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The Order of the Bath

Medicine often deals with complex and technologically advanced subjects, but it's the simple things that are most often important to patients. Three cheers, then, for a down to earth piece from Leeds in a recent BMJ.

Survey

Over a one week period, a senior house officer surveyed all inpatients in eight wards, and all those attending the geriatric day hospital at St James's University Hospital, a total of 129 inpatients and 18 day patients. The patients were asked if they had ever been unable to get out of their bath at home.

Results

Twenty one patients (14%) said they had been unable to get out of the bath at some time, and though most were stuck in their bath for less than an hour, three were stuck for 1-4 hours, and two were stuck overnight. Two were stuck more than once.

Again, most suffered no trauma, but two suffered bruising, one pressure sores and burns, and one had a myocardial infarction.

The reasons for being stuck were split almost equally between a physical disability, and the bath and its environment: lack of bath aids, such as grab rails, was a major factor in preventing people getting themselves out. Only a few were able to free themselves unaided, most needing help, and one needing an ambulance crew.

Conclusions

In this simple survey, one in seven elderly patients aged 70 to 89 years had been stuck in a bath at home. Given that the UK has a large and growing elderly population, this is a problem which needs evaluation. It is a problem easily solved, in most cases, even for people living on their own. Although it is not a medical problem in itself, it could impact on the health of elderly people, and the use of services.

What to do?

It may be that this survey represents an atypical group of patients. They are selected, in that they are patients. Do bath accidents represent a real threat to the elderly living alone, and if so what can be done about it?

It seems that there are questions to be answered here, which touch on the borderline of health and social services. Bath aids (like hand grips, shower stools and the like) are readily available from a number of sources, are relatively inexpensive and not difficult to fit or use.

What is needed here is more information, and perhaps a study looking at the effectiveness of bath aids in preventing accidents in the elderly.

Reference:

Gooptu & Mulley, British Medical Journal 1994 308: 762.
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