A caregiver's guide to safer bathing at home

Many families start thinking about the bathroom after a scare: a parent slips getting out of the tub, or a spouse comes home from a hospital stay unable to step over the tub wall. Others notice small changes, like a parent who bathes less often or holds the towel bar to steady themselves. Whatever brought you here, you are not alone, and there are practical steps you can take.

Starting the conversation

For many older adults, bathing is tied to privacy and independence. A suggestion to change the bathroom can feel like a statement that they are losing ground. These approaches tend to go better:

• Start with their goals. "You've told me you want to stay in this house. What would make the bathroom easier?"
• Ask, then listen. "Which part of a bath is the hardest now: getting in, sitting down, or getting out?"
• Use a neutral voice. A doctor, physical therapist or occupational therapist can recommend changes. Sometimes advice lands better from them.
• Offer choices. Grab bars now, a walk-in shower later, or a walk-in tub. Choice keeps the decision theirs.
• Start small. A night light and a non-slip mat this week shows you are serious without forcing a big project.

Before any bath: set up the room

• Gather towels, clean clothes, soap and shampoo before the person enters the bathroom.
• Warm the room if it is cold. People sit longer in a walk-in tub, especially at drain time.
• Put a non-slip mat outside the tub or shower and clear the floor.
• Check water temperature with your wrist or a thermometer before the person gets in.
• Keep a phone in the bathroom.

Helping with a walk-in tub

1. Getting in. Open the door fully. The person holds the grab bar, steps over the threshold with the stronger leg first if that is easier, turns, and sits. Stand on their weaker side.
2. Closing and filling. Make sure feet and clothing are clear of the door. Latch it firmly, then start the fill. Stay nearby while it fills.
3. During the bath. Use a hand-held shower to help with hair. Do not leave someone alone if they are drowsy, confused or have a condition that could cause a sudden problem.
4. Draining. Open the drain and wait for the tub to empty completely. Drape a towel over their shoulders to keep them warm.
5. Getting out. Have them sit for a moment before standing, since warm water can lower blood pressure. They stand using the grab bar, turn, and step out onto the mat.

Helping with a roll-in or walk-in shower

• A shower chair or a rolling shower commode lets the person sit for the entire shower.
• A hand-held shower on a slide bar can be moved to the person's height and to you.
• Roll-in showers give the caregiver room to stand beside the person. This is a major reason they are recommended when bathing help is daily.
• A curtain rather than a glass door makes it easier for a caregiver to reach in.

Protect your own body

Caregiver back injuries are common, and an injured caregiver cannot help anyone. Some ground rules:

• Never lift a person over a tub wall. If that is happening now, it is a strong signal the bathroom needs to change.
• Bend at the knees, keep the person close to your body, and avoid twisting.
• Ask a physical or occupational therapist to show you safe transfer techniques. Medicare may cover therapy visits in some situations; ask the doctor.
• If the person needs more help than you can safely give, it is time to ask about paid in-home care or a different setup.

Dignity matters

Let the person do everything they can do. Keep them covered with a towel when possible. Talk them through each step before you do it. Respect preferences about time of day, products and routines. Many caregivers find that a predictable routine reduces anxiety for people with memory loss.

Support for California caregivers

California has several resources for family caregivers. Area Agencies on Aging offer family caregiver support services, which may include information, counseling, training and short-term respite. The state's Caregiver Resource Centers provide similar help for families caring for adults with chronic or disabling conditions. The California Department of Aging's statewide line, 1-800-510-2020, routes you to the Area Agency on Aging for your county. Our California aging resources page lists the main agencies in each region we serve.

If the person you care for is on Medi-Cal and needs help with daily activities like bathing, ask the county about In-Home Supportive Services (IHSS), which can pay for in-home help, sometimes including a family member as the paid provider. The county social services office handles applications.

When you are deciding for someone who lives far away

Many California families are spread out, with a parent in Fresno and children in the Bay Area, or a parent in Palm Springs and children in Los Angeles. If you are coordinating from a distance:

• Ask a neighbor or local friend to take the measurements on our fit-check guide and send photos.
• Put the parent's ZIP code, not yours, on the quote form, and note that you are coordinating for them.
• Arrange to be on the phone during the consultation so you hear the same information.
• Plan for someone to be present on installation day and for the first bath.