Choosing Equipment for Showering
Choosing Equipment for Showering
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Choosing Equipment for Showering
- SUPPLY, PROVISION AND SOURCES OF FUNDING
- SHOWER CUBICLES, TRAYS AND WET ROOMS
- SHOWER UNITS
- TRANSFERRING INTO A BATH TO SHOWER
- TRANSFERRING INTO A SHOWER CUBICLE
- SHOWER SEATING FOR SHOWER CUBICLES AND WET ROOMS
- EQUIPMENT FOR USE WHILST SHOWERING
- AFTER SHOWERING
- SHOWER SAFETY
- USEFUL ORGANISATIONS
For up-to-date product and supplier information, please contact our equipment helpline. They are open Tuesday to Thursday 10am-4.30pm, Tel: 0300 999 0004 (calls charged at your standard land line rate even if you are phoning from a mobile).
Alternatively you can write to our letter enquiry service or contact us via email at firstname.lastname@example.org. To help us give you a concise and informative reply, please provide us with as much detail as possible including information on the difficulties you are having and any solutions you have considered, including equipment ideas.
SUPPLY, PROVISION AND SOURCES OF FUNDING
Provision of equipment
Showering equipment is generally regarded as daily living equipment, and may in some cases be provided by your local council either directly or through the DFG system (see below). Provision may include:
- shower trays, panels and units
- toilet/shower units
- showers with suitable controls
- shower seats (fixed, free-standing or mobile shower chairs)
- shower rails
Before making any decisions about buying equipment, or making alterations, it is advisable to contact your local social services/social work department and ask for an assessment from a community Occupational Therapist (OT), to assess your daily living needs. He or she will advise on possible solutions and may be able to provide some items of equipment on loan and give advice on grants that may be available to help with the cost of any adaptations. Find your local social services on the GOV.UK website
Alternatively you can hire a private occupational therapist, a directory is available on the 'College of Occupational Therapists Specialist Section Independent practice' (COTSS-IP) website. www.cotss-ip.org.uk or phone their enquiry Line: 0845 129 7699. All occupational therapists on this directory are registered with the Health and Care Professions Council (HCPC). The HCPC is responsible for the conduct, performance and ethical behaviour of its registrants. Occupational therapist who do not meet the standards of practice, conduct and behaviour required by the HCPC are removed ('struck off') from the register. You can visit the HCPC website to check the registration status of an occupational therapist. Housing associations may provide small fixed equipment and minor adaptations for residents.
National catalogue prescription scheme
In some areas of the country a prescription scheme for equipment is in operation. There is a 'national catalogue' of equipment that may be provided by prescription although local areas can choose which of these items they will include in their schemes. This is part of the Department of Health’s Transforming Community Equipment Services (TCES) programme. There is a small range of showering equipment on the national catalogue that can be provided via prescriptions. If you receive a prescription for one of these items you take your prescription to a local accredited retailer who will provide you with the item. Alternatively you can ‘top-up’ paying extra for an item that does what the specific item prescribed would do but offers extra features or perhaps you prefer its appearance. Thus the scheme is designed to stimulate and encourage choice and control. The national catalogue website bathing aids listing can be viewed at https://www.londonconsortium.org.uk/index.php?option=com_content&view=ar... This factsheet will go through a range of equipment and mention when there is a relevant national catalogue specification for that kind of equipment, as it may be provided by prescription.
Disabled facilities grants (DFGs)
A Disabled Facilities Grant, often referred to as a DFG, may be available for some home adaptations including major adaptations. This can include extensions and structural work to accommodate fixed hoists, stairlifts, downstairs bathrooms, shower units etc. If this type of adaptation is needed, a local occupational therapist (OT) will come to assess your needs and then contact the relevant council departments. Applications for grants should be made via the OT to the local councils.
A means test (including household income and household savings over £6,000) is used to decide how much financial assistance can be provided. Depending on the outcome of the test, the amount of assistance offered can vary from 0-100% of the cost. Disabled children under 19 can get a grant without their parents’ income being taken into account. You must own the property or be a tenant (or be a landlord and have a disabled tenant) and you must intend to live in the property during the grant period (currently 5 years). Please note that you may not receive any grant if you start work on your property before the council approves your application (Disabled Living Foundation 2016).
