Most of us take bathing for granted. We never think twice about the ease we have in cleaning up each morning. For some wheelchair users and patients with severe mobility limitations, a daily shower might not be a viable option.
The type, nature and severity of a patient’s disability all impact exactly how limited his or her bathing will be. Some of these limitations are rooted in more logistical concerns, but most come down to safety.
One provider that has gained a good deal of familiarity in providing bath safety to wheelchair patients is Gaithersburg, Md.’s Ramp and Roll. Jim Privette, Ramp and Roll’s owner, had been working with companies that did van conversions for 13 years, but a year and half ago he and his wife Gail became increasingly interested in bath safety. After working with patients in wheelchairs for so long, and understanding their home situations, and after learning more about bath safety solutions that could help those patients, Ramp and Roll entered the bath safety arena. Jim Privette shares some key observations:
Safety means dignity. In helping create a safe bathing place for mobility impaired patients, a provider isn’t just preventing an accident, they are letting that patient lead an independent life. “Forget the fact that it’s going to get them clean; it’s the fact that they have a little privacy, a little dignity,” Privette says.
Assess the necessary bathroom modifications. Clients that can use the bathroom on their own will most likely be parapelegics or single or double amputees who can get into the room and swing themselves or transfer themselves as needed using grab bars and similar supports. “They have the upper body strength,” Privette says. But the bathroom has to be large enough for them to move. That often becomes the sticking point as that might well mean modifying the bathroom.
A complete bathroom remodel can range between $15,000 and $30,000, Privette says. Simple fixes might be to remove cupboards or install pedestal or hanging sinks, but often the remodel will require actually enlarging the room. This is because so many bathrooms are so crowded to begin with. 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.
Partner with the pros. Obviously most HME providers do not staff certified and licensed plumbers, electricians and contractors. They need to forge relationships with the right expertise. Fortunately, the National Association of Home Builders offers a designation for builders who specialize in these types of modifications. Moreover that designation is geared toward ensuring that the contractor works to understand and match the solution to the patient need and organize the work in such a way as to minimize disruption. Clearly such contractors are key referral partners for any provider offering bath safety to wheelchair patients.
Relocate only the shower. Some patients are simply unable to get to their bathroom to bathe and for one reason or another (cost, they live in a rental, etc.) are unable to physically move their bathing facilities via a remodel. For many, the last thing they want is the embarrassment of having someone help them to their bathroom to bathe.
One solution for accomplishing that is a portable shower, such as the FAWSsit fold-away wheelchair shower, which provides patients with a private place to bathe on their own. Privette was a fan of the product in June of 2007, when Ramp and Roll began carrying the item, but he didn’t get a complete impression of its value until complications related to a knee surgery he had made it impossible for him to bathe in his upstairs bathroom. “Lo and behold what did I have in my garage?” Privette recalls. “The shower. We set it up in the kitchen and that’s when I got really, really excited about the product.”
Get hands-on experience. Using the equipment, such as Privette’s experience with the FAWSsit, is key in providing knowledgeable service, according to Privette. “If I was going to recommend something to somebody, I’d want to go out and kick the tires,” he says. “Do a little self testing, and make sure those grab bars are going to be what the patient needs.”
Learn from the patients. Another way to seek out referrals, bath safety solutions, and reliable, grassroots feedback from the patients themselves is to visit the Abledata web site, which provides a variety of services and forums for patients. “The disability community is a very tight-knit community,” Privette says. “They’re on the web, they’re blogging, they’re emailing each other; always looking for something that can help them get to the next level.”
Points to take away:
• Providing bath safety also means preserving dignity.
• Assess how greatly the bathroom will need to be modified.
• For major modifications, partner with specialized contractors who understand special needs.
• Considering alternatives that
relocate only the shower.
• Try the products out yourself. Get a feel for them.
• Learn from your patients.