels, toothbrush, soap, water pick, etc.) when needed is stressful and frustrating. If you can install shelving, use upper drawers and towel bars close to the sink and bathing area; it is a lot more convenient and safe.

Additional bathroom items that need to be addressed are easy and safe (stable) access to a trash can and scale for weight checking. In order to have convenient and safe scale use there needs to be stable support for standing that will not interfere with accurate weighing.

There are a number of consumer toilet rails that attach directly to the existing toilet using the toilet seat screws. Using toilet rails is very helpful as long as your parent does not use a wheelchair and / or is able to self-transfer. These toilet rails also have a support that rests on the front of the toilet and in a few months will start to rust, as they are not totally covered by most toilet seats. Look for the best construction you can find, as a poorly constructed set of rails will feel lose and unsafe.

In addition to safe and convenient access to a solid toilet paper holder, you may also need access to flushable wipes. Flushable wipes are very helpful in cleaning and feeling clean. Since they are usually in a closed pop up container, a shelf or other horizontal surface within safe and easy reach of the toilet is a must. Access to water, like a small showerhead or some means of washing away solids sticking to the body, is very helpful as the condition of your parent deteriorates.

You will also need space to work at the toilet, so toilet rails that detach or swing away are very helpful for situations like this. There are also “Bidet” type retrofit toilet seats that may be convenient for situations like this. During cleaning, brushing teeth, and other functions, frequently both hands are needed and it’s really helpful to be able to sit at the sink during these activities. Most often, the rolling walkers have an integrated seat, but it is necessary to rotate the walker or the parent 180 degrees. This is a difficult and potentially unsafe situation. If there is any option, put a sturdy seat in front of the sink or other options make it safer and easier for your parent.

Lighting in any room and especially the bathroom is helpful in performing tasks.

Controlling odors in the bathroom is also helpful for everyone. A functioning celling fan is helpful, but again this may induce a breeze. Using small and frequently changed garbage cans, quickly scrubbing / cleaning soiled surfaces and cleaning the floor will do a lot to provide a clean / fresh environment. Also using a Baby Diaper hamper will help to store soiled disposable items in an odor tight and visually pleasing canister.

Flooring in the bathroom should never involve a rug. The incidence of falls is greatly increased with any loose flooring material. Cleaning and odor control is greatly improved with a solid, no seamed (vinyl) flooring material. A tile floor needs to have a high resistance to being slippery when wet. Ceramic tile is rated with a coefficient of friction (COF) value that indicates, “Slippery when wet”.

For safety, choose tile rated at .50 COF or greater.

For bathrobes, as we discussed in choosing a good towel, the material and weight are very important considerations. Weight and absorbency are 2 of the 3 considerations.

Equally important is easy on and off with limited mobility. If you are using a conventional bathtub, you will need to look at a transfer seat or shower chair. Remember, as your parent’s condition changes you will have to create or modify to have a safe environment. A sturdy seat will be one of the best investments you can make. Bathtub railings can appear to be a help, but take a close look at the room / space they take up in transferring. Make sure to shop for the best fit of both size and security.

Of special note: If you have a sliding door tub enclosure, the bottom rail and solid ½ wall will make it very difficult to use for transferring. Shower curtains and rods should be carefully chosen. The curtain may, in an emergency, be used for support. They may need to be quickly moved. A clear curtain may help in observing and monitoring for safety. The newer shower curtain rods that bow out are helpful in creating a more spacious environment within the tub area, but they do take up extra space in the walking and working area of the bathroom. A new invention is a bow rod you can flip into the tub area when not in use, thus giving you back the walkway space.

Joan Shelley, AGPCNP-BC, a Marquette Graduate, ANCC Board Certified in Adult and Geriatric Primary Care, has joined Dr Fitzgerald at Lake Country Private Medical as a health care provider and is currently accepting new patients. Adding to years of Critical Care, Joan has over 23 yrs experience in the Oconomowoc area with home care and hospice patients. She is excited to be able to provide in clinic as well as home visits.