Abstract
The onset of disability in bathing may be followed by disability in other daily activities for older adults. A bathing adaptation usually involves the removal of a bath or inaccessible shower and replacement with a level, easy access shower. The purpose is to remove the physical environmental barriers and restore older adults’ ability to bathe safely and/or independently. The aim of this study was to explore the views and experiences of older adults and their carers who had received a bathing adaptation in order to examine how the adaptation had affected them and identify mechanisms of impact and outcomes from their perspectives. The study was nested within a feasibility Randomised Controlled Trial (RCT) (BATH‐OUT) conducted within one local authority housing adaptations service in England. Semi‐structured interviews were completed between 21 December 2016 and 19 August 2017 with 21 older adults and five carer participants of the feasibility RCT. Interview participants were purposively sampled on living arrangement and gender. Interviews were audio‐recorded, transcribed verbatim and analysed in seven stages using framework analysis. Findings were presented thematically. Five themes were identified: ease of use; feeling safe; feeling clean; independence, choice and control; and confidence and quality of life. The removal of the physical barriers in the bathroom led to older adults re‐mastering the activity of bathing, having an improved sense of physical functioning which gave a sense of ‘freedom’. This appeared to impact a range of areas contributing to a wider sense of increased confidence consistent with constructs underpinning social care‐related quality of life. We suggest that future research should examine housing adaptations from a person–environment fit approach, and that timely restoration of bathing ability is especially important as it can affect confidence and perceived competence in other areas of daily living.
Highlights
The onset of disability in bathing, defined as ‘the inability to wash or dry one's whole body without personal assistance’ (Gill, Guo, & Allore, 2006b: 1524), is a seminal point in the disabling process for older adults
As little is known about the experiences of older adults following the onset of difficulties with bathing or their opinions on how adapta‐ tions to bathing facilities might affect them, this study explored the lived experiences of the bathing adaptations process by older adults and their carers
Older adults ranged in age from 66 to 85
Summary
The onset of disability in bathing, defined as ‘the inability to wash or dry one's whole body without personal assistance’ (Gill, Guo, & Allore, 2006b: 1524), is a seminal point in the disabling process for older adults. It is often rapidly followed by disability in other activities of daily living (Gill, Guo, et al, 2006b), is associated with increased need for homecare services (LaPlante, Harrington, & Kang, 2002), and increased likelihood of nursing home admission (Gill, Allore, & Han, 2006a). There is a dearth of research evaluat‐ ing the preventative effects of bathing interventions for older adults (Golding‐Day, Whitehead, Radford, & Walker, 2017)
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