formatted: bullets and 6. showering and bathing · 2014-01-06 · 6.1 equipment: bath step...

6. Showering and Bathing

Equipment in this section:

6.1 Bath step

6.2 Bath board

6.3 Bath seat,

6.4 Swivel bather

6.5 Powered bath lift

6.6 Shower seat‐ drop down padded

6.7 Shower stool

6.8 Shower chair standard

6.9 Shower chair wheeled

6.10 Shower/commode chair

6.11 Shower/commode transit chair

6.12 Self propelling shower chair

6.13 Tilt in space shower chair

Formatted: Bullets andNumbering

General considerations

Weight limits of equipment

Seat height‐ usually 3cm below knee joint. People with arthritis may need higher seat option

Positioning within the room‐ safety and dignity

Ease of use particularly at night

Emptying and cleaning needs

Single use due to risk of cross contamination

Risk of tipping if weight is put on only one arm

Tripping hazard from legs

Need to check frame and seat regularly for cracks

Maintenance‐ prescribers/delivers of equipment need to reinforce with users/carers the need for equipment to be regularly checked‐ particularly aids that may need adjusting or tightening. If user is unable to take on this responsibility an alternative arrangement needs to identified.

Need to agree with person system for replacing consumable parts e.g. ferrules.

Needs of other household members & their ability to remove & re‐fit pieces of equipment

Contoured or shaped baths may not be compatible with standard pieces of equipment

Bathing equipment can increase the height that the user needs to clear for transfers’ e.g. swivel bather

Consider carefully users post operative needs e.g. 90 degree breech for THR

Consideration should be given to energy conservation needs of users. Showering/bathing is a high energy activity.

Equipment should be supplied to meet an individual’s identified clinical needs as opposed to their equipment preferences. Eg. If a person wishes to sit on the bottom of the bath but a board and seat meets their needs we would not provide anything more than a board and seat.

Consider weight limits of existing household equipment e.g. standard WC weight limit is 20 stone

Wheeled bath & shower equipment should not be supplied as an alternative to indoor wheelchairs

6.1 Equipment: Bath step

Description: a freestanding rectangle plastic step with a slip resistant surface for use alongside the bath. Modular models are available which give a selection of height settings.

Dimensions: 5 to 10cm high, 40cm deep, 50cm wide. Max weight 30 stone/190kg

Related policies/Guidance; Living Made Easy factsheets ‐ compatibility of baths with bathing equipment and 'choosing a bath and bath accessories'.

Example Brand names: Savanah, K40 (Langham).

Indicators The person has a high rim bath and/or is of short stature and requires assistance to step into bath/shower safely. There is a considerable difference between the height of the bottom of the bath and the floor outside of it.

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions

All other alternatives have been explored: Alternative

technique Grab rail alone Rehabilitation Risk assessment Carer assessment Increased care package

Poor balance Person is unable to

stand or partially weight bear

Reduced cognitive ability will increase confusion & risk

User environment Trip hazard if left in situ Are additional pieces of

supportive equipment required e.g. grab rail or handle

Progression of condition Transfers Operator ability Functional

change/improvement Impact upon care

package Impact upon other

Risk assess Product familiarisation

completed HSE/MHRA

recommendations

Risk assessment

Prescription goals identified.

Demo/delivery planned

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http://www.dlf.org.uk/factsheets/pdf/Choosing_a_bath_and_bath_accessories.pdf�


equipment Tripping hazard if not

used in correct position Easily moved & stored

Safety Checking of Community Loan Equipment

FI Legislation DESCRIPTION

STANDARD EQUIPMENT ITEMS

N R

Bar Coded

Manufacturer’s Instructions Supplied to User/Carer

Single use Items LOLER PUWER

Comments/ technical instruction

bath step

M C

Y Y

Key: FI ‐ Final Inspection, N – New, R – Recycled, M – Manufacturer, C ‐ Community Equipment Loan Store

6.2 Equipment: Bath board

Description: A plastic or metal board that fits over the bath to create a safe surface to transfer in/out of the bath or seat for showering.

Dimensions; CELS stock a number of styles & sizes. Many of these products have a weight capacity suitable for heavy duty use. Alton has a bariatric model.