DFGs operate across England, Wales and Northern Ireland. Conditions for DFGs will vary according to the country in which you live. For more information on Disabled Facilities Grants, visit the GOV.UK website.
For details of schemes in Scotland see Disability Information Scotland.
Before considering the building of a downstairs bathroom for someone who cannot use the stairs, check that all other options have been considered. For example, it may be more practical and cheaper to install a stairlift or through-floor lift to provide easy access to the first floor.
Try equipment before you buy
If you decide to buy equipment privately it is advisable to try and compare the different ranges first. You may have an equipment demonstration centre near you where you can visit to view and try out ranges of equipment. You will receive impartial advice to help you choose appropriately. However, centres may not display examples of all the equipment in this factsheet. You will need to contact your nearest centre to find out what they have and to book an appointment. Contact details for your nearest Equipment Demonstration Centre can be found on the Disabled Living Foundation's web page Equipment Demonstration Centres in the UK.
Information and advice on design issues is available from the Centre for Accessible Environments (CAE) which keeps a database of architects, surveyors and similar professionals with experience of designing for disabled people, and has a number of useful publications and design sheets (see useful organisations).
Be cautious of sales people who try to persuade you to buy equipment that may not meet your needs fully or is over-priced. Buying from a company that belongs to a trade association, such as the British Healthcare Trades Association (BHTA) may give you some reassurance. BHTA members have signed up to a code of practice governing standards of customer service (see Useful organisations).
You don't have to pay VAT on products designed for disabled people if you have a long term illness or disability, or are terminally ill. Mobility shops may automatically sell you equipment without charging you VAT, but you may have to ask. Individuals with a temporary injury such as a broken arm or hip do not qualify for VAT relief. For more information, and to check for any changes in the regulations visit the GOV.UK, VAT relief on products and services for disabled people or the HM Revenue & Customs reduced rate VAT webpage (their Charities Helpline covers VAT relief for disabled people: Telephone: 0300 123 1073)
Charitable trusts may sometimes provide funding for equipment. A useful resource is www.turn2us.org.uk , a website that allows you to search for organisations that give grants, including for equipment and other services. You can refine / filter your search by specific health issues such as 'physical disability', 'ageing' or 'rheumatism'. If you're over 60, Charity Search is a free service to help you find a grant-giving charity www.charitysearch.org.uk Charities will only give awards in accordance with a predetermined criteria, so it is important that you carefully select the trusts you apply to.
Most libraries hold directories of suitable funders in their reference section, such as the The Directory of Grant Making Trusts
The Grants for Individuals website is run by the Directory of Social Change and lets subscribers search for grants but is intended for organisations searching for funding for individuals. http://www.grantsforindividuals.org.uk
SHOWER CUBICLES, TRAYS AND WET ROOMS
- the facilities and the amount of space available
- your physical abilities and the amount of support you require
- your size and weight
- the cost involved for any installation
Over-bath showers can be a cost effective way of making use of a bath tub which may already be in place as it just involves having a shower unit either attached to the water intake to the bath or with its own plumbed water supply. Installation will involve some plumbing works. The shower controls will usually be fitted on the wall above the bath taps at a height where you can comfortably reach them in standing.
Other users still have a choice to bathe or shower. Less plumbing as uses existing baths drainage / waste.
Having to transfer in and out of the bath
An over-bath shower eliminates the need for you to lower yourself down to the bottom of the bath to have a traditional bath as you can wash whilst standing, or sit on a board at a height similar to the height of the bath. You will however still need to transfer over the edge of the bath to get inside the bath tub. Shower Boards can quite easily be fitted across the top of the bath to ease this transfer and let you sit down whilst showering, or if more postural support is needed whilst sitting a swivel seats. Both shower boards and swivel seats can be removed if other users need to use the bath, but in such cases it does take up some space in storage. Leg lifters (please see Leg Lifters for more information) can also be used to help you get your legs over the edge of the bath. Wall fitted rails should be used for support when transferring or for when standing when using an over-bath shower. Please see Grab Rails for more information. In order to contain the water within the bath area, a shower curtain will be needed, please ensure it will drape adequately around the board or seat. A fixed screen may be in the way when you transfer into the bath, whereas the curtain can be drawn out of your way. Having an over-bath shower also maintains flexibility so other users can have a bath as they may prefer to soak in a bath rather than shower.
