Bathrooms
Inclusive bathrooms for today’s needs
Inclusive bathrooms in care homes need to be easily accessible for a wide range of resident needs. Here, Thomas Davies, retirement and care director at AKW, discusses the latest occupational therapy advice on inclusive bathrooms, with a particular focus on those suited to aid stroke rehabilitation and those with visual impairments
According to the Stroke Association, there are 1.3 million stroke survivors in the UK and this number looks set to double in the next 20 years. Survival rates are on the up thanks to treatment improvements, and it is estimated that 12 per cent of stroke survivors are discharged from hospital into care homes. The level of disability amongst these new care home residents is high and this has significant care implications. With increasing age one of the strongest predictors for discharge to care homes – and strokes being more likely in those over the age of 75 – it is no wonder that more and more care homes are dealing with residents with this life-changing condition. The long-term consequences of strokes can be many and varied. They range from the physical, such as arm or leg weakness, visual problems, or other issues such as swallowing and loss of bladder control, to social and psychological issues. However, worrying research has revealed that stroke survivors entering nursing or residential homes can miss out on crucial rehabilitation and the Stroke Association has warned that they are being “written off”. As a result, the charity is urging those who plan and provide care to take action to ensure the individual needs of stroke survivors are properly met.
Although there are different types of strokes, damage to the central nervous system always occurs; however, it can be more or less extensive in different people. Some stroke survivors can retain most of their abilities, while others can be significantly cognitively disabled or completely paralysed down one side of their body. However, it is important to remember that stroke itself does not damage the musculoskeletal system, only the brain. Therefore, the goal of
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rehabilitation is to enable the parts of the brain not affected by the stroke to learn the skills that were previously controlled by these now-damaged areas. So, when it comes to rehabilitation, the focus is not on strengthening muscle groups to compensate for weaker limbs – but on retraining the stroke survivor’s brain.
Creating bathrooms that aid stroke rehabilitation
According to a guide written for AKW by Terri Grant, senior lecturer in occupational therapy at the University of Worcester’s Institute of Health and Society: “ … it is essential to remember that there is often the capacity for some positive change for people following stroke. Giving clear, short, and simple instructions as well as the space needed to perform tasks can really help to create improvements. Too much help too early on can prevent that positive change and cause the stroke survivor to become deskilled and lose the ability to do what they have been taught to do
during rehabilitation. Ultimately, it is vital to provide people with the tools to do as many day-to-day activities themselves as possible because the more active they can be, the more activity there is in the brain, which means more blood flow and a greater chance of recovery.”1
According to Terri, one of the most
complex areas for stroke survivors to negotiate is the bathroom. Typical issues for stroke survivors when using the bathroom can include difficulty in transferring on and off the toilet, or getting in and out of baths and showers, as well as altered visual perception and feeling overwhelmed or psychologically confused. However, some simple adaptations to the bathroom can significantly improve the experience of those living with the effects of having a stroke. They can also help support a stroke survivor’s rehabilitation. While each person’s challenges will be different, there are three basic design principles that if implemented, can make this space safer to navigate for those survivors of this condition.
www.thecarehomeenvironment.com July 2024
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