Example Brand names: Alton, Medeci, slatted double width

Indicators The person is safe stepping over the side of the bath (with rails to assist if necessary) but needs to sit whilst showering for safety

The person needs to be able to sit over the bath in order to transfer into it safely. The person needs to be able to sit to use the shower safely. The person needs to lower onto a bath seat.


All other alternatives have been explored: Alternative technique Grab rail Strip wash Rehabilitation Risk assessment Carer assessment increased care package

Poor balance & trunk control

Inability to lift legs over bath & lives alone

Unable to straighten their legs at the knee

Poor balance Person is unable to


Suit most bath widths (dependent on model – check bath width)

Reduced hip mobility User environment Are additional pieces of

supportive equipment required e.g. bath seat Progression of condition

Transfers Functional

change/improvement


completed HSE/MHRA

recommendations

Risk assessment


Prescription form completed


Review date





Impact upon care package

Impact upon other equipment

Needs of other household members & their ability to remove & re‐fit




N R

Bar Coded




bath board

M

C Y

Y


6.3 Equipment: Bath seat

Description: A plastic seat surface with four feet, each fitted with suckers that attach it to the bottom of the bath, to provide a sitting surface within the bath from which a person can wash, shower or bath.

Dimension; a variety of styles and sizes are available

Related policies/Guidance: Living Made Easy factsheets ‐ compatibility of baths with bathing equipment and 'choosing a bath and bath accessories'.

Example Brand names: ‐ Medeci, Derby

Indicators The person is unable to get up/down from/to bottom of bath safely. The person needs to have a controlled decent into the bottom of the bath. The person needs to bath regularly due to medical need or incontinence

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions . All other alternatives have been explored: Alternative technique Strip wash Grab rail Risk assessment Carer assessment increased care package

Poor upper body strength

Particularly tall people or those with long legs




Person is unable to stand or partially weight bear

Removable Easy to store Compatible with a variety

of other equipment e.g. bath board, grab rails, over bath shower.

User environment e.g. short baths

Suits most bath widths Reduced hip mobility Progression of condition Transfers Functional


completed HSE/MHRA

recommendations

Risk assessment

Specify bath wide







Excess joint or cardiac pressure



equipment Needs of other household

members & their ability to remove & re‐fit




N R

Bar Coded




bath seat

M C

Y Y


6.4 Equipment: Swivel bather

Description: A rigid perforated moulded plastic seat with arms, it sits on an epoxy coated steel frame which is positioned on the top of the bath. The seat swivels through a mechanism in the frame and can be locked into position by a lever. Dimensions: seat depth 38cm, seat width 38cm. Maximum weight 102kg Available in 26” & 28” widths. Adjustable width and corner bath models available. Heavy duty option also available.


Example Brand names: Myco, DMA

Indicators The person needs to shower regularly due to medical need or incontinence and requires additional back support. The carer needs additional assistance to complete a safe transfer

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions All other alternatives have been explored: Alternative technique Grab rail Strip wash Bath/shower board Bath seat Rehabilitation Risk assessment Carer assessment increased care package





User unable to manage increased

Removable Easy to store User environment Available to suit most

bath widths Progression of condition Transfers Functional


package


completed HSE/MHRA

recommendations

Risk assessment



Review date





height clearance for transfers.

Needs of other household members & their ability to remove & re‐fit




N R

Bar Coded




swivel bather

M C

Y Y


6.5 Equipment: Powered bath lift

Description: Upright plastic seat with attached back rest that lowers into the bath via mechanical means, normally powered by a rechargeable battery. Additional padded seating available. A reclining back rest option is available on some models.

Dimensions: various


Example Brand names: Aquajoy, Bathmaster, Aquetec. Reclining varieties‐ Xtra/Sonaris/Orca

Indicators The person is unable to get up & down to the bottom of bath safely and other equipment does not meet their needs. The person needs to have a staged descent into the bottom of the bath. The person is waiting for bathroom adaptations/ DFG (equipment is short term solution plus assistance if required) Recline option only supplied if person has reduced hip flexion and/or increased levels of pain. The person needs to bath regularly due to medical need or incontinence