Shower cubicles Access into a shower cubicle is usually easier compared to getting into a bath tub unless the step into the shower is too high. It maybe advisable to have grab rails fitted to hold on to for support, either for the transfer in and out or whilst standing. Shower Stools or Wall Mounted Shower Seats can in some circumstances be used if you need to sit down during showering, but check before trying this as some shower bases can crack from the pressure of these seats/stools (please see Shower Bases for more information). There are essentially two kinds of shower cubicles:
- Corner cubicles - situated in a corner with the tiled bathroom walls forming two of the sides.
- Full cubicles - can be situated anywhere as they have three solid sides and a cubicle door, thus enclosing the shower fully.
Although many cubicles are installed with sealed shower doors to minimise water spillage into the surrounding area, a pump will often be added to draw the water actively towards the drain. It is advisable to have some waterproof flooring immediately outside the area of the cubicle. Cubicles can be bought with a range of shower seats, shower controls, shower outlets, and rails according to your needs. Care should be taken over the choice of equipment used on plastic shower floor base trays, especially stools with four separate legs, because of the risk of puncturing the tray. Always make sure to check the maximum weight limit of the tray. Some companies will strengthen them for heavy users.Check the manufacturer's guidance for both the tray and shower chair, wall mounted shower chairs may be an alternative.
Safe walk-in transfers with level access or ramped cubicles. Range of seating options.
May replace your bath when installed, no users will be able to choose to soak in the bath. Significant installation cost.
Often entering a shower cubicle will require you to take a step upwards into the shower cubicle. Depending on your strength and balance it can be advisable to have a wall fitted rail in place to steady yourself when entering or using the shower. Please see Grab Rails for more information. To eliminate the need to take a step upwards to enter the shower cubicle a level access shower may be chosen. Level access showers cubicles have the entry point close to being flush with the floor and are usually rectangular in shape. The size of the shower cubicle needs to be considered carefully before installation as the cubicle is an enclosed shower area and it will be difficult for a carer to help you whilst showering in it as this could mean leaving the shower doors open, allowing for the water to splash out. Shower cubicles may have double doors or folding doors that allow for more space when entering or exiting. Low doors are available usually only 75-90 cm in height to allow for a carer to reach over them from outside the cubicle if needed (a shower curtain is still necessary to prevent water splashing out onto the floor).
These are shower cubicles which have a toilet included within the unit, they are also called showerloos. You either sit on the toilet to shower or, as it has a ramped or level access, use an over toilet shower chair. Some units also include a wash basin. A shower toilet may be ideal if you do not have enough space for a seperate toilet and shower or cannot reach your bathroom and toilet as it can be positioned in a room that suits you. The toilet can function using a macerating unit so it can be sited virtually anywhere in your house and not just near your existing toilet's sump pipe.
Level access trays Level access showers have an entrance threshold of less than 1cm. They are therefore easy to negotiate independently, and put less stress on a helper's back when he/she is pushing you into the cubicle. However, there is more risk of water falling outside the tray with level access shower trays. Try to ensure that the tray is sufficiently large to take account of the fact that the shower curtains may billow outwards slightly as the shower water hits them.
Some level access bases are designed to fit in the space where a bath stood, so that the drainage from the bath is already in place. Others require under floor drainage to be installed. They often have a waste pump (see below) over the drainage hole to draw the waste water towards it.
Ramped access trays These trays are placed on top of the existing flooring and can be installed almost anywhere - even if it is not near to the main drains. The trays are raised at the front so that the water drains towards the back and is usually pumped above floor level down a narrow pipe to the main drains. A small ramp provides access for you to walk in, or be pushed in by a carer if you use a sanichair, a mobile shower chair or trolley.
However, consider the following:
- not all provide sufficient floor area to allow the use of a mobile chair, so always check the measurements carefully;
- if a mobile chair is used, check that there is enough space around the cubicle to allow sufficient 'run up' and that the ramp is not too steep;
- the mobile chair may have to be reversed into some small trays so that it can be conveniently positioned under the shower head.
Stepped access trays These are the most common type of shower tray available from most standard plumbers merchants and DIY chains. However, they may not be suitable for many users needs due to the need to take a large step when entering/exiting. They have a retaining 'barrier' at the lower front edge to stop the water from flowing out onto the floor. You need sufficient balance and mobility to step over this. Although it is possible to transfer from a wheelchair onto an extended seat a ramped or level access tray is usually much easier and safer. A bath / shower step (see below) can also be used to split the height of the step into the cubicle into two steps.
