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Mechanical and Physical Difficulties

Bathing difficulties vary significantly. Opening faucets and adjusting water temperature are troublesome for many. Those who lack sensation in the hands frequently misjudged the water temperature and got scalded. Low level of illumination made it difficult for bathers to see controls and accessories. In the absence of auxiliary heating, people felt cold while bathing. Inadequate storage caused lying around of articles. This made it impossible to keep the bath space organized. The size of the bathing space presented diametrically opposite problems. Small size restricts movement of wheelchair users and those providing care. Excessively large space makes controls and accessories inaccessible, and wheelchair users become fatigued from wheeling around in an attempt to reach for accessories.

Accessible showers, specially built to provide a greater degree of convenience, are not free of problems. Several users of accessible showers indicated that they have trouble using controls and bathing accessories while sitting on built-in seats. Consequently, many of them were either forced to stand up with water running to reach for accessories, or store them on the seat. One individual had installed a transfer bench and a flexible hose to combat the reaching difficulty. Another individual, who has a paralyzed right side, had no use of the grab-bar (since it was located only on the right side). In the absence of a bar on the left side, getting out of the shower safely was difficult. A third person, a lower limb amputee, found it impossible to make transfers to and from the built-in seat. She used a transfer seat to get in and out of the accessible shower, and used the built-in seat to hold accessories.

A majority of persons have difficulty using integrated level type controls. Even though they felt it was easier using such a control, the difficulties were due to: 1) the problems of understanding the color-coded signage for water temperature and flow, 2) the complex operational demands of the faucets requiring two simultaneous actions, push and turn, or pull and rotate, 3) the non-standard nature of these operations. Those with tremor of the hand or arthritis in the hand were unable to fine-tune the temperature and flow adjustments.

Practically all care-providers indicated that bathing people is the hardest task for them, and getting people out of tub is the most difficult part of the task. They reported that narrow passages and awkward layout of bathrooms make it difficult to handle clients with side-by-side movements. They also obstruct the movement of persons with mobility aids. Inadequate space in the bathroom makes it difficult to roll-in wheelchairs. According to homecare-providers, most clients have great difficulty accepting bathing-oriented assistance from other people. They felt that gaining clients' trust and cooperate in the bathing process are the most difficult part of their job. They complained about sliding glass doors and how they pose great difficulty in transferring people in and out of the tub. Some of the other difficulties they mentioned included:


lack of space between tub and adjoining fixtures,

inadequate space around the tub,

unavailability of a proper transferring device,

slippery floor conditions,

inadequate lighting,

excessive postural stress resulting from bending over,

client's unwillingness to be bathed,

client's ability to assist, and

fatigue of bather. Care-providers find it difficult to shower clients in a shower stall
because they themselves become completely drenched.