Making the Bathtub Accessible for the Physically Impaired
When people become more restricted in their movements and their activities from aging, sickness, or accidents, there could come a time when declining balance or pain leaves them reluctant to use the bathtub or shower.
It is a fact that certain daily activities can become nearly impossible chores to complete as keeping your balance becomes more questionable or when your legs become affected in such a way that they don’t bend so easily, or when a painful hip injury or illness makes the pain nearly intolerable.
There are, however, certain accessories and equipment available that can be added to your bathroom or, more specifically, to your bathtub to ease the effort of gaining access to it, helping you maintain or regain your independence when performing tasks that at one time seemed very simple to do.
Some of those accessories are quite simple in design and also in their installation, making it quite easy to convert such impaired activities into what they once were—simple and easy tasks.
The most basic and commonly used articles are the grab bars that, once crucially placed and secured, will provide a solid handle to grab onto instead of leaning against a flat surface or the top edge of a slippery bathtub and risking at any moment for your hand to slip and for you to crash down and hurt yourself in the tub.
Other devices can be as simple as a wooden board applied transversely across the two edges of the tub and providing a sitting surface from which you can then pivot yourself around while passing your legs above the tub’s sides, one at a time, or more elaborate seats, benches, and lifts, specially designed to assist for various degrees of impairment.
1. Grab Bars
Grab bars must be the most basic impairment solutions there have ever been. Used to provide assistance, especially when needed for support or even balance, you could almost say that handrails are the initial form of such devices. Installed at critical heights from the floor, they prevent you from falling over a balcony, a veranda, or down a set of stairs.
The main difference with grab bars is that they’re available in all sorts of different lengths and shapes to accommodate you at very specific spots where you specifically need to hold on or firmly grab to lift your body weight. They’re designed in lengths from about 8-inches (200 mm) up to over 48-inches (1.2 meters).
They also come in different shapes, from straight, angled, 90-degree bars, corner bars, wave-style and semi-circular bars, floor-to-ceiling posts, and sometimes combined with a swivel movement such as the “Depend-a-bar.”
Straight Grab Bars
Straight grab bars are quite simple in design, being straight with an offset at each end and terminated with the wall flanges, they can be installed vertically for easier grip to assist someone with limited balance or when moving your body vertically, lifting or lowering yourself into a standing or a sitting position.
If you need a grab bar, however, to move or walk around or turn yourself around inside a shower or bathtub enclosure, a straight bar can be simply installed horizontally against the wall to ease the efforts and to provide sturdier support to pull yourself up, and is also beneficial when transferring in and out of a wheelchair or a shower-chair.
Installed diagonally, the straight grab bar can provide you with gradually increasing height support as you transition your body up from a sitting position. Sliding your hand along the rising bar, however, increases the risk of your hand slipping as you’re trying to stand up, so a bar with a textured surface (or knurled bar) would be a better option for a diagonal bar.
For a typical shower or bathtub setup, several straight bars can be installed in all three positions around the enclosure but making sure each one is placed at its most convenient and comfortable position.
A good way to do this is for you to sit inside the dried-out bathtub and figure out where your grab bars would be most needed as you lift yourself out, making sure, however, that you install a vertical bar at the corner of the wall where you climb into the tub and some horizontal bars, one on each of 2 or 3 adjacent walls, making sure that at least your preferred side-wall for getting in has one.
Your vertical bars should also be placed so the center of the bar is at elbow height, while horizontal bars should be placed at the wrist height to provide easier support while standing or walking. That’s to say that they can be combined in any configuration and at any angle that best accommodates your needs.
So, depending on how you sit inside the enclosure, you can also install a diagonal bar on the longer sidewall (most common position) with the lower end closer to you at about three to four inches (75 to 100 mm) above the rim of the bathtub for an easy reach and the higher end away from you.
Bent Grab Bars
Bent grab bars are specialty bars that mainly replace the use of multiple bars for an uncrowded and neater appearance. Some are bent has obtuse angle bars or 90-degree bars to be installed on a flat wall, and others are bent to fit around an inside corner of two adjacent walls and are referred to as corner grab bars.
Obtuse Angled Grab Bar
The obtuse angled grab bar is a single bar with a portion of it bent so that while part of it offers horizontal support, it also has a section angled upwards to offer an alternate type of support, not as demanding for contorting the wrist.
90 Degree Grab Bar
The 90-degree grab bars also provide support in two directions, and with the vertical usually longer than the horizontal, they come as left-hand and right-hand and with three attachment flanges.