Shower areas/wet rooms
In a shower area/wet room part, or all, of the bathroom is converted for showering, either by laying a shower tray or sloping the floor and covering it with a suitable slip-resistant, waterproof flooring. It is also necessary to waterproof the adjacent walls, usually by tiling. Shower areas/wet rooms offer a lot more space for showering, but depending on the layout there may be less scope for supportive features such as rails as the walls are further apart. Since there are no steps or ramps to negotiate shower areas/wet rooms are usually easier to access, and more space is usually available which is helpfull if you are showering on a mobile shower chair (please see Shower Chairs for more information), or cradle/trolley (please see Mobile Cradles or Trolleys for more information). If you require assistance to shower there is more space, but your carer may get rather wet if there is no protection against the water. Waist height, wall-fixed or portable shower screens may be useful in this situation. Please see Shower Screens and Enclosures for more information
This type of shower uses pre-heated water from your homes hot water or tank, but has thermostatic controls which automatically compensate for any changes in water pressure. This ensures that, if someone turns on the cold water tap elsewhere in the house, the person in the shower will not get scalded. Some models will shut off completely if either the hot or cold water supply fails, please read about TMV approval under 'Safety' below.
Instant or electric showers
These run off the cold water supply. They have an element (like an electric kettle) connected to the electricity supply which heats the water as it flows through the unit. Some units have a switch to select various electrical loadings to give cool, warm and hot water. The slower the flow, the hotter the water. An even temperature will therefore depend on a steady flow of cold water. Safety devices are incorporated to help prevent scalding if the water flow falls below the minimum. Please read about the BEAB CARE Mark under 'Safety' below.
Shower unit controls
Depending on your needs and preferences, it may be worth considering models which have pre-set controls or one control which regulates the rate of flow and temperature. The following types are available:
- lever controls
- dial control;
- push button controls;
If you have sight loss you may wish to shortlist shower units that have achieved RNIB endorsement. These showers are designed to making them safer for users with sight loss. They may feature a high visual contrast unit to stand out from the wall, a large on/off button and colour contrasting LED backlit buttons that emit audible beeps when they are pressed. Features to look for include a shower head that can be easily adjusted on its slide bar / riser rail with a friction clamp bracket that can be operated with one hand. An extra long extended side bar / riser rail with an extra long hose will allow for seated or standing showering. If you are going to use a shower stool / chair consider having the controls sited so that are easy to reach from a stable sitting position.
Maintenance In hard water areas, shower heads need to be descaled regularly if they are to work efficiently. This usually involves dismantling the shower head before applying a descaler. You will need to have the ability to do this independently or arrange for someone to carry it out. However, on some models a lever can be operated to force a series of pins through the holes in the shower head to descale it. This eliminates the need to take it apart. Pumps which assist drainage also need regular cleaning and maintenance, accumulated debris has to be removed from waste pumps.
TRANSFERRING INTO A BATH TO SHOWER
- Seat height - If you can sit comfortably with your feet supported, you are less likely to slide forwards in the chair. Wall-fixed shower chairs can be fixed at the appropriate height; free-standing chairs and stools may have height adjustable legs. Many mobile chairs have adjustable height footrests to provide support.
- Backrests - a padded backrest will provide more support and be more comfortable than plastic moulded or tubular backrests.
- Armrests provide support while you are seated but should not be used to help you stay in the chair. If, without the arm supports, you would slide or fall, then it will be necessary to look for a supportive system that will provide a more stable seat and you require specialist advice from an occupational therapist.
Shower boards fit across the width on top of the bath tub and secure with adjustable stoppers against the inside of the bath. To transfer into the bath you reverse towards the shower board and sit down on it before swinging your legs over the edge to place them on the floor of the bath. It is strongly advised to have wall fitted grab rails fitted to support yourself whilst completing the transfer. Whilst showering you would usually remain seated on the shower board, but some people prefer to stand up and hold on to grab rails for support. Shower boards are usually made from plastic, but can in some circumstances be made from coated metal or wood. They often consist of 6-7 slats with gaps for the water to run through, but some have a perforated top surface. Some incorporates grab handles or indentations designed for you to hold on to. Shower boards may sometimes also be called bath boards but we consider shower boards to have greater width/depth than bathboards providing a greater area of support. Whereas bathboards are narrower to provide more room if you wish to transfer onto a bathseat (see our bathing factsheet). Shower boards are on the national catalogue which operates equipment prescriptions in certain parts of the country (see the introduction) with the codes BA04 26inch, BA05 27inch, BA06 28inch.
