Techniques and safety tips for safe showering

By Amy Hogan

Regular and consistent personal care can be tricky for both the person with CP and their caregiver.

One of the most important and regular aspects of caregiving for people with CP is showering and bathing. The nature of showering and wet, slippery areas means it can also be complex and something that needs careful consideration for the safety of both the person with CP and their caregiver.

There are a number of safety techniques that can reduce the risk of someone slipping or losing their balance.  These techniques may be more applicable to some levels and types of CP than others, but the general safety principles apply to all.

The first aspect to consider in adapted bathroom environments is the space that the person or people are moving around in. For example:

• How wide are the doorways?
• What is the distance between the shower or bath and other bathroom features such as the towel rail?
• Can the caregiver move fully around the bathroom or showering space?

All bathrooms are set up slightly differently and some are less than ideal particularly with the intensification of housing and changes to building modification requirements. When developing care routines or connecting with a new caregiver, it could be worth discussing the elements of the environment for bathing routines and adjustments that may need to be made in different circumstances.

The second aspect to consider is the different levels of support that the person with CP may need first thing in the morning, at night, or when personal cares are taking place.
For example, it’s not uncommon for people with CP (at any level) to be especially stiff and sore first thing in the morning or in the evening.
There could also be sensitivities due to changes in temperature when dressing or undressing or moving under the shower spray. It may be worth ensuring that the room and the person with CP is as warm as possible before starting the undressing process and moderating the shower or bath temperature with potential sensitivities in mind.

The tips outlined below are not an exhaustive list by any means but are some elements that members and their families found useful, either when training new support staff or when their circumstances change, e.g. after a period of illness.

Tips for people with CP

• Type of soap: Consider having a pump soap dispenser rather than a bar of soap because soap bars can slip out of your hand and have the potential to make the floor extra slippery.
• Grip rails: Whatever your level or type of CP, consider having a sturdy grip rail somewhere in the bathing space just in case your balance is affected.
• Amount of soap: As a general rule, consider using a ‘smallish’ amount of soap or shampoo because the excess can make your skin, walls, or floor extra slippery.
• Types of bathing products: It’s not uncommon for people with CP to be sensitive to strong smells or textures. There is a broad range of soaps and shampoos with different aromas. Consider experimenting because skin or the senses can react quickly after use.
• Seated showering: There are many different types of shower chairs ranging from fully supportive, to a simple plastic model or built-in fold-down seats. Whatever your level of CP, it may be worth considering these options or at least exploring if your bathroom has the capacity for a seat for times when you are in need of a little extra balance.
• Drains: Consider a regular schedule for unblocking drains especially if you have a wet area shower. When drains are blocked it’s very easy for surface water to gather on the tiles which can make moving around trickier.

Tips for caregivers

• Bathmats: Consider investing in several non-slip bathmats for the bathing area. But be aware that not all non-slip mats are created equal. Some mats struggle with the movement of wheelchairs or people doing standing transfers. It may be worth looking at the ones sold specifically with mobility impairment in mind or testing them out in different contexts, e.g. when there is a small amount of water or large amount.
• Shoes: Assisting someone with showering or bathing can involve moving on different floors and environments. Consider sturdy shoes that have a good grip and are somewhat resistant to water damage. You may need to do bathing unexpectedly so having a spare pair may be useful.
• Balance: In all situations when supporting someone with mobility needs, it is fundamentally important that you keep your balance. Make sure that you are familiar with the bathroom and its quirks before moving or assisting a person.
• Necessities: Make sure that everything you need is in relatively easy reach so that you aren’t straining yourself or leaving the person unattended unexpectedly.
• Temperature control: Especially with older houses, water pipes and temperature control can be somewhat unpredictable. Make sure you are familiar with the temperature range and set the temperature before starting the showering process.
• Set routine: It can be useful to have a routine for extra aspects to the daily bathing process such as assisting with shaving or checking for skin irregularities. Having a routine can make it easier to plan for additional supplies.
• Check in: This type of caregiving can be physically demanding. It can be worth taking your time and moving slowly if you yourself aren’t feeling one hundred percent, ie you’ve got a sore back. There are lots of things to consider when you are caring for someone in a bathroom environment.

There are several suppliers on the CP Society’s getThis&That programme that provide adaptive bathroom equipment to assist either someone living with CP or their caregiver.

For more information, please contact me at amy@cpsociety.org.nz.