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 A Bathroom That Works 
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Joined: Sun Jun 24, 2007 5:35 pm
Posts: 344
Post A Bathroom That Works
My husband, John, was diagnosed with LBD in June 2007. He is still in early stage.
One of the smartest choices I have made in caregiving was early remodeling of the bathroom. My caregiving friends all told me the bathroom was a crucial point of stress for them.
We had a traditional bathroom with a combination tub/shower and floor mounted toilet that just was not going to work with movement issues for John or for me as I aged with back problems.
I decided to gut the old bathroom and start from scratch in order to get what we needed. There were two major problems that LBD presented in the bathroom---how to bathe if a walker or wheelchair was in our future and how to deal with inevitable messes around the toilet.
The key to solving both these issues was to use the back half of our bathroom as a €œwet zone€ and remove all obstacles to cleaning and stepping into the bath area. I designed a tile floor that gently sloped toward a single drain in the shower area, using a European model of shower design or more like an American commercial bathroom floor. Floor tiles are the one-inch size, so the floor is not slippery. There is no raised lip that separates the shower from the rest of the bathroom. Instead, the back half of our bathroom floor gently slopes toward the drain from any point, so that any water on the floor moves into the drain. This also makes it easy to bring in a shower chair when it is needed---there are no barriers on the floor and there is the feeling of having a lot more space. The caregiver can easily maneuver all around the chair in this setting to help with bathing.
The toilet, which is placed in the €œwet zone€, is a wall hung type by American Standard, so that cleaning under it is a matter of reaching for the handheld showerhead with a long (six foot) hose, turning on the hottest water to rinse the floor and the undersides of the toilet, spraying antibacterial cleaner, and rinsing everything into the drain at that end of the bathroom. Let the hot water, the floor design, and the cleanser do the work for you. There is no getting on the hands and knees to scrub around the base of a toilet involved, so stress levels and back issues stay low.
Besides an obvious addition of hand holds in strategic places, the other item that has been a blessing to us is the toilet bidet seat. It is an expensive item, but has been worth it. We chose the top of the line bidet seat by Toto that has a remote that I mounted onto the wall next to the toilet with heavy duty Velcro.
A bidet seat acts like a bidet, in that it washes you after going to the bathroom, but it takes the place of a normal toilet seat on top of a regular toilet. This is helpful for back issues and any movement problems because the work is done mostly by the seat’s cleaning sprays and all you have to do is dry yourself with a few sheets of toilet paper without the usual twisting and turning needed with regular toilet cleaning.
After we started to use the bidet seat, we realized that it also helps with issues of constipation because the warm sprays actually help to relax that part of the body to make going to the bathroom easier. My husband, who was a skeptic, is now a believer in bidet seats. For me as a caregiver, this will help in the future when helping John with cleaning will be more of an issue. I think that this item alone can keep John at home for extra months because it reduces both the stress and some of the physical labor involved with toileting.
Just last week the new bath design was put to the test when the toilet overflowed. What would have taken 2-3 hours to clean (with significant back stress) took about 20 minutes (with no back stress) and was not very hard or upsetting at all. Both of us were very glad we had changed the bathroom space to be so much more user friendly sooner rather than later.

SEE BEFORE AND AFTER PICTURES OF THE BATHROOM ON SECOND PAGE OF THIS THREAD.

1. Remodel completely if you can afford it to create a wet zone and drain for the floor. If not, consider:
2. Modify the bath area by installing a step in shower.
3. Modify the toilet area with a handicapped height toilet or a wall hung toilet.
4. Invest in a toilet bidet seat.
5. Install handgrips everywhere you need them in the bathroom.

_________________
Pat Snyder, husband John, dx LBD 2007
Author of [i]Treasures in the Darkness: Extending Early Stage of LBD...[i][/i] [url]http://www.amazon.com/Treasures-Darkness-Extending-Alzheimers-Parkinsons/dp/1466428228/ref=sr_1_1?ie=UTF8&qid=1334092686&sr=8-1[/url]


Last edited by Pat on Sun Jul 08, 2012 6:10 pm, edited 2 times in total.



Tue Oct 19, 2010 11:56 am
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Joined: Sun Jun 24, 2007 5:35 pm
Posts: 344
Post Re: A Bathroom That Works
I would add to the list. If installing or replacing an exhaust fan, buy the slightly more expensive quiet model. This makes the bathroom an easier place to communicate and reduces distractions at a potentially stressful time.