Swivel bath seats
Swivel bath seats fit over the bath and swivel to aid transfers over the bath. These seats have a back support and armrests. Most have a lever to lock the swivel mechanism in place whilst you are sitting down on the seat and when over the bath. These seats do not lower you into the bath, you shower from a seated position, or stand if you prefer. There is a specification for a swivel seat on the national catalogue which operates equipment prescriptions in certain parts of the country (see above) with the code BA17.
View a short demonstration of how to use a swivel bath seat when transferring in and out of the bath. http://www.dlf.org.uk/swivelbathseat
If you have difficulty lifting your legs over the bath rim when attempting seated bath transfers on a shower board or swivel chair a leg lifter may help. Manual leg lifters consist of a reinforced strap with a loop on the end. You hook your foot through the loop and then, with your arms, physically lift the loop (and thereby your leg) up to the edge of the bath rim and then down into the bath.
For more information on equipment for use in the bath including bath seats, bath lifts, bath rails please read our Choosing a Bath and Bath Accessories factsheet
TRANSFERRING INTO A SHOWER CUBICLE
Shower/Bath steps can be used to provide a step like platform outside a stepped shower tray/cubicle, lessening the height which you need to lift your legs to get into the cubicle. However, they are not suitable for people who have difficulty keeping their balance, and they will not help you to lift your legs out from a deep shower tray. If used, a slip-resistant step provides a safer surface to stand on; and a grab rail mounted on the wall may provide a secure handhold to grip whilst using the step. There is a specification for a shower/bath steps on the national catalogue which operates equipment prescriptions in certain parts of the country (see above) with the code BA16.
A variety of rails exists which can increase safety whilst in the shower or during the transfer in and out of the shower. Before installing a rail check that the wall you fix it too is strong enough to support the rail and the weight placed on it. Rails are available in different lengths and diameters, in plastic or metal and in a range of colours, some are angled rather than straight. Rails that are fluted or ribbed rails can provide greater grip on the rail, especially when wet. Floor to ceiling rails also exist, and these are attached to both the floor and the ceiling. They are usually positioned close to the tap end of a bath tub to provide support for a bather stepping into the bath, or to give a pivot point when used from a seated position, for example when using a bath board.
The following specifications are recommended in Part M of the Building Regulations. However, they should be used only as a generic guide when the users are not known. When an individual user is known / for someone in their own home personal factors such as the height of the person should be given priority:
- Folding armrests or safety rails attached either side of the shower seat can help to prevent somebody sliding off a wet slippery seat (BSI, 2009). A rail can be fixed on to the wall at the side of the shower seat, approximately 20 cm above the height of any seat. This may be used for help when standing and may assist wheelchair users to pull on to transfer across onto the seat from a wheelchair. See diagram 22 on page 59 of the building regulations. http://www.planningportal.gov.uk/uploads/br/BR_PDF_AD_M_2010.pdf
- In shower cubicles it may be useful to have an additional horizontal rail fixed on the wall opposite the shower seat at a height of 1m from the ground if it can be easily reached from the seat.
- A vertical rail at least 50 cm long can be fixed at the entrance to the shower compartment for use when stepping in / out of the cubicle. The rail should be mounted at a height that the user can comfortably reach whilst stood both from outside the cubicle and from in the cubicle.
- Vertical rails can be installed on the wall opposite a shower seat. The lowest fixing should be fixed 80 cm above floor level. However, the distance between the front of the seat and the rail must be less than 55 cm if it is to be used successfully.
Wheeled shower chairs
Wheeled shower chairs can be used to transfer into a level access shower cubicle or wet room area. Please read more about Wheeled shower chairs under Seating below.
Mobile shower trolleys and cradles
Mobile cradles are four-wheeled devices which often have a mesh fabric stretched over a metal frame. This allows for you to be showered in a semi-reclined position with knees and hips flexed which will not only help to inhibit extensor spasm and provide a more stable position, but it will also reduce the overall length of the cradle so that it can be used in some shower cubicles. Using a cradle requires for a carer to administer the shower, and requires quite significant space to position the cradle. Users of shower cradles are usually hoisted into the cradle which often come with side supports and belt straps to keep you safe in position when being showered. Some cradles have a folding facility for stowing away when not being used.