Ladder Approach Contraindications Safety & function Prescriber/assessor Actions All other alternatives have been explored: Alternative

technique Grab rail Strip wash Bath board & seat Bath step Swivel bather & over

bath shower (if

Particularly tall people or those with long legs




Removable but heavy & can be difficult to store

User environment e.g. short baths, integral bath handles

Progression of condition

Transfers Functional


completed HSE/MHRA

recommendations

Risk assessment

Specify side flaps Order controller Prescription goals identified. Prescription form completed





available) Rehabilitation Risk assessment Carer assessment Increased care package




equipment Needs of other

household members & their ability to remove & re‐fit

Requires regular cleaning

Batteries need to be recharged & managed

Additional water depth will be required

Should not be positioned at plug end of bath

Review date

Add to maintenance/service contract

Add to PAT list




N R

Bar Coded




powered bath lift

M

C Y

Y

Y

Y


6.6 Equipment: Shower seat‐ drop down padded

Description: wall mounted seat with arms that can hinge down into position within the shower area. Drop down legs provide additional security.

Related policies/Guidance Living Made Easy factsheets ‐ compatibility of baths with bathing equipment and 'choosing a bath and bath accessories'.

Example Brand names: Homecraft

Indicators The person is unable to stand safely in a shower cubicle. The person needs to shower regularly due to medical need or incontinence.


All other alternatives have been explored; Alternative technique Rehabilitation Free standing shower

stool Risk assessment Carers assessment increased care package




Construction of shower base

Construction of shower walls

Space to allow for persons legs in seated position and to turn to sit down

Consider provision of supportive equipment e.g. grab rail, step, non slip mat.

User environment Progression of condition Needs of other household

members Ability of person to reach

shower controls Size of shower area


completed HSE/MHRA

recommendations

Risk assessment



Review date

Set at appropriate height







N R

Bar Coded




shower seat – drop down padded

M C

Y Y


6.7 Equipment: Shower stool

Description: freestanding four legged seat that sits on the base of the shower. Each leg is fitted with rubber ferrules for stability.

Corner version is also available, adjustable height triangular shower stool which fits neatly into the corner of the shower base.

Dimensions: Width between arms: 19" (485mm) Seat size: 15"x11" (380mm x 280mm) Base size: 18"x15" (455mm x 380mm) Height adjustment range: 20½"‐25½" (515mm ‐650mm) Weight Allowance: 127Kg (20st)

Corner seat dimensions Seat width: 400mm (16") Seat Depth: 335mm (13 1/8") Seat Height: 510mm ‐ 610mm (20" ‐ 24") User Weight: 165kg (25st) Footprint: 425mm (16.75") x 425mm (16.75")


Example Brand names: Welland Medical Bosworth.

Indicators The person is unable to stand safely in a shower cubicle. The person needs to shower regularly due to medical need or incontinence. The person is waiting for bathroom adaptations/ DFG (equipment is for short term solution plus assistance if required).


All other alternatives have been explored; Alternative technique Rehabilitation Fold down shower seat



Person is unable to

Construction of shower base & risk of puncture.

Space to allow for persons legs in seated position and to turn to sit down

Consider provision of


completed HSE/MHRA

recommendations

Risk assessment


Demo/delivery




Risk assessment Carers assessment


Construction of shower base

supportive equipment e.g. grab rail, step, non slip mat.

User environment Progression of condition Needs of other household

members Ability of person to reach

shower controls

planned

Review date


Advice person to check ferrules regularly & identify system for replacement.




N R

Bar Coded




shower stool

M

C Y

Y


6.8 Equipment: Shower chair standard

Description: patio style freestanding height adjustable four legged seat with a back and arms that sits on the base of the shower. Each leg is fitted with rubber ferrules for stability.

Dimensions: Internal width between arms 18" (455mm) Outside depth(front to back) 20" (500mm) Floor to seat height 18" (455mm) Adjustable Height Range 5" (125mm) Weight 140kg (22st)

Related policies/Guidance Living Made Easy factsheets ‐ compatibility of baths with bathing equipment and 'choosing a bath and bath accessories'.

Example Brand names: Welland Medical Foxton

Indicators The person is unable to stand safely in a shower cubicle. The person needs to shower regularly due to medical need or incontinence The person is unable to stand in a shower & needs additional support from arms & a back. The person is waiting for bathroom adaptations/ DFG (equipment is short term solution plus assistance if required)


All other alternatives have been explored; Alternative technique Rehabilitation Shower stool Fold down shower seat Risk assessment Carers assessment




Construction of shower base & risk of puncture.

