Health care must improve for the Third Age
Hospitals and nursing homes need suitable places to accommodate the elderly and disabled people.
Despite an aging population and consequently an increase in movement disorders,
hospitals or residential care centers do not consider elderly patients or those
with disabilities a priority.
The bathroom in care centers is one of the areas that surely, before anywhere
else, should not contain any barriers. Accessing the toilet facilities must
be made quick and easy, not only for the user, but also for the assistants who
help wash and look after the user.
The grab bars in this sense play a central role. They ensure greater independence
for the user while moving on and off the toilet, around the shower or washbasin
area, making it easier for those who assist as well.
The grab bars should be installed in a vertical position at a height of between
600 and 1200 mm from the floor, on the wall adjacent to the main entrance or
exit point. For showers, the grab bars should be placed 150 mm away from the
shower unit door, and 150 mm from the back wall or corner. There should be a
grab bar next to the wash basin in a horizontal position at about 800 mm from
the floor or alternatively at 800 mm in a vertical position, placed at 850 mm
from the floor.
Toilets and bidets should preferably be the wall mounted type, in particular,
the medial axis of the toilet or bidet should be placed at a minimum distance
of forty centimeters from the side wall, the front edge at 75/80 cms from the
back wall and the higher part at 45/50 cms from floor level. If the axis of
the toilet or bidet is more than forty cms from the wall, a grab bar or handrail
should be provided, to assist user transfer, at 40 cms from the axis of the
sanitary appliance. The toilets should be at a height of 45 cms to facilitate
moving from a wheelchair, which is generally 46 cms high. The bathroom should
have the necessary space for a wheel chair user to approach the toilet and bidet
from a side angle.
In the washbasin area, the sinks should have an upper surface level of 80 cms
from floor level and should always be without a column with a siphon, and be
preferably of the fitted type or wall mounted. Elbow support should also be
provided and easy access for wheelchair users ensured, as well as including
the necessary accessories, such as positioning the shower next to the toilet,
soap holder and towel rail at a maximum of 100 cms and a seat in the shower.
Where possible, it would be advisable to equip the room with a flush fitting
shower tray to allow for wheel chair access and to provide an alarm bell in
the shower or near the toilet.
Finally, lever taps should be the preferred option, and when a hot water supply
is provided, this should be adjustable by means of thermostatic mixing valves.
Sliding doors or outward opening doors should be installed.
But safety also means antibacterial activity: hospitals should be equipped with
baths made of antibacterial materials. A real challenge for health workers.
The problem is often addressed with a combination of infection prevention and
control strategies, including hand hygiene, cleaning, training and the adoption
of new technologies. To this end, a wide range of infection control products
and technologies is already available on the market, including antimicrobial
technology. An example is one that uses silver, an excellent antimicrobial agent,
thanks to its high efficacy against a wide range of microorganisms, which are
dangerous from a clinical point of view.
In conclusion, all this confirms that the real challenge of the future will
be the care of non self-sufficient and elderly people. In areas such as hospitals
and health care residences, this should not only be done by using qualified
personnel and performed according to a correct working method, but also by using
appropriate tools and ensuring accessibility.