Assessment of Bathing in Occupational Therapy

Abstract

Personal cleanliness is important for all of us. The ability to bath independently is considered important by occupational therapists and their clients. This paper describes the assessment methods used by occupational therapists working with adults with physical disabilities. In addition, it explores the factors that were considered important during the assessment and solution phases of bathing intervention. A survey questionnaire was sent to 108 occupational therapists working in health and social services within Greater London. The findings highlighted that the methods of assessment used most frequently by practitioners were observation in the home or in a simulated environment and face-to-face interviews. During assessment, the components ranked as most important for consideration were ‘mobility’, ‘client priorities’, ‘safety factors’ and ‘medical diagnosis’. During the solution phase similar factors were found, with the additional item of the availability of bathing equipment. The findings of this study raise questions related to bathing issues and indicate a need for further study. Of particular interest are the questions of client priorities within the process and the high number of practitioners not including water in the assessment of this potentially dangerous activity.

Interrater reliability of Algo used by non-occupational therapist members of homecare interdisciplinary teams

“…[13] Criteria for a straightforward clinical scenario were: (1) being able to get to the tub or shower stall with or without assistive mobility devices, but without human assistance; (2) not needing or wishing to soak in the water (no transfer to the bottom of the tub); (3) being aged 18 years old or over; (4) weighing less than 250 pounds; (5) having a stable medical condition (neither degenerative neurological disease nor end-of-life condition); (6) having no medical restrictions (no restriction such as partial weight bearing); (7) being able to stand up with or without support for 5 seconds; (8) can use a bar for support; (9) being able to follow simple instructions (neither severe dementia nor misbehavior); and (10) using a standard shower stall or bathtub at home (neither podium tub nor tub on legs). [13] A convenient number of six simulated clinical scenarios was selected since it covered a variety of Algo's potential recommendations for bathing in home environments, including at least one instance of bathing: (1) standing in a shower stall, (2) sitting on a bath stool, (3) sitting on a bath chair, and (4) sitting on a bath board or bath transfer bench.…”

“…[1,2] This is not surprising in an aging population where staying at home as long as possible is often the first choice, [3] and also since bathing is the most problematic activity of daily living associated with aging. [4][5][6] Despite this reality, it is noticed that in homecare occupational therapy in Health and Social Services Centers (HSSCs) providing publicly funded services to the Quebec population, the priority criterion to determine the degree of urgency for bathing difficulties is quite moderate, thus leading to a target wait time of 3-6 months. [1] Some consider this wait time as unacceptable [7] because the risk of bathroom falls is elevated, and both prevention of injury and promotion of functional autonomy are essential for the elderly.…”

Brazilian Assistive Technology in Bath or Shower Activity for Individuals with Physical Disability

“…Bathing or showering may be described as a sum of experiences that provide maintenance of health, well being and relaxation (Gooch, 2003).…”

“…Gooch (2003) considers bath or shower as a complex and potentially dangerous activity to all people since it involves a combination of water, foam and a smooth surface, characterized by a tub surface of the floor. Considering this context and the disabled or handicapped person, such situation may become even more complex.…”

“…A more adequate and appropriate solution involves a selection and denotation of a bath or shower equipment that must necessarily follow a "hierarchical path" to be prescribed, in which it should be primarily thought from the simplest adaptations till a specific bath/shower, being that in more complex cases, environment changes may also become necessary (Gooch, 2003).…”