_________________
Pat Snyder, husband John, dx LBD 2007
Author of [i]Treasures in the Darkness: Extending Early Stage of LBD...[i][/i] [url]http://www.amazon.com/Treasures-Darkness-Extending-Alzheimers-Parkinsons/dp/1466428228/ref=sr_1_1?ie=UTF8&qid=1334092686&sr=8-1[/url]


Thu Nov 04, 2010 5:46 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: A Bathroom That Works
This "wet zone" bathroom sounds great.

One small improvement that doesn't take a whole remodel is a higher toilet. It is one of those ideas that seem so obvious after someone has come up with that it makes me wonder why on earth we ever made toilet seats so low? An ADA-approved height is better for everyone (except perhaps small children.)

Other "obvious" solutions from industry that come to mind include wheels on suitcases. Duh. How many millenium was it between the invention of the wheel and the bright idea to apply them to a common household item whose purpose is to be moved frequently? :lol:

And blending water in the pipe before comes out a single faucet -- how many decades did we have indoor plumbing before someone got the bright idea that sinks didn't need separate faucets for hot and cold water?

Yep. Now that we've finally figured out that toilets should be at a reasonable height to assist rising from them, I don't know why any other kind are sold. If you have to replace a toilet or you are remodeling or building, I suggest you not consider a "standard" height toilet.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sun Jul 17, 2011 2:53 am
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Joined: Mon Feb 14, 2011 10:22 pm
Posts: 190
Location: Portland, Or
Post Re: A Bathroom That Works
Pat- your bathroom sounds like my dream bathroom, I'm so envious! Before my mom was diagnosed with LBD in Feb of this year, we were dealing with a broken leg that didn't heal correctly ( a LONG story!) and the bathing/shower issues that go along with that. As my mother is low income, our local Aging/Disability office was able to contract a bathroom mini remodel which included handrails and her bathtub was cut-out 19in W by 9in L, so there is still a small step into the tub, but what a difference it made! She can now make the one step in and then sit on a shower seat and I can bathe her, using a removable shower head/ hose. We also use a plastic toilet seat that sits on top of the regular toilet seat to make it higher for her. (we actually have two of them, so I can take one with us when we travel). The Aging/Disability office paid for the bathtub cut-out and the handrails. This might be something that others who are low income could check into. The remodel was done in the master bedroom/bathroom so we still have a regular bath/shower in the main bathroom.

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Ellen 59, caregiver for mom Marion 81,dx LBD Feb 2011


Sun Jul 17, 2011 12:17 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: A Bathroom That Works
Here's one reason they still make lower toilets - some of us are 5' tall and handicapped height toilets do not work for us! Higher ones are particularly awful in public restrooms where one is trying to use them and not touch the toilet seat - you women all know what I am talking about!!! :lol: :lol: Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Jul 19, 2011 1:12 pm
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Joined: Sun Oct 21, 2007 4:18 pm
Posts: 835
Location: Acton, MA
Post Re: A Bathroom That Works
Lynn, It's called "hover", I'm 5' and shrinking, so that means my feet are dangling in the air. I wasn't in the right line when the lord was giving out height.

Gerry

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Gerry 67, cared for Frank 71, married 49 yrs; dx 2004, passed away October 26, 2011.


Tue Jul 19, 2011 2:12 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: A Bathroom That Works
Lynn, Ma's about 4"11" and she needs a riser on her standard toilet. I guess that is what made me asume taller toilers work for most adults. 'Course I wasn't considering a "hover" manuever! Just plain sitting down.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Tue Jul 19, 2011 4:25 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3378
Location: Vermont
Post Re: A Bathroom That Works
Thanks ladies - "hover" is what I'm talking about!!! And sitting on a tall one is not good either what with the dangling feet routine!

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Tue Jul 19, 2011 8:16 pm
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Joined: Sun Jun 24, 2007 5:35 pm
Posts: 344
Post Re: A Bathroom That Works
A few days ago, John had another awful constipation event, but we avoided the ER with good advice from our nurse and pharmacist and some patience. However, the messes once again made me very grateful for making the decision to redo that bathroom very early at a cost equivalent to about 3 months nursing home care.
My back staying in good shape and John's lack of stress were the by-product once again. He was not over stressed because I was not as stressed.
I know everyone cannot afford to do this, but if it is an option, it truly makes a huge difference.
I cannot count the times I have washed the floor around the toilet with ease instead of angst and physical stress to my back. Of course, John is still in early stage LBD.
My friend whose husband has advanced Parkinsons is cleaning up daily multiple big messes in the bathroom with wipes, and using a regular tub with a fixed position showerhead. She is about to lose her mind and is finally having a long hosed removable showerhead installed this coming week. i hope that will help her.