Shower trolleys are effectively height adjustable platforms on a wheeled frame where you lie on a padded surface whilst being showered by one or two carers. Shower trolleys have side supports, and there is often a drain outlet in the foot-end to allow the water to run out, often through a hose to control the surrounding environment. Shower trolleys are designed for people with very high care needs and do require significant space in the shower area. Due to their layout shower trolleys can make assisting with transfers easier for carers since sliding equipment can be used to transfer the user in a horizontal position directly from the bed onto the trolley, thus eliminating the need for hoisting.
Overhead track hoists
Overhead track hoists with a straight, jointed or curved track can be fixed, if the layout of the house permits, so that you can transfer in a sling from the bed and into the bathroom where you can use the toilet and or shower. An electric traversing system may enable you to transfer independently; a manual traversing system requires a carer to push the the hoist head along the track. Structural alterations may need to be made such as strengthening the ceiling, or adapting the top of the door frame to take the track. Please ask our helpline 0300 999 0004 if you require more information on overhead track hoists.
SHOWER SEATING FOR SHOWER CUBICLES AND WET ROOMS
Shower stools are free standing stools with non-slip feet, and often have height adjustable legs. Stools have little or no back support (unlike the shower chairs below), although they may have tubular arm rests or side handles, and some are foldable. They usually have a plastic seat and 3 or 4 legs, often made from aluminium or metal with non-corrosive coating. If considering using a shower stool it is strongly advisable you ensure the shower tray you have can support this as the weight distribution of the 3 or 4 legs can cause some shower trays to crack. There are specifications for a shower stools on the national catalogue which operates equipment prescriptions in certain parts of the country (see above) with the codes BA10, BA11 (corner), BA15 (round).
Wall mounted shower seats
A wall mounted shower seat can either be fixed, in which case it doesn't fold, or hinged, in which case it can be folded against the wall when not used. They often have two legs which rest on the base of the shower tray, but some sustain the weight of the user through the wall brackets, and thereby do not have feet. Some have back support and armrests, some consist only of the seat itself. If you are considering installing a wall mounted seat with feet it is strongly advisable you ensure the floor base you have can support this as the weight can cause some shower trays to crack, and also that the wall can sustain the required weight of the user. There are specifications for wall mounted shower chairs on the national catalogue which operates equipment prescriptions in certain parts of the country (see above) with the codes BA12, BA20 (with back and armrests).
Shower chairs are free standing chairs which are either static or mobile. Static shower chairs have four, often height adjustable, legs, a seat and back rest, thus making them a sturdier option than the shower stools. Shower seats with arm rests are also available. Some are foldable, some come with padded seating whereas some have a perforated plastic seat. Similarly to shower stools, if you are considering using a shower chair it is strongly advisable you ensure the floor base you have can support this as the weight can cause some shower trays to crack.
Wheeled shower chairs
Mobile shower chairs have wheels and can either be user propelled or attendant propelled with large rear wheels. This may enable you to push yourself, or be pushed, into a shower cubicle or area - avoiding the need to transfer onto a wheelchair and from there onto a shower stool or fixed seat. They usually have a backrest, armrests and footrests. They take up more space than shower stools or hinged shower seats. Some mobile shower chairs have an over-toilet/commode facility, and some have a tilt-in-space function.
Consider the following:
- the larger the wheels, the easier the chair is to push, whether independently or by your helper;
- make sure that there is enough space to manoeuvre the chair into position. Swivel front castors will make turning easier;
- smooth surfaced floors are easier to push over than carpet;
- chairs with removable or foldaway armrests are usually easier to transfer on to than those with fixed armrests;
- footrests that fold up and/or swing away can also make transfers easier, and safer;
- chairs with a folding frame can be useful for storing and transporting.
Shower chairs with castor base
These small wheeled chairs are designed for you to be pushed into a shower area or cubicle. They may be difficult to push over some floor surfaces, e.g. thick carpet, since the small wheels offer more rolling resistance and are therefore more difficult to push. However, because of their smaller overall dimensions, they take up less space. There is a specification for a wheeled shower chair with castors on the national catalogue which operates equipment prescriptions in certain parts of the country (see above) with the code BA14.
