Bariatric Bathrooms

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Toileting aids
Bariatric bathroom support
Showering
Bathing

Toileting aids

Many really heavy people are nervous about using the toilet in case they break it and injure themselves. A traditional ceramic pan will take a load of about 20 stone, but there is now a heavy-duty toilet surround, (shown left) which will convert any standard toilet into a facility that can be used safely by people weighing up to 70 stone.

Most configurations of grab rails in the toilet are not sufficient for the needs of obese patients, as they do not extend far enough forwards, and may not be sufficiently supportive. A sturdy floor-mounted support in front of the toilet may be more helpful, as the user can then lean forwards and use both hands to pull themselves up.

Provisions for assistance in this area also include extra-wide commode chairs (right). As well as providing a portable facility, a chair like this can also be used over the toilet, without the removable pan, in place of a support frame or raised toilet seat.

Personal cleansing after using the toilet may be especially difficult: a specialist unit that combines a bidet and warm air drying with the WC may be the solution to maintaining patient dignity and privacy in this area. The heavy-duty automatic shower toilet shown here is combined with an electronically controlled toilet lift which raises and lowers the user in a safely supported seated position. It is suitable for individuals who way up to 47 stone (300 kg), and has an ergonomic seat specifically designed for bariatric users.

Pressure management is also important: chronic digestive problems may involve extended periods seated on the toilet, and obesity is one of the risk factors for development of pressure sores, so it is good practice to extend pressure relief measures to this area. A padded seat can help.

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Bariatric bathroom support

Many suppliers of grab rails include heavy duty supports in their range, to accommodate the needs of heavier users. Plastic rails, with a tubular aluminium core for added strength, are a good choice in the bathroom, as they don't require earthing. Rails with five fixing points give more support than those with the more usual three.

When installing a grab rail, it is always important to choose the right kind of fixings for the wall it is being attached to - if it must support the weight of somebody of 20 stone or more, this is clearly paramount. Many internal walls are constructed from plasterboard mounted on a timber frame, known as stud work. You would not be able to get sufficient fixing points in a standard timber frame to support a heavy duty rail, so in this case, it would be safest to fix the rail to a backboard on the other side of the wall.

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Showering

For users weighing up to 55 stone (350 kg), a carer propelled shower/commode chair manufactured from wider diameter tubing for extra strength, with robust twin castors that make manoeuvring easier, even with a maximum load. Armrests and heavy duty footrests lift up out of the way, to facilitate side transfers.

To accommodate the largest users, a very generously proportioned shower enclosure, or a wet room, are ideal. A heavy duty former or level access tray, with a slip-resistant surface will suit both ambulant users and those in a chair. If you choose a wall-mounted shower chair, remember that the weight it can safely support will depend as much on the quality of the fixings and the wall it is attached to, as the chair itself.

An effective solution for users who have severely limited mobility is a bariatric shower trolley. The unit shown here can safely transport a load of 63 stone (400 kg), and is height adjustable, so that it can be moved to a safe working height for carers. The base is high enough to accommodate a mobile hoist, if the user is transferred from bed to trolley using a sling. Waterproof padded cushions form a comfortable base and sides. For transfers, the sides drop down level with the base. This type of trolley is suitable for wound care, as well as washing.

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Bathing

To help support the heaviest users to bathe independently, a bariatric bath board, as shown here, is made from steel with a very generous powder coating, to prolong its life without corrosion. Heavy duty adjustable brackets enable it to be fitted securely to almost any bath, and it can accommodate users weighing up to 70 stone (450 kg).

Steps of two, four or six inches (50, 100 or 150 mm), which also come with a support rail on one or both sides, also contribute to enabling a bariatric bather to access the bath safely. They are particularly helpful where the user is short in stature, or the edge of the bath is rather high.

For individuals who don't have enough mobility in their hips and knees to lift their legs into the bath, either a walk-in tub or a bath with a powered lifter can enable them to continue enjoying the pleasure and therapeutic benefits of a soak in hot water. You can see more in our assisted bathing and walk-in bath sections.

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