Topical article: Therapeutic Bathing

Delivering greater Dementia care through specialist bathing

We have manufactured life enhancing care baths for over 30 years. Combined with our specialist G360 bathroom and wet room services, we provide the proven holistic solution for safe bathing within long term care. The sector as a whole continues to experience increased demand for Dementia care which is being supported by innovative assistive bathing technology.

Peter Eckhardt, CEO, Gainsborough Healthcare Group, explains trends in the industry and how Gainsborough remains a thought leader:

Peter Eckhardt CEO, Gainsborough Healthcare Group

Peter Eckhardt, CEO, Gainsborough Healthcare Group

What specialist assistive bathing solutions are available to service providers within the Dementia care sector?

There are a multitude of specialist solutions to assist carers who bathe semi-ambulant Dementia residents. These can include power-assisted baths, adapted showering solutions and accessible wet rooms with level access. In terms of baths, there is a range of designs that include variable height adjustment, bather transfer seats, reclining functionality and specialist sensory features that are beneficial to service users with Alzheimer’s or other types of Dementia. When selecting the ideal bath, it is essential that healthcare providers fully consider the needs of service users, the care tasks in hand and how operational costs can be optimised. Only by discussing individual requirements with specialist bath suppliers, ideally manufacturers, can the most appropriate solutions be recommended. This is critical for maximising care, minimising risk and ensuring efficient performance.

For Dementia care, why is it beneficial to choose assistive baths direct from a manufacturer instead of a supplier?

Healthcare procurement and management teams can benefit from several advantages when selecting a OEM to supply a specialist bath. Manufacturers can have the ability to provide more choice and a greater range of bespoke solutions at greater speed to meet rapidly changing challenges.

They commonly offer more access to specialist options for advanced care – resulting in final solutions that deliver a more rewarding and engaging bathing solution. Assistive technology is evolving at pace and leading manufacturers are striving to be at the forefront of innovation. However, product quality, reliability and ergonomics can vary between suppliers so it is always best to select a proven and trusted company. Manufacturers with an established heritage tend to deliver better solutions that are tried and tested – backed up by efficient and consistent servicing and maintenance. Bath providers with UK-based manufacturing also provide the advantage of stable pricing when compared to importers that are being affected by fluctuations in the value of Sterling.

What are the important considerations that make a bathroom layout fit for purpose in a Dementia care setting?

Dementia care homes can benefit from selecting a specialist bath manufacturer with a broad range of in-house design, technical and clinical expertise. Bath suppliers with a holistic approach to specialist bathing offer a complete package of support from site surveys and clinical recommendations through to installation, servicing and beyond. This ensures the many critical factors regarding appropriate bath provision can be considered in a more cohesive manner – resulting in a more effective accessible bathing solution.

As Dementia is a complex condition, the specific requirements of bathers need to be considered with due diligence when selecting accessible baths. This is why reputable manufacturers work closely with Occupational Therapists and Physiotherapists to ensure products provide the best possible dignity, comfort and care.
Equally the risk to carers is taken into account with the provision of safe working heights through hi-lo functionality eliminating possible musculoskeletal injury from excessive bending and lifting. A powered bath with variable height and/or a bather transfer seat ensures users can be lifted and lowered in a safe manner without the need for manual handling.

The spatial planning of high-traffic accessible bathrooms is also key to the effectiveness of a specialist care bath. If space permits, 360-degree access around a bath provides greater care flexibility and the ability for carers to engage more fully with patients. It also further reduces the need for carers to bend or stretch when delivering personal hygiene or showering the bather – hence lowering the possibility of back and muscle strain.

How can the latest specialist bath designs provide a more pleasant bathing experience for Dementia patients?

Bathing service users with Dementia can be one of the most difficult activities that carers will face. It is essential that personal care is delivered in a sensitive and dignified manner. However, as the act of bathing is an intimate experience, many with Alzheimer’s and other Dementias may perceive it to be unpleasant.

Commonly residents can resist being bathed due to reduced patience or increased unfamiliarity with the process through memory loss. There are also other issues that can cause distress including the fear of falls, feeling cold and having to endure a lack of modesty. Losing privacy is very difficult for many people irrespective of whether they live with a medical condition or not. Having to rely on a carer to maintain personal hygiene can be frustrating for many service users who struggle with a loss of independence.

Increased skin sensitivity to changes in temperature and pressure are also common with Dementia patients so controlling the warmth and depth of bath water is imperative.

Features such as TMV3 temperature controlled water eliminates the risk of scalding and autofill programming ensures water levels are optimised on an individual basis.

glowing blue bath

Bath with glowing blue water – chromotherapy can relax bathers through a calming sensory experience

Anxiety, confusion and stress can be reduced for service users when bathing through use of an intelligently designed product. The process of getting in and out of a bath can be controlled and straightforward with a powered transfer seat that moves smoothly and with minimal noise.

Changing and drying processes can also be performed more easily so users remain comfortable and warm. A range of sensory features can be integrated into some of the latest baths to relax the bather including Hydrotherapy, Chromatherapy and music. These stimulating elements can improve bather mood and encourage engagement with carers so ultimately bathing is regarded as an enjoyable event.

Hair washing can be an issue for many with Dementia so giving carers access to an easily controllable, inbuilt showering system can reduce bather stress during this process. If healthcare providers select baths from a manufacturer with proven credentials in Dementia assisted bathing, then these factors will have been considered in detail.

buble bath

Spa bath with bubbles

How is infection control being delivered by leading Dementia friendly baths?

