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Bathing as a Wellness Experience

October 1, 2003
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Design features to enhance the independence of cognitively intact residents BY JULIE MOLLER, ASID, AND CARRIE RENEGAR
Bathing as a Wellness Experience

Bathing area design features enhance independence and feelings of well-being

BY JULIE MOLLER, ASID, AND CARRIE RENEGAR Editor's note: Some of the suggestions the authors make herein are not intended for LTC residents with dementia or other types of cognitive impairment. This article focuses primarily on bathing for residents of nursing homes and assisted living facilities who are cognitively intact. From the times of Hippocrates through today, bathing has been used as an effective tool to renew and revive our bodies. Because the act of bathing carries such important health and wellness benefits, showers and baths should go beyond the typical day-to-day function of only serving as personal hygiene outlets and be used as focal points of wellness promotion.

How can the bathing areas of long-term care facilities function as wellness centers and work to enhance the different aspects of senior wellness-physical, emotional, and spiritual-and break away from the conventional? What design features can facilities use to enhance resident health and happiness?

According to a report by AARP, a poor-quality physical environment is not only a barrier to independence, but it might actually increase functional loss in older adults. In this article, we explore finishes, designs, and special touches that, when incorporated into resident bathing areas, create physical environments that can contribute to a healthy and satisfying life for residents-and promote senior wellness.

Aspects of Wellness
Bathing as a wellness experience should evoke feelings of physical, emotional and, on some levels, spiritual well-being. Bathing encourages physical activity through movement and can provide a feeling of independence, self-confidence, and satisfaction with daily hygiene. For those residents with medical conditions that prevent or limit physical ability, bathing may be the one simple form of physical activity in which they can participate.

Enhancing a sense of positive personal contentment and balance, bathing serves as a stimulus for healthy emotional and spiritual well-being. Bathing encourages feelings of self-worth through taking care of oneself. The daily routine of bathing also provides a continuity of daily activities and habits formed over a resident's lifetime-helping to formulate a strong emotional foundation.

The act of releasing pent-up stress and anxiety during bathing perhaps can be one of the greatest benefits and can help ward off common depressive states. If bathing takes place in a peaceful, healing environment, spiritual wellness can be solidified through meditation, prayer, and thought, which can occur while in the relaxed setting of a bath. An elevated inner peace can parlay into a positive outlook, allowing residents to live in the moment and bring balance to life.

The Physical Environment
The physical environment is key to encouraging residents to participate in bathing as a wellness experience. The environment should offer warm, intimate spaces encompassing every function of bathing. This can be achieved through the layout, lighting, finishes, furnishings, and special touches within the bathing area.

The basic layout of a bathing space should incorporate areas for shower, bath, toilet, dressing, and grooming. These areas should open from one to the other, with visual divisions using half- to full-height walls or furnishings such as privacy drapes or screens. Privacy is essential. It allows residents to maintain dignity and alleviates their self-consciousness. Even on a tight budget, with a little creativity these divisions can create an intimate, private area, both in new construction and as modifications to existing facilities.

Lighting and Noise Reduction
Lighting is used universally to establish the mood and ambience of a space, and the bathing area shouldn't be any different. General lighting used for physical maneuvering about the space should always be on dimmers to enable residents to adjust the "mood" when they wish.

Lamps provide wonderful luminescence and warmth, adding to the comfort of a space. Place lamps on a vanity, the back of the toilet, or storage shelving to create warmth. To protect residents, caregivers should turn lamps on and off as needed. Another safety measure would be to only plug these lamps into GFI (ground fault interrupter) outlets that are connected to light switches. Coffered ceilings with pendants or close-to-ceiling chandeliers and cove lighting over the bath are also fantastic residential soft touches.

When the layout of the bathing area is designed, a window should be included to allow natural light to filter in-a necessity for normal function and emotional balance. Overall, mixing a variety of lighting types helps to create different atmospheres that can be alter-ed based on a resident's mood.

Reducing noise in bathing areas is vital to the success of encouraging residents to participate in the bathing experience. Noise can be diminished in a multitude of ways, including the installation of a tub with a noise-reduction faucet; using soft finishes, such as slip-resistant, welded-seam sheet vinyl; and using hard-surface materials, such as tile, only where necessary on walls and floors that will become wet. Hard surfaces tend to magnify noise, while vinyl or other soft surfaces tend to absorb it.

Privacy drapes (cubicle curtains) around the tub, shower, and at the windows also absorb noise. Placing plants throughout the environment is another great way to curb noise.

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