Getting in and out of the bathtub or shower may be a risky and potentially dangerous task for many older adults, even if they have bathrooms equipped with safety features.

A new study suggests a third of adults over age 60 have difficulty climbing in and out of the bathtub or shower, and more than 70 percent of those with shower stalls use unsafe features -- such as the glass door or towel bar -- for support.

Researchers say bathing without assistance is viewed as a sign of independence among the elderly. But the results suggest many older adults may be putting themselves at risk for potentially disabling falls.

"We found that there are a lot of independently bathing older adults who have trouble or are unsafe getting into and out of the tub or shower stall," says researcher Susan L. Murphy, ScD, OTR, an occupational therapist at the University of Michigan Medical School's division of geriatric medicine, in a news release

"For older adults, losing the ability to bathe is associated with having falls, fracturing bones, and even being admitted to a nursing home. It is important that we take steps to help to prevent bathing disability before it occurs," says Murphy.

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Elderly at Risk for Bath Falls

In the study, published in the Journal of the American Geriatrics Society, researchers videotaped 89 independently bathing adults over 60 as they demonstrated (fully clothed) how they normally get in and out of the shower or tub. The average age was 82 years, and most of the study participants were women.

Researchers examined their fluidity of movement and noted if the participants had difficulty negotiating the environment or used things like grab bars, towel bars, shower curtains, glass doors, tub seats, or other parts of the tub to assist themselves.

The results showed that a third of the older adults had difficulty getting in or out of the bath. The most common problem was falling or difficulty positioning themselves onto a tub seat or into the bathtub.

About 30 percent of the participants hit the sides of the tub or the bath seat with their legs during the transfer.

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Shower Stalls Pose Greatest Danger

Researchers found most older adults used safe features, like grab bars, to assist themselves getting in and out of the tub or shower. But many used unsafe features in addition to the safe ones.

Nineteen percent of the participants using a tub used unsafe features, and 70 percent of those with shower stalls used unsafe features.

The biggest problem was using sliding glass doors in shower stalls for stability or balance. More than three-fourths of older adults who had shower stalls used the sliding glass door for assistance.

"This is extremely unsafe because shower doors were not designed to support a person's weight," says Murphy. "This problem could be easily remedied by educating older adults not to use the door as a support or possibly replacing it with a shower curtain, which was used only rarely by older adults in this study."

The second most commonly used unsafe feature was the towel bar, which was used by about half of the participants.

“While bathrooms in senior housing facilities are designed to be safe, we have found that older adults often do not know the difference between a grab bar and a towel bar. They also have unsafe strategies of getting into and out of their shower or tub,” says Murphy. "We think the results from this study demonstrate the need for health care professionals to become involved in helping to prevent bathing disability, instead of just treating people in the hospital after they have had a fall in the bathroom."

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SOURCES: Murphy, S. Journal of the American Geriatrics Society, August 2006; vol 54: pp 1265-1270. News release, University of Michigan Health System.