Bathrooms
age, it also has added symptoms of fatigue and often a feeling of general malaise.
The specific challenges of arthritis Due to the nature of arthritis, movement can be a challenge for those living with the condition and this is likely to worsen with age. Therefore, it stands to reason that with the ageing nature of care home populations across the UK, demand for bathrooms that support the comfort, safety and independence of users with arthritis or an MSK condition are on the rise. So, what are the main challenges that
bathroom adaptations must accommodate when it comes to arthritis and MSK conditions? When arthritis is mentioned, most will think of inflammation and painful joints in knees, hips and hands, and also of stiffness and a reduced range of movement, as these tend to be the most visible symptoms. However, balance and coordination, fine motor skills, muscle weakness and weight-bearing movements can be impacted too. Also, those living with arthritis and MSK conditions are likely to live with persistent pain. The functional impact of these symptoms
means that residents with these conditions will often have difficulty standing up or sitting down, trouble gripping taps or handles and problems getting in or out of baths and showers. They will also have an increased likelihood of falls and experience a loss of independence when it comes to personal care. This last point is important, as research shows that when residents
are encouraged to do what they can, they maintain a better mood, have higher energy levels and, not surprisingly, experience reduced frustration.
Adapting to suit general arthritis needs Although it can be difficult in a care home setting to implement user- specific adaptations, there are a range of recommendations that will benefit most residents. Also, sensitive bathroom adaptations can be life changing for those living with arthritis – and many of these
1. Talk to people living in the home to identify their usual habits in the bathroom and at what times of day they use it, alongside their access needs.
10-point accessible bathroom tick list resident is never going to use.
2. Keep the room layout logical for users and ensure everyday objects are positioned at waist height, within easy reach and where possible, where they can expect to find them.
3. Consider designing the space with seating or resting areas to support functioning while seated.
4. Future-proof the environment to support people with a degenerative condition.
5. Keep it simple – there is no point bringing in an adaptation that the
6. Products featuring automated operation will reduce bending and stretching by users and can still be used by carers as needed (e.g. a remote controlled care shower).
7. Remove clutter such as unnecessary items of furniture which may become an obstacle, and bath mats or trailing wires to reduce the risk of trips and falls.
8. Design the space with both short-term solutions and long-term changes in mind if possible.
9. Prioritise user confidence in the environment to encourage engagement and independence.
10. Be flexible and use available established knowledge resources if necessary.
changes are very straightforward. Although there are different types of
arthritis, including spondyloarthritis, ankylosing spondylitis, psoriatic arthritis and gout and calcium crystal diseases, there are key adaptations that can be made to support the wide range of needs of those living with arthritis and other MSK conditions. And thoughtful design, product specification and installation can transform a resident’s bathroom use experience. Let’s take a moment to look at the main
bathroom barriers for residents living with arthritis (see infographic). Generally, these involve a person having limited support surfaces and a need for excessive reaching, gripping or bending because of the layout of the space and placement of facilities. Where controls and fixtures are placed can make them inaccessible to people with muscle weakness or reach issues - which is not helped by the poor ergonomic design of many features used to operate facilities such as taps, flushes and showers. Also, if the flooring and placement of piping and radiators aren’t thought through, these can lead to an unnecessary increased risk of slips, trips or falls.
Clinical recommendations to overcome the challenges So, what can be done to make care home bathrooms safer and as easy to use as possible for those living with arthritis and other MSK conditions? Here are the key clinical recommendations from leading occupational therapists and Arthritis UK:
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