Large rear wheeled shower chairs These are designed for you to propel yourself independently into a shower area or cubicle. They may also be used as an attendant-propelled chair where the floor surface is difficult to push across, e.g. thick carpet, since large wheels offer less rolling resistance and are therefore easier to push. Check that you can operate the brakes.
Mobile shower, over toilet and commode chairs Mobile shower, over toilet & commode chairs (also called sanichairs) can be used in a shower but are also designed as mobile chairs with an aperture or hinged toilet seat for use over a toilet. They are available with large or small wheels.
EQUIPMENT FOR USE WHILST SHOWERING
In addition to the above shower seating and rails other equipment that you may wish to use whilst showering includes shower head holders, shower screens, long handled bathing aids.
Shower head holders
If an existing shower installation is positioned where you can't reach the shower head then shower head holders are available from many highstreet and DIY stores. They can usually be fixed to a wall with either screws or a suction cup attachment. Some shower head holders incorporate a built-in handrail.
Half height shower screens and enclosures
Shower screens and enclosures can be either wall fixed or portable and can be used in a range of walk-in showers or wet rooms. They are usually used by carers for splash protection and are usually 750mm or 900mm in height so the carer can reach over them. They are available in a range of configurations.
Long handled bathing aids
There is a range of long handled washing and personal care equipment and hand and foot care aids available designed to help make it easier to reach parts of your body when washing with less stretching or bending. This long handled equipment can be used for washing your feet, back or other hard to reach areas of the body such as between the toes. It may be best to use this equipment whilst seated in your shower to help avoid any potential difficulty with your balance when reaching with the equipment.
Waste pumps can allow for a shower to be installed in pretty much any part of a home and minimise the risk of flooding the area since they actively pull water towards the drain outlet. They are available with a range of maximum flow rates (how much water they pump from the shower in a set time period). Analogue drainage pumps will provide a constant rate of pumping and a fixed drainage speed, digital models vary the pumping rate depending on the volume of water flow from the shower. They use a flow switch attached to the shower's water supply pipe to calculate the flow. Some showers can communicate their flow rate to a shower waste pump directly (wired or wireless) which removes the need to fit a flow switch.
Wall-mounted body driers can be positioned in the shower cubicle or on the wall in a shower area. They produce a jet of warm air that can dry you whilst standing. It is not possible to dry all areas of the body from a seated position.
Shower seats/chairs outside the shower area
If space is available it may be possible to create an area adjacent to the shower area or have an extended cubicle which provides a dry area for dressing. This could be formed of a long bench seat which you can slide across.
Healthy adult skin requires only 30 seconds of exposure to water at 55 degrees centigrade before third-degree burning occurs. At 70 degrees centigrade burning occurs in less than a second. The skin of children and older people is even more sensitive to extreme temperatures. A maximum hot water temperature of 40 degrees is recommended for showers. Wherever possible there should be a guard against sudden water temperature changes, especially if scalding could occur. Therefore, the following are not recommended:
- a shower spray simply fitted over the taps of a bath, unless the hot water available is at a constant temperature.
- a variable heating source, e.g. from instantaneously heated gas or electric water heater.
