Survey of elderly people who get stuck in the bathBMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6931.762 (Published 19 March 1994) Cite this as: BMJ 1994;308:762
- C Gooptu,
- G P Mulleya
- Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5ST
- a Department of Medicine for the Elderly, St James's University Hospital, Leeds LS9 7TF
- Correspondence to: Dr
Many apparently healthy old people are unable to bath without help1 and some are not able to bath as often as they would like.2,3 We met several elderly people who had become stuck in the bath, and we decided to investigate.
Patients, methods, and results
During one week one of us (CG) assessed all inpatients on eight wards for the elderly and all those attending the geriatric day hospital at this hospital. The patients were asked whether they had ever been unable to get out of their bath at home. Those who had were then interviewed using a standard questionnaire.
Of the 233 patients initially assessed, 43 with mental impairment (abbreviated mental test score less than 7 out of 10) and 15 with severe dysphasia were excluded, as were 28 who lived in nursing or residential homes. The remaining 129 inpatients and 18 day patients were interviewed. Twenty one of the 147 patients said that they had been unable to get out of the bath at some time. Their ages ranged from 70 to 89. The table shows the results of the questionnaire.
Most people had had difficulty getting up out of the bath after completing their bathing; one had slipped and fallen and four had lain down in the bath and then been unable to get up. In 11 cases the inability to get out of the bath was related to physical disability - usually poor mobility resulting from a previous stroke (five), osteoarthritis (four), or both (two). One patient had severe rheumatoid arthritis and three were disabled by cardiac failure. Of the 10 other patients (who were in hospital with various impairments, including respiratory infection, myocardial infarction, jaundice, and leg ulcers), six blamed a lack of bath aids - for example, not having any grab rails. Two thought that the bath sides were too high to allow them to get out easily. In two cases alarms had been fitted near the bath but were at the wrong end to be of use.
All but one person had pulled the plug out to allow the water to drain away and several had covered themselves with a towel to reduce the risk of hypothermia. The patient who was admitted to hospital with extensive pressure sores and burns (table) was unable to get out of a zinc bath in front of a fire. Every patient had vivid memories of the event. Nine described it as “a terrible experience”; six others admitted to panicking. Three remembered banging on a wall to attract attention. All had changed their bathing activities since the event. Five had abandoned having a bath and now had a strip wash; four had baths at day centres. Six bathed only with the help of a relative, while three had had showers fitted. Another three were waiting for bath aids to be fitted.
One in seven elderly people in a geriatric unit had been stuck in the bath at home at least once. Physical complications were few but potentially severe: pressure sores may develop within a few hours and require weeks of hospital care, and hypothermia can be fatal. Plastic surgery was necessary for the burns sustained by one patient. The psychological impact was considerable, one episode being enough to deter many subjects from bathing at home again.
Elderly people should be advised not to have a bath unless someone else is in the house and to leave the bathroom door unlocked. Appropriate aids and walk in showers may also help. We could not identify those at particular risk: half of our subjects had no underlying physical disability. Furthermore, those with the most reduced mobility are not necessarily at greatest risk because they often cannot get into a bath. We suspect that many healthy old people living at home are at risk. Our future community based studies should determine the prevalence of this problem and identify those at particular risk.