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.
