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Common dementia related issues with using the bathroom and toilet include perception, continence, hygiene and grooming difficulties, falls, floods, burns, behaviour such as placement of inappropriate items in the toilet, and fear of toilet, shower or water spray.
The bathroom is designed to provide functionality and safety for aged and frail residents who wish to stay in their home longer, while demonstrating some design features to assist carers of people living with dementia.
The following Environmental features may support independence and safety:
- remove mats, clutter and hobs
- circulation space
- remove screen and use shower curtains – easier to clean and more space
- contrast and lighting to highlight key locations – assist way finding for a person with dementia, eg contrasting tape on rails, contrasting colours for the door, toilet seat and grab rails to highlight way to bathroom, and to assist with perception problems
- wide entry blue door provides cue for way finding, and is hinged to allow removal of door for easy emergency access to bathroom
- adjustable height shower chair, drop down shower seat
- remove bold/ busy patterns on wallpaper, curtains or floor coverings if disturbing
- correct toilet height for person and toilet paper easily seen and reached
- adequate natural or artificial light in the bathroom area for age, vision and perception needs
- paint on or self-adhesive non-slip strips in shower and bath and non slip/ slip resistant flooring
- hand held shower hose to direct water spray away from face
- hobless shower with level floor surface
- grab rails (not towel rails) beside the toilet and in the shower recess
BCS Age Friendly Home Bathroom Renovation
Prior to most renovations and particularly bathroom renovations a hazardous materials audit is recommended to ensure that asbestos is identified. Our bathroom had asbestos behind the wall tiles; this was removed using approved methods for demolition and disposal.
The home had a separate bathroom and toilet, with tiles that could contribute to perception problems. The wall between the two was removed and the space made into a suitable size for an accessible bathroom, complying with AS1428.1. The demolition revealed termite damage which needed rectification and a need for a further inspection by a suitably qualified pest manager.
The bathroom attempts to demonstrate that it is not necessary for a compliant bathroom to look institutional. It demonstrates that there are design options in the bathroom that can help to manage problems associated with dementia. The walls are a different colour to the floor, allowing clear delineation between the two. The toilet seat is not white, in our case we have chosen a navy blue seat and a navy blue hand rail – clearly visible to a vision impaired resident or a resident with dementia. The other grab rails are white to demonstrate that they can look less institutional. The shower is hobless, removing any trip hazards from the bathroom.
The hand basin is suitable for a person in a wheelchair, with a lever tap, fitted with an extended lever for easy reach and clear space underneath. The floors are non-slip tiles, non-institutional but functional. The shower has the facility to install or remove, quite simply, a shower seat, the same system was used to install or remove drop down rails beside the toilet. The walls have been lined with plywood to enable the simple installation of more grab rails should they be necessary.
The lighting for the bathroom can either be manually controlled or can be programmed to come on at 30% once a movement sensor in the bedroom has been activated at night. The path to the bathroom can be lit to provide way finding and safety. The light can be turned off at a programmed time after activation, based on the residents own patterns of behaviour. The bathroom door was painted dark blue to highlight it and make it easier to find.
The door can be removed from the outside should a person fall and be leaning against the door. The door lifts off at the hinges and there is a space at the top of the door that allows it to be lifted.
A duress alarm for emergency contact with the call centre or a nominated person has been installed; this is a stand alone product that can be installed in the home without any hard wiring, making it perfect for areas such as bathrooms.
Some of the ideas are simple and inexpensive, whilst others require professional installation and are more costly. For professional advise regarding your circumstances and needs, please contact the Independent Living Centre on 1300 885 886.