Bathroom safety for older adults
For Americans over 65, no other cause sends more people to the hospital with injuries than falling, and bathrooms are a common starting point. Below: the evidence, and the fixes that matter.
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What the numbers say
CDC surveys find that roughly a quarter of Americans 65 and up report falling in a given year, which makes falls the top source of injuries for older adults. NIA research agrees, and stresses that a large share of those falls can be prevented.
When CDC researchers looked at bathroom injuries treated in U.S. emergency departments, falling was behind the large majority, and a big portion happened around bathing. The older the person, the higher the injury rate, peaking among those 85 and over.
Most of those injuries begin with something routine, like swinging a leg over the side of a tub, pushing up from a low surface or leaning out for a towel with wet feet. That is good news in one sense. Ordinary moments can be redesigned.
Why the bathroom is a hot spot
Wet, hard surfaces
Tile and porcelain are slick when wet, and they are unforgiving when you land on them.
Tall tub walls
Stepping over a standard tub wall means balancing on one foot on a slippery surface. That gets harder with arthritis, a new hip or knee, neuropathy or weakness.
Low seats
Standing up from the floor of a tub or a low toilet takes leg strength many people lose gradually without noticing.
Health factors
The NIA lists causes like blood pressure that drops on standing, medication side effects, vision problems and conditions that cause a rushed trip to the bathroom.
The trouble with vintage Chicago bathrooms
Chicago's housing is old by national standards. Bungalows built between about 1910 and 1940, greystones from the decades before that and many two-flats have bathrooms designed for a different era. They are often small, with a single tub alcove, a pedestal sink and a steam radiator, and many were never built with grab bar backing in the walls.
Common hazards we see include towel bars that people grab for balance (they are not designed to hold body weight), small hexagon tile that gets slick with soap, a hot radiator next to the tub, and a bathroom door that swings inward, which can block a helper if someone falls against it.
Radiator safety: a radiator beside a tub or toilet can cause burns during a fall. A radiator cover and a grab bar placed away from it help.
A practical bathroom safety checklist
Hold-ons
- Grab bars by the tub or shower and the toilet, anchored into framing or with rated anchors
- Nothing a person might grab that cannot hold their weight
Footing
- Non-slip surface in the tub or shower
- A rubber-backed mat outside it
- No loose throw rugs
Seating
- A shower chair or bench
- A raised toilet seat or safety frame if standing is hard
Water and light
- Anti-scald protection or a lower water heater setting
- Night lights from bedroom to bathroom
- A handheld shower on a slide bar
Research summarized by CDC scientists found fewer falls when home modifications like grab bars were combined with an occupational therapist's guidance. If you can, ask your doctor for an OT home assessment.
Where a walk-in tub fits in
A walk-in tub takes the riskiest motions out of bathing: there is no tall wall to climb, you sit on a seat at chair height rather than lowering yourself to the floor, and grab bars and a textured floor are built in. For people who still want to soak, that is a big change.
It is not a medical device, and it does not prevent every fall. It works best as part of the whole checklist. For someone who cannot step over even a low threshold, a transfer tub or roll-in shower may be safer.
Safer habits
- Lay out towel and clothes first
- Check water temperature by hand
- Stay seated until the tub drains
- Rise in stages, then step out
- Skip baths during thunderstorms
Coming home after a hospital stay
Many bathroom changes happen in a hurry, after a fall, a hip or knee replacement, or a stroke. Hospital and rehab teams often recommend bathing equipment before discharge. Ask the occupational therapist what the bather will be able to do safely at home in the first weeks and in a few months, because the answer changes how permanent a bathroom change should be.
For the short term, a transfer bench, a handheld shower and a raised toilet seat may be enough. For the long term, removing the tall tub wall altogether may make more sense. If you are planning a walk-in tub around a discharge date, tell us early so measuring and ordering can happen in time.
Ask the therapist: "Can you write down the bathing setup you recommend?" That note is useful for installers, and sometimes for VA or insurance paperwork.
Local help with falls and home safety
City of Chicago residents
The Department of Family and Support Services is the city's Area Agency on Aging. Its information line, 312-744-4016, connects older adults to services. Income-eligible seniors may also qualify for the city's Small Accessible Repairs for Seniors program for items like grab bars.
Suburban Cook County
AgeOptions is the Area Agency on Aging for suburban Cook County, and many townships run their own senior services.
Collar counties
AgeGuide Northeastern Illinois serves DuPage, Kane, Lake, McHenry, Will and other counties.
Statewide
The Illinois Department on Aging Senior HelpLine is 1-800-252-8966.
Full details and links: Chicago-area senior resources.
Safety questions
Are grab bars enough, or do I need a new tub?
Grab bars help a lot and cost little. They do not remove the tall wall of a standard tub. If stepping over it is already unsteady, a walk-in tub, transfer tub or low-threshold shower removes that step entirely.
Who can check my parent's bathroom for fall risks?
Ask their doctor about an occupational therapy home safety assessment. Your local Area Agency on Aging can also point you to fall-prevention programs.
Can I install grab bars on plaster walls?
Yes, but the mounting has to reach studs or use hardware rated to hold a person, because plaster alone will not. Many older Chicago walls have plaster over lath, so an experienced installer is worth it.
Sources
- Centers for Disease Control and Prevention, older adult fall statistics: cdc.gov
- MMWR Volume 60 Number 22 (bathroom injury study): cdc.gov
- NIA guidance on falls and fractures: nia.nih.gov
- Overview of CDC fall prevention efforts (Stevens and colleagues): ncbi.nlm.nih.gov
- WBEZ, "100 years of Chicago bungalows": wbez.org
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