Understanding the Goals of Shower Chair Placement
Proper placement of a shower chair goes beyond simply putting it in the shower. The primary goals are to maximize stability, facilitate safe transfers, and ensure comfort while bathing. This decision is not one-size-fits-all and should be based on the user's specific needs, the type of shower, and the available space.
Option 1: Facing the Showerhead
This is the most common and often most intuitive position for many users, especially those with good upper body strength and limited mobility in their lower extremities. It works best in walk-in showers or larger tub areas where the water flow is easily managed.
Advantages of facing the showerhead
- Direct Water Access: The user can easily wash their front and upper body without straining or twisting. This setup is straightforward and feels most like a traditional shower.
- Control of Faucet: If the faucet is on the same wall as the showerhead, the user can reach and adjust water temperature and pressure without getting up.
- Simpler Setup: This is often the most straightforward configuration and requires less complex maneuvering for entry and exit.
Disadvantages and considerations
- Overexposure to Water: Some individuals may find continuous, direct water spray uncomfortable or overwhelming. This can be mitigated with a handheld showerhead.
- Difficult Back Washing: Without a handheld sprayer, washing the back can be challenging and may require twisting, which is a fall risk.
- Limited Space: In a smaller stall, facing the showerhead can feel cramped, limiting space for personal care and caregiver access.
Option 2: Facing Sideways or Diagonally
For individuals with limited mobility, those requiring caregiver assistance, or those with unique shower layouts, a sideways or diagonal orientation can be far more effective. This is particularly useful in tub-shower combos where a transfer bench is involved.
Advantages of facing sideways or diagonally
- Easier Caregiver Access: This position gives a caregiver clear access to the user's front and back, making assisted bathing much safer and more efficient.
- Improved Water Control: When paired with a handheld showerhead, facing sideways allows the user or caregiver to direct the water flow more precisely, avoiding sensitive areas like the face.
- Optimized for Transfer Benches: For a transfer bench that straddles the tub wall, the user slides across the bench sideways. In this case, turning the chair to face the showerhead is not an option.
Disadvantages and considerations
- Less intuitive for independent use: The orientation may feel less natural and requires a bit more planning for positioning and managing the water source.
- Requires More Space: A sideways setup can occupy more floor space, which may be unfeasible in very narrow shower stalls.
Option 3: Using a Transfer Bench
A transfer bench is a specialized type of shower chair that is essential for individuals who cannot step over a bathtub wall. It is positioned with two legs outside the tub and two legs inside.
How to use a transfer bench
- Sit Down: The user sits on the dry portion of the bench outside the tub.
- Slide Across: The user lifts their legs one at a time over the tub wall while sliding across the bench until they are fully inside.
- Position for Showering: The bench is typically oriented sideways relative to the showerhead. The user or caregiver can then use a handheld showerhead to wash, turning slightly as needed. Using a curtain slit is key to preventing water from pooling on the floor. For more detailed instructions, refer to safety resources from the Centers for Disease Control and Prevention (CDC) on preventing falls.
Comparison of Shower Chair Positions
| Feature | Facing Showerhead | Facing Sideways | Transfer Bench |
|---|---|---|---|
| Best For | Independent users in walk-in showers with good upper body control. | Users with limited mobility, caregiver assistance, or unique shower layouts. | Individuals who cannot safely step over a tub wall due to mobility issues. |
| Primary Benefit | Direct, familiar water access and control. | Easier caregiver access and targeted water flow control. | Safest transfer in and out of a bathtub, reducing fall risk. |
| Water Management | Head-on spray, may require handheld for full-body wash. | Requires a handheld showerhead for effective washing. | Requires a handheld showerhead and a curtain slit. |
| Space Requirement | Requires clear space in front of chair. | Requires more lateral space for entry/exit and bathing. | Requires space on both sides of the tub wall for the bench. |
| Stability Risk | Low, if chair is stable. | Low, if chair is stable. | Low, provided legs are securely positioned and locked. |
Essential Safety Considerations for Any Position
Regardless of the chair's facing direction, several safety measures are non-negotiable for elderly users:
- Ensure Chair Stability: Before sitting down, always check that the chair is stable and all legs have firm contact with the floor. Use anti-slip mats for added security.
- Adjust the Height: The chair height should allow the user's feet to rest flat on the floor with their knees at a comfortable 90-degree angle. This position makes standing and sitting easier and safer.
- Install Grab Bars: Strategically placed grab bars are crucial for support when transferring to and from the chair. They should never be confused with towel racks or other non-load-bearing fixtures.
- Use a Handheld Showerhead: A handheld unit significantly enhances control, allowing for washing without twisting or overreaching, which minimizes fall risk. It is especially beneficial for sideways or transfer bench setups.
- Clear the Area: Remove all loose items, such as shampoo bottles, from the shower floor to prevent tripping hazards. The space around the chair should be free of clutter.
- Sit Centrally: Advise the user to sit fully in the center of the chair and not on the edge, which can cause the chair to tip.
How to Safely Position the Chair: A Step-by-Step Guide
- Assess the User and Space: First, consider the user's mobility level and the layout of the shower or tub. Is it a small stall, a large walk-in, or a tub? Does the person need caregiver assistance?
- Prepare the Bathroom: Place a non-slip mat under the chair and ensure grab bars are securely installed nearby. Gather all necessary toiletries and place them within easy reach.
- Choose the Facing Direction: Decide whether facing the showerhead, sideways, or using a transfer bench is most appropriate based on the assessment.
- Adjust the Chair Height: Set the chair to the correct height, ensuring the user's feet are flat on the floor when seated. Check this with the user before turning on the water.
- Test Stability: Before the user enters, give the chair a firm push and wiggle to ensure it is completely stable and doesn't rock.
- Assist with Entry and Exit: Help the user enter the shower, encouraging them to use grab bars for support as they slowly sit down. Once seated, ensure they are positioned centrally. Repeat the process in reverse for exiting.
Conclusion
There is no single correct answer to which way should a shower chair face for the elderly, as the best position is always customized to the individual and their environment. By carefully considering the options—facing the showerhead, facing sideways, or using a transfer bench—and prioritizing key safety measures like stability, proper height, and grab bars, seniors can bathe securely and maintain their independence. Regular reassessment of needs ensures the setup remains safe and effective over time. Always consult with a healthcare professional or an occupational therapist for personalized recommendations.