The Corner Grab Bar
The corner grab bar also comes with a 90° bent but runs the other way as to follow the inside corner between two adjacent walls and proves to be very useful at providing solid uninterrupted support as you turn yourself around inside the shower or the tub’s enclosure. It also comes with three attachment flanges for added support.
2. The Floor-to-Ceiling Pole
The floor-to-ceiling pole is basically a fully adjustable eight foot+ vertical pole that is simply jammed between the floor, and the ceiling with an anti-slipping pad tightened against the floor by screwing it out while the H-shaped top section is placed under two ceiling joists and screwed in place for a permanent installation.
It has to be installed outside the bathtub after you determine a good location for when you get in or out of the tub. The floor-to-ceiling pole can be used simply as a vertical bar, or it can also be accessorized with a pivoting straight bar or a wave-style grab bar.
Pivoting Straight Grab Bar
Pivoting straight grab bars can be added to your pole to provide horizontal support at any of eight different locking positions on the pole. So extreme care must be taken at the installation to make sure that the locking sleeve is located at the most appropriate height but also pointing the bar in the right direction as it can be positioned at different angles while moving yourself into different positions.
Pivoting Curved Grab Bar
Pivoting curved grab bars come in different shapes and forms, such as a curved “M” shape, or a “P” shape. The shaped bar is welded at both extremities to a long enough sleeve that pivots around the pole and locks in specific positions, same as the straight bar, but offering extra vertical support as well as horizontal.
Here again, great care must be taken while doing the installation to get the positioning and the height perfectly set for ease of use.
3. Wall-Mounted Pivoting Grab Bar
The pivoting bars such as the “Dependa-Bar” offers the same benefits as the floor-to-ceiling pole with its pivoting curved grab bar, which can also be locked into one of five different positions.
The grab bar comes as a four-part package, with a horizontal bar terminated with a sleeve at one end that you’ll have to attach to the wall first—the positioning of the end sleeve will determine if the bar is left or right-handed.
You will then have to insert the bottom end of the bar with a curved bar attached to it into the pivot sleeve of the horizontal bar. This new piece can then be secured at the top with a wall pivot sleeve complete with a fastening flange that you place above the curved bars and screw to the wall, thus completing the installation.
4. Bath Side Rail
The bath side rail is commonly seen with a curved bar attached to a base clamp that can accommodate bathtub wall thicknesses of up to seven inches thick.
Clamped to the front wall of the bathtub, its curved or circular bar provides sturdy, dependable support for getting in and out of the tub. They will not accommodate all thicknesses of bathtub external walls, however, and it would be a good idea to measure yours and verify the maximum width of the clamp before buying it.
An alternative bath side rail solution is the “Merton Bath Side Rail,” which extends to the floor for screwing in its base plate, offering better stability but limited to a 3-5/8 inches thick wall.
5. Grab Bar Clamps
The grab bar clamps are designed to be secured with suction cups activated with a lever and present a simple common solution, but they should be used strictly for maintaining your balance in the shower or the bathtub, as the suction cups or the walls they’re attached to cannot provide the necessary gripping force to carry a person’s full weight. They also require that the suction cups be re-tightened from time to time.
6. Non-Slip Bathtub Mats
Unlike some shower pans that have a textured surface, a bathtub floor is usually very smooth, making it a true slippery hazard for anyone as they’re getting in and out of it. A non-slip mat is, therefore, a definite asset to add to your bathtub in order to avoid all risks of injuries while using the bathtub.
A standard bathtub mat usually comes with a general contour cut to fit around the drain of most bathtubs. The soft rubber mats should preferably be made of mold-resistant latex-free rubber with the underside covered with a multitude of suction cups to make it adhere to the bathtub floor.
Those non-slip mats must be lifted off the bathtub and cleaned while you clean the tub after every use, as they will otherwise form algae and slime after a few uses.
8. Non-Slip Strips
These textured self-adhesive strips are made available in packages with shorter pre-cut pieces that can be easily applied by peeling off the back before sticking them on the clean, dry bathtub floor. They are also available in rolls that you can cut to the desired length according to your creativity in patterns, before peeling the back and sticking them on.
9. Bath Board
Bath boards are designed for people to enjoy a shower inside their bathtub without anyone’s help. They can be used even if you can’t lift your legs to get into the bathtub or even if you simply can’t stand on your legs for too long while taking your shower, it will provide you with a seat while you wash under the shower stream.
Built from strong and sturdy material, the board is long enough to reach across both sides of the tub.
The easiest way to get on the board from a wheelchair is to bring it close to the tub near the board and with the brakes locked on, and the side arm raised, transfer from the chair onto the bath board.
