Bariatric Bathing Solutions

 Recognizing the special bath safety needs of obese patients.


Kermit the Frog used to say, “It’s not easy being green.” He knew that the world doesn’t always understand how hard it can be to be different. The same is only too true for very large individuals, or bariatrics, and especially for the morbidly obese. It’s not easy being big.
Obese patients face the indignity every day of trying to fit into spaces designed for the average-sized individual. They also face challenges of falling because of poor balance, maintaining adequate hygiene of areas under skin folds, and complete washing because they can’t reach parts of their own bodies.
Unfortunately, the suppliers of products to meet daily living requirements have not always recognized the special needs of the obese.

Access and Safety Issues
One of the first problems is simply that of access. For example, getting into a bathroom that has a 24” door, as many of them have, can present an obstacle that previously could only be solved by an expensive remodeling job.
And, even if the doorway is large enough, most shower stalls or bathtubs are designed for individuals under approximately 250 pounds. A 36”x36” shower is simply not usable by someone who weighs 300 pounds or more. A standard bathtub at 31 inches wide is out of the question.
Balance is a problem for large patients. Simply wielding 400 or 600 pounds or more on a skeletal structure designed for half or a third of that weight can be frightening, and falling can be catastrophic.
Even if a person can get up without help, he or she still risks injury. In many cases a large individual simply cannot get up without help, and may suffer further injury when others try to assist.
Stepping into a shower stall or a tub, even an oversized one, presents dangers of slipping and falling. Poor balance only exacerbates the problem.
The inability even to reach all parts of their own bodies can make adequate bathing more than just a hygiene issue; it can become a major health issue. Skin folds can hold in body oils and moisture, and can become prime locations for both bacterial and fungal infections. Skin breakdown, UTI’s, and other infections can add to the health risks for all individuals of large size.
Accordingly, many very large individuals find that their only real alternatives for bathing are sponge baths or bed baths. Isn’t it ironic? Bariatric patients, more than almost anyone with disabilities, need thorough washing and drying to ensure that all parts of their large bodies are kept healthy. Yet their size frequently limits them to the least satisfactory practice—sponge baths.

A Self-contained Solution

Happily, there is more and more help for bariatric bathing coming onto the market. Recognizing that many large people cannot stand up to take a shower, portable sit-down shower stalls such as the FAWSsit Fold Away Wheelchair Shower (Model B5000 Bariatric) were designed specifically to meet the needs of large individuals with disabilities.
The FAWSsit is a completely self-contained shower stall that can be set up anywhere there is access to warm water. Access to a bathroom or to a traditional shower or tub is not a requirement. The FAWSsit can be set up in a kitchen or a laundry room, or even in a bedroom which is near a bathroom. By simply attaching the shower sprayer to a regular sink faucet, warm water is supplied to the shower stall. A pump removes waste water and a drain hose takes it down the sink drain.
And, because the unit is designed to allow a wheelchair to roll straight in, there is no need to step over the side of a tub. For those large people who are able to walk, a simple bariatric-sized shower chair placed inside the stall will suffice.
With a portable shower, a caregiver can remain outside the stall, but still reach in to assist with bathing, and ensure that all body areas are reached. Clean skin generally means healthy skin. Slipping and falling are eliminated as risks.

Additional Product Resources

Other devices help to ensure adequate hygiene for the obese. Specially designed shower/commode wheelchairs can accommodate as much as 1000 pounds. With these chairs, in combination with a shower stall, perineal cleaning and washing of both back and front can be accomplished easily, thoroughly and safely.
Support bars that can hold heavy weight are also available, assuming they are properly anchored for the weight they need to support.
Blow-up bed baths are also available, although their function is somewhat limited. While their primary benefit is giving some water immersion, the whole body might not have water flowing over all the hair and skin, as they would with a shower.
Combining available products can solve even the most challenging situations. Even lifts are now an alternative for bathing support. By using an overhead lift, a portable shower can literally be set up around the person — while they are suspended in the lift! The shower is given while the person is still in the sling, then the lift can bring the person back to the bed to be thoroughly dried and dressed—without requiring manual lifting or transferring.
Kermit knows he will always be green, and many large people know they will always be large. Even though life is not easy for either of them, at least big people can now feel better about their hygiene, safety and health. That, along with giving large people a measure of dignity and self-esteem, is cause to celebrate.

This article originally appeared in the November 2008 issue of HME Business.

About the Author

Judith L. Seidmeyer, R.Ph. is president of Care Giver Support Products, LLC, manufacturer of FAWSsit portable wheelchair showers. She can be reached at 877-FAWSSIT.

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