How to Organize a Bath Safety Remodel

Bath safety is a key element of home access. Simply put, patients of all sorts need to use the bathroom throughout the day. But for bariatric, geriatric and mobility patients, bathing can pose both frustration and safety hazards.

For instance, stepping into a shower stall or tub poses the risk of falls for geriatric and bariatric patients, and for mobility patients, bathing comes with even more complications due to their mobility limitations. And if bathing complications result in reduced frequency of bathing, this can mean that a patient risks hygiene issues that can cause sores and infections. This is especially a concern with bariatric patients, who are sometimes left with sponge baths as their only real bathing options.

Fortunately, HME providers are in a position to help. There is a multiplicity of bath safety offerings available to help them ensure patients of all stripes are able to bathe safely. The key is to get started, and that’s often the hardest part. What should providers consider when remodeling a bathroom to ensure safety?

Patient needs. The first thing is to consider the patient’s needs, and that varies in terms of disability. For geriatric and bariatric patients, a primary concern is falls. Older and overweight patients can suffer severe injuries from a fall; bariatric patients because of their weight and geriatric patients because of their age. So strategically placed grab bars and rails are important, as well as bathing benches or chairs and non-skid surfaces for the shower or tub.

Moreover, bariatric patients run additional risks from average bathroom fixtures catastrophically failing on them, since those fixtures cannot support the patient’s weight. Fixtures such as sinks and toilets must be built to support bariatric patients’ weight.

For patients with mobility limitations, providing ample room for maneuvering and performing bathroom tasks is important, but can be difficult to accommodate given the cramped size of most average bathrooms. Patients might be fully capable of performing all their bathroom tasks on their own, as long as they have freedom of movement. When it comes to bathing, patients might require special shower chairs or transfer chairs that let them transition from their regular wheelchair into the shower.

Tier the solutions. A safety remodel can range from adding some key pieces of DME to completely enlarging the room, and everything in between. A complete bathroom remodel can range between $15,000 and $30,000 on average. However, it might not be necessary. Simple fixes that increase maneuvering space as well as safety might include removing  cupboards or installing pedestal or hanging sinks. That said, if the bathroom is too cramped, it will need expansion. Other modifications include moving the toilet and removing the tub and installing a roll-in shower, which requires a change in drainage system and other plumbing modifications.

Which bathroom? A central question is which bathroom will be upgraded to accommodate the patient’s needs. This requires a look the entire household’s needs and daily activities, not just the patient’s, to see which room is best. Often a patient might, for various reasons, live in a two story home even though the patient might not be able to easily negotiate the stairs. As a result, a common bath safety remodeling projects is to covert a downstairs room into a bedroom, and to have a downstairs half bathroom converted into a full bath.

Relocating just the shower. Another option is to relocate the shower to another part of the house. If, for instance a patient cannot afford a full bathroom remodel, or lives in a rental, a portable shower might be a good option. A fold-away wheelchair shower, which can be used by not mobility and bariatric patients, provides them with a safe, private place to bathe themselves, or with a caregiver’s help.

Find the right partners. Since HME providers typically do not employ certified and licensed plumbers, electricians and contractors, they need to create relationships with the experts. In fact, some of these experts might be very familiar with bath safety remodels for homecare patients.

The National Association of Home Builders offers a Certified Aging in Place Specialist (CAPS) designation for builders who specialize in these types of modifications. The certification ensures that those contractors understand bath safety needs and organize the work in such a way as to minimize disruption for patients.

The certification also helps ensure that homecare remodel increases safety and access without negatively impacting home value, as well. CAPS contractors take a three-day course that teaches them how to effectively communicate with patients and providers to understand and accommodate needs. These contractors will be key partners for any provider offering bath safety remodels, and will most likely be a source of information and insights, as well.

Points to take away:

  • Bath safety is an important consideration for a wide variety of homecare patients. Fortunately, there are an equally large number of solutions.
  • Patients’ bath safety needs can vary greatly, depending on the type of patient. Ensure every aspect of the remodel accommodates those needs.
  • Bath safety starts at grab rails and goes all the way to room remodels costing thousands of dollars. Ensure your options cover the spectrum.
  • A remodel might include expanding an existing bathroom or relocating the room altogether.
  • Ensure you partner with contractors who understand and can work within homecare needs.

Learn More

The National Association of Home Builders offers a Certified Aging in Place Specialist (CAPS) designation for builders who specialize in home accessibility modifications. CAPS-certified contractors could be important partners in your efforts to help ensure bath safety for bariatric, geriatric, mobility and other patients. To learn more about the certification, and to find a directory of professionals who hold the CAPS certification, visit the CAPS web site at


This article originally appeared in the July 2009 issue of HME Business.

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