You can then raise one leg over the edge of the tub and bring it inside as you rotate your body and finish with the other leg as you turn to face the faucet wall. Once you’re done showering, you can simply repeat the process in reverse order to return to your wheelchair.
10. Bathtub Seat
If you have difficulty keeping your balance or standing long enough to take a normal shower, the bathtub seat might be a better alternative to the bath board as it offers you a backrest which is a definite advantage over the bathtub board as it makes it easier to sit for a longer period of time.
The flared slip-resistant rubber tips on the legs also help to prevent tipping and provide added stability to the chair, while being adjustable in height from about 14 to 20-inches. The side handles also provide an easy-grip hold to steady yourself.
11. Transfer Bench
Transfer benches are basically bath seats that stretch over the side of the bathtub with two legs resting outside the bathtub while the other two are placed inside. With its stretched frame, the wider seat is designed in three sections providing an opening above the inside of the tub for the shower curtain to fit in.
Transferring yourself to this type of bench is not as strenuous, with the extra wide seat stretching out past the side of the tub so that you don’t have to reach over as far to get on the bench, before sliding yourself to the center of the tub.
With its removable armrests that double up as a horizontal support bar, sliding over is much easier to do, offering more stability and comfort. The seat usually has drainage openings to prevent the water from pooling, making the bench less slippery and more comfortable.
You should also take note that some more elaborate transfer benches are designed to operate with rollers on two pieces of tubing. So instead of you sliding yourself across the plastic seat, the “sliding transfer seat” with a regular-sized seat and armrest can easily roll from outside the bathtub’s edge to the center of the bathtub and back again as you’re sitting on it all that time.
12. Bath Lift
A bath lift is basically a seat that rises up slightly higher than the sides of the bathtub. The seat also has a removable flap on each side, each one sliding against each of the sides of the bathtub, as the seat moves up or down.
With the seat up so the flaps lap over the sides of the tub, you can get on the bath lift the same way you transfer to a bath board. When you activate the down button on the power pack, the scissor-lift mechanism starts to fold upon itself, lowering the seat down to the bottom.
As it stops at the bottom, another mechanism falls into play, and the backrest starts moving back until it leans against the tub’s back wall in a more relaxing position.
Although most of the bath lifts today are battery operated from a rechargeable power pack, you could come across some older models that used to be activated with hydraulics, therefore using a piston instead of a scissor-lift to move up and down.
13. Walk-In Bathtub
Walk-in bathtubs or step-in tubs are bathtubs designed with a watertight door and a very low sill, making it possible for you to simply walk into the bathtub instead of climbing in or out of it.
A distinct difference from a traditional bathtub is the molded seat provided that lets you take a bath in a normal seated position which makes them a great asset if you have difficulty standing, bending, or getting up from a regular bathtub.
Most walk-in tubs are also provided with basic safety features such as textured anti-slip floor and built-in grab bars besides their standard gated door with special seals to prevent the water from leaking out, which some manufacturers will even guarantee for life. Installing that type of bathtub may require some modifications to your water supply and your drainage.
As they do hold much more water than a regular tub, You’ll need a greater flow rate in GPM to properly fill the tub within a reasonable time, plus a hot water heater of 50+ gallons which is usually recommended to purvey for the sudden need in providing the preferred water temperature throughout the filling process.
For some more elaborate models, you’ll also need to modify the bathtub drainage to accommodate for a second drain outlet to empty the large water volume faster in case of emergency or to simply avoid a long wait after you’re done taking your bath.
Although an out-swing door takes up more space inside the bathroom, it does provide a much easier transfer from a wheelchair to the bathtub and should be taken into account in such cases.
Other luxury and therapeutic features and accessories to provide you with maximum benefits can also be added to your list of options when you make the purchase, such as the handheld shower head, a shampoo wand, a disinfection wand, water jets, air jets, or the combination of both for massage therapy, and heated seats can also be made available.
You should know, however, that such a set-up can cost you from $25,00 to $25,000 part of it based on chosen options, but also on whether you do the installation yourself or hire a contractor.
Accessorizing Your Bathtub
There are also several articles that can be added to your bathtub for an affordable price to make the bathing experience much easier.
A removable hand-held shower head with a 5-foot hose, for instance, will bring the shower spray at your reach while sitting on your shower seat or transfer bench, and for just a few dollars, you can complement it with a wall-mounted suction bracket to bring it right next to your seat.
The hand-held can also be equipped with a small shut-off valve at the base of the spraying head to control the water flow from a sitting position.
There are many ways you can improve access to many facilities or activities at your house. Many more solutions to accessibility problems can be found online by reaching for links such as 3 Handicap Bathtubs Options and 10 Bathtub Fixtures for Disabled People.