Space to allow for persons legs in seated position and to turn to sit down.

Consider provision of supportive equipment e.g. grab rail, step, non slip mat.

User environment


completed HSE/MHRA

recommendations

Risk assessment



Review date

Set at appropriate





Progression of condition Needs of other household

members

height Advice person to check

ferrules regularly & identify system for replacement.




N R

Bar Coded




shower chair standard

M C

Y Y


6.9 Equipment: Shower chair wheeled

Description: patio style wheeled metal framed with plastic seat that has drainage holes. Fitted with 4 wheels the rear two has fitted brakes. It does not have foot rests. Should only be used as an internal transit chair in exceptional circumstances.

Dimensions: Internal width between arms 18" (457mm) Outside depth(front to back) 20" (510mm) Floor to seat height 18" (457mm


Example Brand names: Welland Medical

Indicators The person is unable to stand in a shower & needs additional support from arms & a back. The person needs to shower regularly due to medical need or incontinence To reduce the number of transfers a person completes when showering.

The person is waiting for bathroom adaptations/ DFG(equipment is short term solution plus assistance if required) Ladder Approach Contraindications Safety & function Prescriber/assessor Actions

All other alternatives have been explored; Alternative technique Rehabilitation Shower stool Fold down shower

seat Risk assessment Carers assessment




Carer ability to manoeuvre shower chair

Step into shower High door thresholds

Space to allow for persons legs in seated position

User environment – particularly floor surfaces

Progression of condition Needs of other

household members Storage User needs to be able to

raise own feet/legs


completed HSE/MHRA

recommendations

Risk assessment



Review date








N R

Bar Coded




shower chair wheeled

M

C Y

Y


6.12 Equipment: Self propelling shower/commode chair

Description: shower chair with large rear wheels enabling the person to self propel or to be pushed by carers. Complete with foot rests. Fits over a standard toilet and can be used as a commode. Accessories are available as a special to adapt seating/positioning.

Transit version is available with brake son each caster if self propelling isn’t required.

Dimensions: Maximum User Weight....100kg (15.75st) Overall Height....106cm (41.5") Overall Width....69cm(27") Overall Depth without footrests....83cm(32.5") Overall Depth with footrests....114cm(45") Seat Height....58.5cm(23") Seat Width....46cm(18") Seat Depth....41cm(16") Front Wheels....12cm(4.75") Rear Self propelling wheels....60cm(24")


Example Brand names: DMA plus some other stock items.

Indicators The person is unable to stand in a shower & needs additional support from arms/back/feet. The person is unable to maintain a safe seating position in a standard shower chair. The person needs to shower regularly due to medical need or incontinence


All other alternatives have been explored; Alternative technique Rehabilitation Shower stool Standard shower chair



Person is unable to



Progression of condition


completed HSE/MHRA

recommendations

Risk assessment






Wheeled shower chair Risk assessment Carers assessment increased care package



Needs of other household members

Storage Range of design option &

accessories are available to custom the chair to the person’s individual needs.


Review date




N R

Bar Coded




self propelling shower/commode chair

M

C

Y

Y


6.13 Equipment; Tilt in space shower chair

Description: shower chair with facility to recline the seating area whilst maintaining the 90degree position at hips and knee joints.


Example Brand names: Various

Indicators The person is unable to stand in a shower & needs additional support from arms/back/feet. The person needs to shower regularly due to medical need or incontinence. The person is unable to maintain a safe seating position in a standard shower chair. The person needs to be hoisted in to the shower chair & this cannot be achieved in a standard upright shower chair.


Risk assessment Carers assessment All other alternatives have been explored; Alternative technique Rehabilitation Shower stool Fold down shower seat Standard shower chair Self propelling shower

chair





Additional space requirements needed to manoeuvre chair



Progression of condition Needs of other household

members Storage


completed HSE/MHRA

recommendations

Risk assessment



Review date







N R

Bar Coded




tilt in space shower chair

M

C Y

Y


formatted: bullets and 6. showering and bathing · 2014-01-06 · 6.1 equipment: bath step...

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