Hello- my first question here. I will be caring in my home for my 90 year old MIL who has dementia. She's in reasonably good shape physically for her age- she does walk with a walker though because of balance issues. She's in memory care right now, but has to leave because they feel they can't help her any further there. It's the nursing home or my home, so I want to try and see if I can care for her here. She's not a difficult person but has trouble following directions, and I know she's going to need assistance with cleaning herself. Am I correct in thinking that a walk-in tub would be easier for both of us rather than a walk-in shower? In a shower situation- (of course she would have a shower chair) it seems I would have to actually get in there to assist her, which seems messy and uncomfortable. Any insights are welcome. I'll be having a new bathroom put in just for her, so of course I'd like to get it all right. Cost is not really an object. TIA :)
My mom is 88 with severe dementia and its in her best interest to be in a memory care facility with professionals around her.
Hope this helps
I’ll vote for a shower to be done and you have them build one that is totally walk in for 2. As far as design, look at ADA compliant gym individual showers for ideas. These tend to rectangular with 1 of the long walls being only a 2/3 wall and lower height with the other 1/3 open with a channel (like a French drain) all around at the bottom to capture water from going out. Walls will have 2 sets of grabs bars at different heights on each side and the floor is somewhat raked (like that done for ballet) to the far wall. 2 shower heads w 1 with a moveable arm/head.
Mom gets an adjustable Geri shower chair, these are heavy plastic open design and slunk down in the molded seat so she can’t slip out or shift forward. Some have grab bars atop the arm rests which if she still has upper body strength she can help you help her to get in or lift and get out. To bathe, You get her undressed and transferred into the Geri chair and wheel her into the shower. Makes bathing, hair washing, way way easier. Drape a big towel over the chair after shower over so she stays warm & seated while move her into the regular part of the bathroom and you dry her off and put on shoes, etc.
My moms NH had a big shower set up like this and it was amazing to watch the aides in action give mom a shower. The bathing room was heated too. Another plus with a Geri bathing chair is they can be cleaned and sanitized.
a walk-shower (no curb) with a bench seat and we use a commode in there. Just this morning my husband managed to have a 's*&t storm' - much easier to deal with in a shower and the commode. I still had a santitize the shower but having had feces all over the shower, we found that sitting on the commode (with bucket when episodes are iminent) was a much safer option. We have decided the commode is also more stable than the shower chair - so we have him use the commode as a shower chair also.
Now, on the other hand, my husband does wish to sit and soak at times for therpeutic reasons. So we are entertaining putting a walk-in tub (somewhere - haven't figured out that part yet) But the shower stays.
As you're having a whole new bathroom put in I can give you my personal wish list!
GOOD HEATING. A decent sized towel rail that also gets the room properly warm. Put it on the wall away from the shower so it doesn't get wet, but within reach so you don't need three hands or extendable arms to grab a towel when she gets shampoo in her eyes.
Non-slip flooring which must be easy to clean and dry and pleasant under foot - there are plenty on the market, but consider how you're going to maintain it and also how it will feel on her toes when they're bare and wet.
Looking at the shower wall - somewhere to put soap, shampoo, brushes and sponge when in use, such as a built in ledge. No grouting or tiling, avoid anything that can gather sludge, hair or mould.
Other walls - shelf storage and a bin. Otherwise the basin and shower will soon be cluttered with denture pots, toiletries, creams, boxes and goodness knows what, and plastic bottles are much more breakable when they drop on the floor than you'd think.
Good lighting. You need to be able to check skin integrity without having to bend down and peer at bits of her.
Good ventilation. Especially if either of you wears glasses.
Give serious thought to a bidet function on the toilet. Worth every penny both in terms of labour-saving and quality of outcome - they wash and dry a person's undercarriage really well without her getting upset or anyone else having to lift a finger (except to press Start).
No sharp corners. On *anything.*
No designer gadgets. A mixer tap (faucet, I mean, do I?) on the handbasin is a good idea but avoid space-age aesthetics or hidden controls. Hot should say Hot, Cold should say Cold, you shouldn't need a master's degree to let the water out.
