How accessible bathrooms can reduce injuries at assisted living facilities

If you asked the average person on the street which professions suffer the most workplace injuries, you’d likely hear such answers as police officers, construction workers and loggers. While it is absolutely true that these jobs can be dangerous, what may be less well known is that direct care workers who assist patients, the elderly and disabled residents also face serious physical risks on a daily basis.

In fact, occupational injury rates for direct care workers are among the highest in the country. According to a report from the New York-based nonprofit PHI, the injury rate for nursing assistants in 2016 was 337 per 10,000 workers. Personal care aides had an injury rate of 144 per 10,000, while for home health aides it was 116. By comparison, the overall injury rate for all U.S. workers was 100 per 10,000.

What makes direct care so dangerous? The answer lies in the nature of the work itself. Assisting patients and residents that are elderly, disabled or otherwise limited in mobility puts a lot of strain on care workers. The leading cause of injury among direct care workers is overexertion, most commonly caused by lifting or repositioning clients.

An article published in the December 2020 issue of the Journal of Occupational and Environmental Medicine found that musculoskeletal injuries that occur during patient handling and mobility (PH&M) tasks are one of the biggest contributors to both employee injuries and workers’ compensation claims.

Taking safety from the bedroom to the bathroom

Herman Walker, the US sales director for Pressalit, a leading provider of accessible bathroom solutions, said that many facilities could improve both worker safety and user independence if the same safe patient handling and mobility (SPH&M) techniques that are typically in place in bedrooms were also used in the bathroom.

“The bathroom is a common spot for workplace injuries,” Walker said. “Transferring an elderly or disabled person to and from the toilet or helping them bathe can put a lot of physical strain on the caregiver. This is often compounded by a lack of physical space and rigid bathroom fixtures that don’t meet the varying needs of residents.”

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Assistive technologies like adjustable beds, slings and lifts are fairly commonplace in the bedrooms of most elderly care and assisted living homes. But Walker said that not enough facilities extend this same approach to the bathroom by installing solutions that would make it easier for staff to assist clients with their toilet visits and bathing – or even remove the need for their involvement at all.

“Grip bars and seated showers are great, but they’re really just the bare minimum,” Walker said. “By outfitting bathrooms with things like support arms that are fully adjustable, both vertically and horizontally, and sinks that can be lowered and raised with a touch of a button, you minimize the amount of assistance a client needs in the bathroom. This improves worker safety while also boosting the independence and dignity of the residents.”

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Facilities can’t afford worker injuries

Reducing workplace injuries is particularly important in light of the care industry’s worker shortage. A sector that has long struggled with recruiting enough workers for what is often low-paying and physically demanding work has been hit hard by both immigration policies and, more recently, the COVID-19 pandemic.

In a November 2021 report, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), which represent around 14,000 nursing homes and assisted living communities across the United States, said that 221,000 workers have left the industry since the start of the pandemic. That’s a 14 percent overall workforce reduction.

“As many caregivers are getting burned out by the pandemic, workers are leaving the field for jobs in other health-care settings or other industries altogether,” Mark Parkinson, the president and CEO of AHCA/NCAL, said when the report was released.

When a worker is injured while helping a client, it can set off a vicious circle. When the injured worker takes time off to recover, residents miss out on receiving care from someone they’ve come to trust. The worker shortage means that facilities have a difficult time finding a temporary replacement, which often results in the remaining staff members having to shoulder the extra burden. This increases the risk that they will be injured or feel so overworked that they quit their jobs, repeating and accelerating what PHI called “a cycle of unsafe conditions, injuries, and disruptions in care.”

The JOEM article found that an effective way to break that cycle is to invest in SPH&M equipment and train staff on how to utilize it to ease their physical burden. There is also a clear financial incentive for facilities. The article cited one study that concluded that an effective SPH&M program can lead to an average annual net savings of $143 per bed and $165 per full-time equivalent (FTE), while other cited studies found that implementing SPH&M programs reduced patient handling claims in 80 percent of nursing homes and reduced workers’ compensation costs by the same amount.

Similarly, the PHI report concluded that investing in appropriate equipment will result in “cost-savings [that] will likely outweigh the initial investment”.

For Walker, the advantages of investing in equipment that is safe, flexible and accessible are obvious.

“When facilities implement solutions that decrease the risk of workplace injury, they’re also increasing the quality of life for the residents,” he said. “No one wants a caregiver to be injured on the job, least of all the residents who depend on them and often have developed a close bond with them.”