Facts about safety in the bathroom
• More than 1/3 of people age 65 and older fall each year
• 80% of the falls occur in the bathroom
• Over half of the bathroom falls were related to bath or toilet transfers
• Increased likeliness of an injury from falling is 2.5x in bathroom vs. living room
• Reaching activities from bath bench to toilet or MSCC may result in injury or fall
• 80% resulted in mild to severe injuries
(Aminzadeh, 2001; King, 2019; Medina, 2020; Naik, 2004)
Safety Issues When Using Various MSCCs (Mobile Shower Commode Chair)
• Reaching to perform bowel, bladder or hygiene routines when on commode
• Reaching to grab shower device or wash various areas of body
• Non-locking or swiveling casters or rear wheels
• Inability to sit upright due to gravitational pull
• Non-locking arm supports
• Non-adjustable footrests
Safety Tips: Transferring on / off Raz Mobile Shower Commode Chair
MSCC: make it as stable as possible
• Locking casters (AP / ART) or wheel locks (SP – large rear wheels)
• Self-actuated directional caster locks (locks caster in most stable position, and prevents the caster from swivelling when doing an independent lateral transfer)
MSCC: check rigidity of frame and components
• AP / SP frames feel “solid” and have little flex when being used for transfers
• Züm frame has rigidizer bar across rear of seat, which helps minimize frame flex
• Arm support lock kits ensure arm supports do not move unexpectedly when leaning or pulling
• Foot support design and mounts can be selected as needed, e.g. one piece, swing away, or removable
MSCC: check options and accessories are well attached and / or not in the way
• Locking arm supports – use to brace, grip,
• Flip-up arm supports – move them out of the way during lateral transfer
• Foot supports
MSCC: Check environment
• Floors that are sloped, tiled, uneven or slippery due to water and soaps / detergents / etc.
• Lips and thresholds
Safety Tips: Using Raz Mobile Shower Commode Chairs for bowel care, intimate hygiene, showering / bathing, positioning and repositioning
MSCC: make the base as stable as possible and select a seat that has:
• Appropriate design / cut-out for perianal access, e.g. side cut-out so that the user doesn’t have to reach over as far to access under seat
• Appropriate size for the user, e.g. seat depth and width
• Appropriate cushioning for skin integrity management
• Seat clamp / mounting system is adjusted correctly as per User and Dealer Manual (rear metal hooks are adjusted correctly; front seat clips are locked; all fasteners are tightened)
• Use IPAS to position the aperture optimally for user’s functioning, stability, postural control and bony prominences
Resources:
• Aminzadeh F, Edwards N, Lockett D, Nair R C. Utilization of bathroom safety devices, patterns of bathing and
toileting, and bathroom falls in a sample of community living older adults. Technology and Disability 2001; 13(2): 95–103. https://doi.org/10.3233/TAD-2000-13202
• Friesen E, Theodoros D, Russell T G. Clinical assessment, design and performance testing of mobile
shower commodes for adults with spinal cord injury: an exploratory review. Disabil Rehabil Assist Technol 2013; 8(4): 267-74.
• Friesen E, Theodoros D, and Russell, T G. Usability of mobile shower commodes for adults with spinal cord injury,
British Journal of Occupational Therapy 2017; 80(2): 63-72.
• King E C, Boscart V M, Weiss B M, Dutta T, Callaghan J P, Fernie G R. Assisting Frail Seniors With Toileting in a Home Bathroom: Approaches Used by Home Care Providers. Journal of Applied Gerontology 2019; 38(5): 717-749.
doi:10.1177/0733464817702477
• Medina J, Lerer L. When Mom’s Zoom Meeting Is the One That Has to Wait. The New York Times. (2020, 23 April) Retrieved from https://www.nytimes.com/2020/04/22/us/politics/women-coronavirus-2020.html
• Naik A D, Concato J, Gill T M. Bathing disability in community-living older persons: common, consequential, and
complex. Journal of the American Geriatrics Society 2004; 52(11):1805-1810. doi:10.1111/j.1532-5415.2004.52513.x