Temperature control for non electric mixer showers It is recommended that you choose a system with thermostatic controls so that the water temperature remains constant even if other water outlets in the same circuit are turned on. It is also advisable to have a safety cut off at specific temperatures. Products called TMVs (thermostatic mixing valves) are available to accurately control the temperature of water for showering and bathing. They maintain the pre-set temperatures even if the water pressure varies when other appliances are used. Installed and maintained correctly, they can significantly reduce the risk of scalding in the home. Some types of thermostatic mixing valves can be installed with existing conventional taps, others can replace existing taps. TMV valves for domestic installation are governed by the TMV2 scheme, TMV3 valves meet requirements for use in public places such as Schools and Hospitals. The scheme's purpose is to monitor, test, approve and list complying manufacturers' valves. For more information contact the Thermostatic Mixing Valve Manufacturers' Association www.tmva.org.uk To check whether a valve is approved as a TMV2 valve visit the BuildCert Product certification website http://www.wrcnsf.com/Buildcert.com/check_an_approval.htm Fitting a TMV is not a DIY job. A registered plumber should be used. For help finding local competent traders, such as plumbers, who meet relevant standards you could visit www.trustatrader.com
Temperature control for electric showers, the BEAB CARE Mark Some electric showers will have a feature called 'phased shutdown', this protects the shower’s next user from high water temperatures by flushing out water from inside the shower when you finish showering. The BEAB Approved Mark is an electrical safety mark that demonstrates that independent specialists have evaluated the electrical safety of a product to the highest European and International standards. The BEAB CARE Mark extends this for certain products within the care industry such as electric showers. Showers with this mark have passed the appropriate electrical safety standard AND provide stable outlet water temperatures under normal supply variations. They should protect from scalding under rapid and abnormal water supply variations, without adjustment by the user. You can search for products that have the BEAB CARE mark on the ASTA and BEAB Marks directory web page (select BEAB CARE under the Approval Mark drop down selection box) http://www.astabeab.com/buyers-by-criteria.asp
Water temperature indicators
These products are usually used prior to getting into a bath to reduce the risk of scalding. Temperature indicators show when the temperature of the water is above a safe level by changing colour or giving a reading of the water temperature. They are preset within a safe range which is usually 34-47 degrees centigrade, and if the temperature of the water goes higher than this they may emit a warning such as a change of colour or sound an alarm. Some can also sound an alarm to warn of a dangerous water level which could lead to flooding.
Slip resistant products
Self-adhesive strips or circles for use on the bottom of baths or shower trays are available and may help to reduce the risk of slipping in the bath or shower. There are a wide range of bathmats readily available on the high street. These mats are secured with sucker feet to the bottom of the bath, shower tray or cubicle, and are available in a range of sizes.
The British Healthcare Trades Association (BHTA) is the UK's largest healthcare association. Members of the BHTA sign up to a code of practice designed to ensure the public can trust that members will give a good service, and a high standard of behaviour.
The British Association of Occupational Therapists is the professional body representing a diverse and thriving community of occupational therapy staff across the UK.
The Centre for Accessible Environments (CAE) is the UK's leading authority on inclusive design. Their aim is to help secure a built environment that is usable by everyone, including disabled and older people.
Planning Portal is the first port of call for anyone wanting to find out about the planning system in England and Wales. Its aim is to provide a one-stop-shop supplying answers, services and information to anyone involved in the planning process - from home owners and businesses to planning professionals and Government officials. Further guidance and regulations about access to and use of buildings (Part M): www.planningportal.gov.uk/buildingregulations/approveddocuments/partm/approved
Rica (formerly Ricability), the Research Institute for Consumer Affairs, are a national research charity dedicated to providing independent information of value to disabled and older consumers. Their reports are based on rigorous research and provide practical information needed by disabled and older consumers.
Released December 2014, to be reviewed by December 2017, Version 2
References Show references
BSi British Standards (2009) Design of buildings and their approaches to meet the needs of disabled people – Code of practice BS8300:2009. British Standards Institution: London - (Type 2)
College of Occupational Therapists (COT) (2006) Minor Adaptations without delay. College of Occupational therapists: London - (Type 2)
Disabled Living Foundation (2014) Trusted Assessor Training Course handbook, Disabled Living Foundation: London - (Type 2)
NBS (2013) Part M Building regulations - Access to and Use of Buildings. Accessed 4th November 2014. Available from- http://www.planningportal.gov.uk/buildingregulations/approveddocuments/p... (Type 2)
Pain, H., McLellan, L. and Gore, S. (2003) Choosing Assistive Devices: A Guide for Users and Professionals. Jessica Kingsley Publishers : London and Philadelphia - (Type 2)
Rica (2013) Fitting and using a bath board Available from: http://www.rica.org.uk/content/bath-boards [Accessed 29th December 2013] - (Type 2)
Sveistrupa, H., Lockett, D., Edwards, N. and Aminzadeh, F. (2006) Evaluation of bath grab bar placement for older adults. Technology and Disability Vol.18 p45-55 - (Type 2)
For more information on the Types of Evidence, please visit http://www.livingmadeeasy.org.uk/scenario.php?csid=276
If you would like further advice regarding daily living equipment related to showers you could try relevant sections of AskSARA. AskSARA is our free online guided advice tool. AskSARA will ask you questions about yourself and your environment and then offer relevant advice, product suggestions and supplier details.
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