With the Covid-19 crisis, infection control has become an even more vital consideration when supporting Dementia service users. Surfaces must be durable, impermeable and easy to clean to eliminate the build-up of potentially harmful bacteria that can cause cross-infection. Leading manufacturers continue to focus intensively on research and development to ensure baths incorporate the latest technology to minimise infection risk.

It is recommended to seek baths that have in-built antimicrobial technology such as BioCote which is intergrated into all Gainsborough baths. Gainsborough was the first and remains the only bath manufacturer capable of this level of infection control. BioCote antimicrobial protection consists of silver-ion technology which is integrated during the GRP manufacturing process therefore providing 99.9% 24/7 protection against an array of harmful microbes including Influenza H1N1, E.coli, Salmonella and antibiotic-resistant CPE, CRO, CRE, VRE and MRSA. BioCote cannot be wiped or worn away and hence enhances hygiene management and reduces the possibility of cross infection.

assistive bath with 'protected' on the seat

Biocote protected baths

Recent laboratory tests with BioCote treated materials have proven that a strain of Coronavirus (not Covid-19) can be combatted by up to 90% within 2 hours. This evidence demonstrates the antiviral efficacy of BioCote technology against a member of the Coronavirus family – possibly paving the way to proven effectiveness against Covid-19.

How can healthcare providers reduce the ongoing cost of specialist bathing whilst improving sustainability?

Dementia care facilities continue to experience financial pressures as the cost of service provision rises year on year. Being able to provide excellent care at a fee that is affordable to local authorities and private clients is a major challenge. By selecting assistive baths that offer cost-effective performance and assured reliability the strain on operational expenditure can be reduced.

Certain manufacturers provide baths that improve sustainability through design features that lower water and electrical consumption. These can also reduce the time it takes to fill and empty the bath so more service users can bathe in less time – offering a significant advantage in multiple user situations. Product features such as key hole bathing spaces, footboards, depth indicators, Auto-fill and TMV3 temperature-controlled water all contribute to reducing energy consumption whilst ensuring utmost safety and comfort. Certain manufacturers have also consolidated components across their product ranges so maintenance and servicing is faster with less down time.

Sustainability can be enhanced by selecting assistive baths that are WRAS (Water Regulations Advisory Scheme) compliant. This ensures conformity with Water Supply Regulations preventing waste, misuse, undue consumption or contamination of the water supply and ensures that they are of an appropriate quality and standard. Only a bath that is WRAS approved or has WRAS compliant components will meet these legal and regulatory requirements.

How and why do you think bathing solutions for Dementia care are likely to evolve in the next few years?

According to the Alzheimer’s Society, by 2025, the number of people living with Dementia in the UK is likely to exceed one million. Currently, there are 850,000 individuals with the condition, a third of which reside in residential care or nursing homes. Hence the demand for Dementia care will grow substantially in the future resulting in the need for further research into the condition and product innovation by equipment manufacturers.

Bath manufacturers will need to work more closely with LTC providers, healthcare professionals, specifiers and end users to ensure designs are future proof and capable of meeting ever-evolving challenges.

There may well be an increased demand for specialist therapeutic features that improve Dementia resident well-being and a more bespoke approach to individualised care. Baths will need to become more efficient in terms of utility consumption and bathing performance with reduced bathing cycle times. In addition to enhanced hygiene, bathing must become as pleasure as possible with developments that improve dignity and therapy.

Improvements in bath technology will provide more effective rehabilitation and care pathways through stimulus, engagement and enjoyment.

carer with woman in shower bath

Helpful care home assistant – powered bather transfer seats eliminate moving and handling risks

Can you provide an example of a Dementia care setting that is benefitting from the latest in assistive bathing technology?

Advancements in Dementia friendly interior design and equipment is a clear focus within the LTC sector. As a leading example, the Marbrook Centre in Cambridgeshire has implemented the very latest techniques in décor and layout so that residents benefit from a sense of community and purpose as they live daily life. The Marbrook Centre is a purpose-built, specialist neurological and Dementia care centre with 81 beds for service users with Acquired Brain Injury, Spinal Injury, Stroke and Dementia. Several hi-lo baths from the leading manufacturer, Gainsborough Specialist Bathing, have been instrumental in helping The Marbrook Centre provide safe and dignified bathing that is perceived by many residents as a daily highlight.

Head of Care Pathways at Marbrook, Robert Myers explains:

“We believe assisted bathing provides multiple rehabilitation benefits to our residents and can be for some, a far more pleasurable option than showering in an accessible wet room. The simple fact that the baths and water are raised up and over the bather as opposed to the bather being lowered into water is an important psychological feature I would say. Moving and handling risk is minimised for both carer and bather through the hi-lo adjustment of each bath. The powered transfer seats can be detached to provide onward transit chairs. This provides a smooth and efficient transfer from bathroom to bedroom and eliminates the need to invest in ceiling track or mobile hoists.”

Robert adds:

“Functions such as Chromatherapy and Air Spa enhance residents’ experience so that bathing sessions are both relaxing yet stimulating and help promote engagement with their key carers.

Each Gainsborough bath adds to our ethos of providing unsurpassed care with meaningful activity here at Marbrook.”

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