Please make sure the handbasin is tall and deep enough to get a bedpan and/or the bucket from a commode under the tap (unless you have a separate sluice somewhere, not many family houses have) - not for emptying, obviously, but for 3 x filling to rinse, disinfecting, 1 x filling to remove disinfectant. The contents go down the lavatory pan, of course, but if you can't get the pan or bucket under the tap to fill it it's extremely irritating. I get very sick of dainty little dolly's handbasins that some numpty designer thinks anyone can actually wash anything at.
As MIL is currently able to stand and walk with support, it would be good to encourage that by having grab rails so that she can engage fully in showering herself and stand safely - but you are now in the realms of OT assessment and recommendations. Which it would be sensible to get anyway.
I would opt for a walk in shower with NO threshold. Also called a zero entrance shower.
the reason for this is it will be easier to roll a shower wheelchair in if and when she needs it.
It will be easy to walk in with a walker.
If necessary it will be easier to get equipment in like a Sit to Stand or a Hoyer Lift.
The bathroom that I have in the house that is "handicap accessible" is large enough to get a wheelchair into as well as being able to turn it around so you can place it over the toilet. (shower wheelchair has an open bottom so that it can be placed over the toilet rather than emptying a basin that can also be slid into place.) 2 people can comfortably bathe and care for a person in the room and have space to do what needs to be done.
Place grab bars wherever you can think that she might need them.
There are companies that will come in and assess the room and give recommendations on how to make it safe and functional.
And if possible an ADA height toilet with an elongated bowl rather than a round one.
I purchased a Carousel Sliding Transfer Bench with Swivel Seat by Platinum Health, plus with a 32-inch Horizontal Extended Rails. Also, have safety rails on all three sides of the bathtub.
Turn on the bathroom ceiling heater. If you don’t have a ceiling heater use a plug in heater in a safe location.
Wheelchair her into the bathroom. She transfer to the sliding seat on the outside of the tub. Once in the seat, I slide her into the center of the tub.
Control the hand-held shower water stream to low and soft to avoid frightening her. Also, with the control hand-held shower I control the direction the water flows. Use the shower curtains for front and for back to avoid getting drenched.
She uses the safety rails to raise herself so the most odor parts get washed. The ceiling heat keeps the room warm, no problem.
With the ceiling heat on, I sweat, but that’s okay, the job gets done.
Either way, I think a handheld extension and multiple support rails -- and a heated floor if the expense is no object -- would help make her safer and more comfortable in either case.
My grandmother liked a small amount of warm water in the bottom, or in a basin, to keep her feet warm. I think she would have liked a walk-in tub but she was also fearful of things, so not sure how she'd feel sitting in water up to her chest. Can you try out a walk-in tub with your mom?
We remodeled the bathroom in my parents' house from a 9-year-old tub to a large shower with a handheld sprayer. We also put in a bathtub faucet about a foot above the floor so it could be used to wash feet or fill a bucket easily if needed. There was plenty of room for a walker and a shower chair to get in there, and honestly, I wouldn't have been a wet mess if I'd had to get in to help my mom shower. It would have been much easier to clean her "bits" than trying to lean over a walk-in tub.
Unfortunately, my dad died and my mother was in a nursing home before we were ever able to use that shower. We went from beginning the remodel, to my previously-healthy dad dying, to my mom having to go into a nursing home all in a span of six months, so know that things can change very, very quickly. Your mom has already been in a nursing home, so know that most of us see this plan of yours as probably not really feasible for any period of time. I do wish you luck, though.
Three years later, it sits there unused, but it's an asset to that house and not an obvious handicapped bathroom, so we'll do fine when we sell the house this spring.
Imagine the walk-in bathtub filled with water and the patient poops in it. Not firm poop that stays together due to roughage and fiber in the diet. No, runny poop like a baby. The bathtub water turns yellow and the dissolved poop is all over her body. YUCK!
In the shower the poop goes to the floor and the patient remains clean.
