Planning bathroom routines during rehabilitation

In this guide, we explore setting a bathroom routine during physical rehabilitation, offering some thoughts around the factors that should be considered as part of building a plan that works for the mobility impaired individual and those supporting them.
Roll-InBuddy XL SB6c-22 in front of shower

Our bathroom routines are highly personal

The bathroom routine is probably such second nature to most of us that we don’t give it a moment’s thought. Go in, do what you need to do and leave again. But these routines are built up over years of using the bathroom – what order we brush our teeth, do our hair, shave and even use the toilet. It might seem pretty minor but our bathroom routines are highly personal. It’s not until our bathroom use is interrupted from an injury or other mobility impairment that we truly appreciate what independence means to us.
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Share the support

Who will be involved in accessing the bathroom?

Deciding the people that will help you use the toilet and shower is an important step of this process. The OT may suggest engaging more than one person so the load is shared across multiple people – a parent, partner and a home carer.

Those involved need to be comfortable assisting you to get from anywhere in the home to the bathroom and preparing to use the toilet and shower without much trouble. It’s actually not always practical for a partner to take this role on, such as in circumstances where the partner is greatly outweighed by their mobility impaired loved one – for the safety of both parties a home carer may be a better decision.
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Consider your current routine

What order will you conduct bathroom activities?

Do you have a preference as to how you approach your morning and evening routines? What about during the day? It seems trivial until the process is underway and these minor details start to really matter.

Consider what your bathroom routine has been prior to the injury or impairment. What would make your life easier and more in line with your preferences? It’s important to let the OT know this information as they can to a large extent accommodate these requests, depending on the nature of the injury.

Some things that we know our Showerbuddy community of users think about during their bathroom planning:

  • Do I use the toilet every morning before taking a shower?
  • Can I still see myself in the mirror when seated?
  • What hair products do I use each day?
  • Can I apply my own deodorant or aftershave?
  • How often do I shave?
  • Do I brush my teeth before getting into the shower or after?
  • What typical bathroom activities do I have during the day time (i.e. outside of the main morning and evening bathroom routines).
  • Do I get undressed outside of the bathroom or enter the bathroom first and then get undressed for bathing?

This process of establishing the order of activities is all about surfacing what makes you the most comfortable.

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Shower Transfers

How will you get into and out of the shower unit?

Transferring into and out of the shower is one of the more difficult manual movements any of us make, unless we’re in a bathroom with an open plan ‘wet room’ style shower. For anyone with an injury they’re rehabilitating, the ‘transfer’ demands help through a combination of equipment and human support to execute safely.

The occupational therapist will do an assessment on your bathroom and shower against the status of your impairment to create a plan, but you may wish to contribute to this by thinking about your preferences here. At different stages of the physical rehab, you may be able to take on more of a role in the actual transfer, whether that’s mounting onto a transfer system, or moving a shower chair up to the shower for transfer.

Then consider what happens once bathing is over – do you dry yourself off in the shower before getting out? What help if any is required after this?

Don’t feel like you need answers to all these questions. An OT will ensure you have a safe bathing experience. But if you’ve got preferences with the transfer, it’s good to voice these.

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Backup plans

What are the back up plans in the event of a cleanup?

Accidents happen, more often than you might think. First, the speed at which one can get to the bathroom is not quick in most cases. And the actual process of getting over the toilet and completing the task doesn’t always happen with laser precision.

While this is certainly not a fun thing to cope with, your support plan should have this type of occurence planned out as much as anything else. Having your say around this scenario might feel awkward to talk about, but if everyone knows what to do in the situation well before it happens, there’s less stress when it does.
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Assistive equipment

What equipment will be available for both toilet and bath use?

Asking about the equipment options you have (as well as doing your own research) is a great way to get involved in your own rehabilitation and care plan.

As you might read in our other resources on this website, there’s a number of assistive technologies available to you – and in many cases more than one good option so personal preference does play a part in some cases.

Your OT may work with the physical therapist to choose equipment that supports the process of rehabilitation. Some equipment will also be able to be adjusted or even customised around different stages of mobility.

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Solo bathing

Which periods of usage can you be left alone?

With privacy such a sensitive issue for most of us, those moments where one can be left alone to conduct some of their bathroom business is a big deal. As part of building the latest bathroom routine with the OT, establish which of these tasks is feasible to happen without someone in the room (even if they are nearby to provide help at a moment’s notice).

Once the transfer is made over the toilet or into the shower, can you have periods to tackle the process alone? If mobility is still low but there’s a desire for any privacy possible, your OT may work out a way to retain the person-based help for the key tasks of bathing and toileting, whilst adding extra moments in the plan that allows the carer to leave (such as having a nice relax under a hot stream of water).

Rehabilitation roadmap

What is the roadmap for rehabilitation and how does this affect the routine?

When dealing with an injury or impairment that has a long term outlook that’s positive, be it full recovery or a satisfactory regaining of mobility, it’s useful to understand what the key stages are in between today’s movement ability and that ideal future state.
An occupational therapist will work with doctors and other health providers to build a clear understanding on the injury and the milestones that the individual is aiming to achieve and by when.

The bathroom activity can in many ways mirror these milestones by gradually introducing more personal input by the individual, such as bathing oneself with the removable shower head, or managing the toilet process solo. Setting goals is an important part of a physical therapy programme, and so too in bathroom usage.

Things may start out as ‘high touch’ in terms of the equipment and personal help to get through the bathroom routine, but at each milestone may drop off a particular aspect of support in order to empower the individual to do this themselves. It won’t be a sudden process whereby these tasks can’t be done and then can – like all motor skills and rehab exercises it’s a matter of practice and building up capability over a longer period. This obviously needs to be tempered with ensuring that bathing and using the toilet is still as pleasant an experience as possible.

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Work with an expert

Work with an occupational and/or physical therapist

The best source of information and planning is going to be with the OT and Home Care PT. They are able to apply their training and experience to understand your mobility levels at a given point in time, and put together a plan that offers you the best possible bathroom experience at the time.

They can engage with other support people like family or carers to help coordinate the help you may need. Beyond this, OTs and PTs are very well informed on the assistive technologies available and therefore can get demonstrations or arrange the ordering of this equipment for you.

If ever in doubt, your OT or PT are the best ones to talk to and get help to adjust the plan. That’s what they’re there for!

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More info

More information about this topic:

You can find useful information about this topic across the web via the following excellent online resources:

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Helpful Guides

Learn more in these related guides: 

Using The Toilet With An Injury

It’s understandable that the idea of someone else being in the same room with us, let alone near us during toilet use is unpleasant.  There are few activities in a person’s daily life that demain such privacy.

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How To Bathe Comfortably During Rehab

Bathing isn’t just a function of daily life to keep us clean and smelling nice; it’s the moment in the day we regaing our thoughts and relax.  Why should this be any different for someone in the midst of a physical rehabilitation journey?

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Equipment To Help Bathroom Use When Injured

Assistive technology plays a crucial role in rehabilitation and conducting taks for millions of people across the world each day.  While for many people this equipment doesn’t solely cater to their support needs, they’re still an important complimentary factor.

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Common Injuries And How They Prevent Bathroom Activities

There’s hundreds of serious injuries that can prevent bathroom activity from being carried out without support.  Physical rehabilitation is often required to assit the individual to regain their coordination and strength.

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