_________________
Pat Snyder, husband John, dx LBD 2007
Author of [i]Treasures in the Darkness: Extending Early Stage of LBD...[i][/i] [url]http://www.amazon.com/Treasures-Darkness-Extending-Alzheimers-Parkinsons/dp/1466428228/ref=sr_1_1?ie=UTF8&qid=1334092686&sr=8-1[/url]


Sun Sep 11, 2011 11:46 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: A Bathroom That Works
Ah, if we only knew in those first months what we would find useful down the road! A bathroom that works would be something to spend down on, if spending down is needed.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Mon Sep 12, 2011 12:12 am
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Joined: Tue Feb 23, 2010 10:32 am
Posts: 215
Location: Kalispell, MT
Post Re: A Bathroom That Works
Yes, remodeling the bathroom can be money well spent for several reasons--spenddown, increases value of property depending on what you do, and even if the LO doesn't get to use it, as in my case, it is there for me so I have the security of knowing I won't have to move out of my house because of being inaccessible for handicap or wheelchair. The custom built item was the walk-in, barrier free shower, and boy, do I enjoy it!


Mon Sep 12, 2011 12:36 am
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Joined: Mon Sep 19, 2011 4:34 pm
Posts: 6
Location: Portland, Oregon
Post Re: A Bathroom That Works
Wow Pat, your bathroom sounds so functional and perfect! I am new to the community so I hope my suggestions are not repetitive, sorry if they are!

I just did a bathroom remodel for my grandfather because the vanity was an entire length of the wall and made it impossible for wheel chair access. We tore out the old vanity and replaced it with a single sink one. I also tore up the laminate flooring and installed tile so the cleaning and smell of urine wouldn't seep into the floorboard.

One HUGE and easy thing I did to accommodate toilet function was buying a commode. This allowed us to adjust the height and gave grandpa some security and safety with the hand bars. We removed the bucket during the day and placed it over the toilet seat. This also was useful at night when he was still able to get out of bed on his own to use the toilet. We put the commode next to the bed to reduce the fall risk, I hated the idea of him walking to the bathroom from his bed in the middle of the night. Because my grandpa is short I used dog training pads rolled up and stuck/wedged them inbetween the commode and the toilet seat so when he sits down the urine doesn't trickle out through the space onto the floor.

Of course, grab rails are a must. I actually got one on the tub that is adjustable with a couple screws rather than drilling it on the wall. It has been well tested and works great! We didn't have a stud in the wall close to the bath/shower so this was our "next option."

The dog training pads also worked on the under the toilet to absorb any accidents. :)

We also got a hand held shower faucet with an extra long hose.

One last thing... we bought a toilet paper holder/stand rather than having grandpa reach around to grab toilet paper holder mounted on the wall. this way we can put the toilet paper right in front of him. We also are able to move it next to the commode at night rather than just leaving the tp on the dresser and having grandpa try and reach for it.

These are just a few things we did on our budget- it is function and a lot more easier without the obstruction of the old vanity. Hope these tips help others who are thinking about ways to make the bathroom more accommodating.

Kaeti

_________________
Kaeti (33), granddaughter of Kennie (86) diagnosed with LB, who is a survivor of combat action in WWII (Purple Heart & Bronze Star), Kidney Cancer, Prostate Cancer, and married for 65 years to Ruth, 87 (who currenty has Alzheimer's).


Tue Sep 20, 2011 11:51 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: A Bathroom That Works
Good tips, Kaeti!

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Wed Sep 21, 2011 12:14 am
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Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: A Bathroom That Works
Kaeti, thanks for the tips. We're trying to work a commode into my LO's routine but she is confused about it's purpose and often chooses the toilet over the commode at night. Putting the commode over the toilet might help to make her used to it. In some ways, it is like an experience I had once training my cat to "go" in the toilet. I gradually adapted her to the toilet by putting a litter box on it...well, it is a long story and probably not appropriate to compare my Mom to a cat, but it did work. On the bathroom topic, the ALF where she lives will soon be under new management. They have a lot of new ideas, including installing two walk-in tubs. I've heard that submersion in hot water helps with osteoarthritis pain, so I am excited by the idea for all of these elderly residents. Annie

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Annie, daughter of brave Marie, dx 2007 and in ALF


Wed Sep 21, 2011 9:53 am
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: A Bathroom That Works
Annie, Coy loves our walkin tub. The AL where our daughter works has several, but she reports that they are almost never used! She can't figure out why.

_________________
Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Wed Sep 21, 2011 1:14 pm
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