My dad would poop in the shower all the time (he was incontinent). A bathtub would have been disgusting.
Sitting on a shower chair being hosed off is very cold for the person being bathed. And yes, a certain amt of water gets on the helper, too. To me, it's a miserable way to take a bath. Not to mention, to really clean the private parts, the person needs to stand for a period of time - even with the safety bars, strength is an issue to avoid falls.
I installed a lift chair for my mom (w/existing tub). Chair comes over edge of tub for her to sit on, then I activate it to lift up - turn to be over bath water - then lower to bottom of tub. She was so happy to be able to get into a warm bath and soak/have the jets in tub running. I raise her up a little when done, use shower sprayer to rinse her off and wash her hair - it minimizes the amount of time she is in the cooler air and not surrounded by warm water. I'm not having to stand there and wash every nook and cranny - she can do it.
I personally hate the thought of sitting on a shower chair being hosed off. You only feel warm when the water is all around your body...instead of just certain parts being sprayed. For me, that would be torture because I'm usually cold any way.
I will forever regret not going to greater lengths to keep my parents in their home a little longer.
And for the in-between shower days you can use the extra large body wipes. and waterless shampoo and conditioner caps if needed. They both work really well. you can order both from Amazon or Walmart.com
I wish you the best as you will certainly have your hands full. I really hope you're thinking long and hard before making the decision to bring her into your home.
Putting in a walk in tub is very expensive. We had a walk in shower. Mom used a shower bench. I installed a handheld shower head. I kept the room warm with small heater. I would wet her down and turn off the shower. Then soap her down and rinse. Have a towel nearby and dress her as much as I could. Bathroom was small. I eventually placed Mom in an AL and eventually LTC. At 68 I could not do the showering and the toileting. And the accidents. One being a "blow out" that took 3 hrs of cleaning up. The bathroom first because she needed a shower. I had a small table outside her bathroom door. I caught her using it as the toilet.
I hope your husband is going to be helping in her care. You will have sleepless nights because she is roaming or trying to get out of the house. Just as you sit down, she will want something. Its like having a toddler again.
I do suggest that you try a commode over the toilet. There are splash guards that take the place of the bucket. This will give MIL the arms and legs for stability.
Good Luck if you go ahead with this. If you find that her care is beyond you, please don't feel guilty. I personally could not do it because of the unpredictability. I like knowing what comes next. I like organization. Don't do well when a ball in thrown into the mix.
I am reaching a point where we must start looking at some bigger stronger more competent help for me with my DH at home. I had wanted to keep him here for the duration. It is slowly, but surely, dawning on me that this is probably not a good idea.
In saying all that, Silvie, I did have the big whirlpool bath taken out and replaced with a ceramic shower with a bench. The shower itself is great, the shower-ee is the problem! As you said, if the MC can't do it, how can a person alone do it? Will your DH help in the bathroom with a naked mom?
Think this over, and I also think you are an extraordinary princess for even wanting to do this, your MIL is a very lucky woman, and you DH also. Best of luck and God Bless.
If she was not, then it won't be worth putting an expensive walk-in tub in.
How much space do you have for the shower/tub? Because there are some really great shower configurations for ease of access and assistance. A good contractor should be able to help you with the ideas.
I, highly recommend, heat lamps for the area, showers are cold and need to be heated up before she gets in and when she gets out.
Do a Google search for wheelchair accessible showers, it will give you some ideas.
Contact your local aging service program - the Senior center, Board of health, county social services can tell you who to call. See if she will be eligible for help with bathing, as it is much easier to let a trained aide to help with the shower or bath. Also, that person can show you how to help her.
There are plenty of businesses that offer home safety services for elders - ramps, rails, bathrooms, etc. They will have ideas...
A former poster offered good insights into bathing: make it a pleasant ritual, with her favorite music, a treat before or after (flowers, or the music) and guide the experience into something positive, as well as one that's more safe.
If you do stick with the shower remodel, make sure you find a carpenter (and ONLY a carpenter) to install grab bars, on all sides, at low and medium high levels. They're lifesavers.