An overview of the topic of Paediatrics: Common Health Conditions and the Impact on Bathroom Activity, based on our recent webinar on the topic.
Consideration of the home environment is essential when supporting children and young people to engage in daily occupations in the home. At times, the home environment can create barriers to optimal occupational performance and a focussed assessment can help identify any obstructions to independence.
This can be especially true in the bathroom.
When working with children and young people, the bathroom is often a family space, used by multiple members of the household and therefore making any changes should reflect the family are occupational beings, with their own needs, routines, and roles. If a child is unable to safely access a bath, replacing this with a level-access shower prohibits not only that child to benefit from the value of bathing, but prevents others from accessing those rewards too. For example, younger siblings may wish to use baths for play, as part of a daily routine at bedtime and older family members may benefit from the relaxation or pain relief a bath offers.
As occupational therapists, our holistic assessment incorporates not only the needs of the child or young person but their role within the family unit and the needs of the family.
Therefore, alternatives to removal of the bath should be considered, such as the provision of a ceiling track hoist used with a height-adjustable bath. Similarly, if the bathroom is to be used by multiple people, it would not be appropriate to provide a fixed-height wash hand basin suitable for a wheelchair user when able‐bodied family members and visitors to the home would need to use the basin. A height-adjustable basin may be more expensive; however, the justification for the installation of this is clear and clinically justified.
Bathroom designs should also take account of a child’s sensory needs. Are they hyposensitive – and seek out stimulation from the environment, or hypersensitive and avoid any sensory-stimulating situations? A child’s safety and risk levels are an integral part of decision making around a design of a bathroom. Lighting, safe heating, noise/echo levels and the ability to control or limit the temperature of water should all be considered. Even the ability to limit the amount of water dispensed by the taps should be considered for those children with sensory-seeking behaviour which will reduce the risk of flooding.
If a child or young person requires the benefits of a toilet which washes and dries, a ‘bolt on’ system will likely prevent the use of other toilet training seats to be placed onto the toilet seat. A wash dry toilet such as a Palma Vita will facilitate younger family members to undertake toilet training as they would with a standard toilet. Also, consider that a parent may use the toilet to sit on to supervise children in the bath and therefore a lid is essential.
Activity analysis of the occupations carried out in the bathroom will assist in identifying this small but significant matter and assist in promoting a family’s normal occupational routine.
In summary, a thorough and holistic assessment of the child, their family, and roles within it, will assist in decision making around the design of a bathroom which in turn will assist in optimising functional performance and addressing risk.