For children who need support in a sitting position Sitting supports These have a seat, backrest and sometimes side supports to provide support for children who cannot sit upright unaided. Some allow the child to have their legs supported in a long sitting position. Before choosing sitting supports, consider the following: Babies and small children may be able to use some of the standard baby bathing equipment, such as the support rings that attach to the base of the bath with suction cups The height of the back support; a lower back support may provide greater freedom of movement, a higher backrest gives more support The type of support straps, i.
The lower the support sits in the bath, the less water will be needed to surround the child for washing and playing, but the parent or carer will have to stoop down further The material of the support. An open mesh will allow the water to circulate around your child and is more pliable than a close weave plastic mesh The material of the frame. A plastic frame, which is lighter than metal, will make the support easier to lift in and out of the bath Angle adjustment of the backrests offers a choice between a more upright or reclined position.
A larger angle of recline can make hair washing easier. A more upright position can make it easier for children to play with bath toys or may prevent extensor spasm Detachable mesh at the head end can assist with hair washing The sizes on offer and whether the chair will fit into your bath The method of transfers.
Whilst a bath chair will free your hands from supporting your child and reduce the amount of stooping required to provide assistance, the issue of lifting your child in and out needs to be addressed. For example, you may use a ceiling track hoist Check how easy it is to lift the seat in and out of the bath Allocate safe, suitable storage of the bath chair, leaving the bath free for other family members to use.
The chair will need to be stored somewhere where water can drain so that the mesh can dry, and where it will not impede other family members from taking a bath. Models that fold up or flatten out can make storage and transportation easier.
The width of most backrests is adjustable and suction cups secure them to the sides of the bath. The grab bar can be used in conjunction with a sitting support. The suction cups may deteriorate with age and lose their grip, so they should be regularly checked for wear and tear and also to ensure they are gripping for each use.
Effectively, you're lying next to your baby, but you're not sharing bed coverings. The mesh side also lets you and baby see each other, which provides peace of mind in the early stages.
The information contained below is not intended as a replacement for a thorough assessment in your home environment. Information and advice on design issues is available from the Centre for Accessible Environments.
The organisation is a leading authority on inclusive design and they provide consultancy, training, research and publications on building design and management to meet all user needs. This organisation keeps a database of architects, surveyors and similar professionals with experience of designing for disabled people, and has a number of useful publications and design sheets.
The needs and preferences of the child and the parents The age of the child - the facilities may need to reflect their changing needs as they grow and their emerging independence and need for privacy Other bathroom users Structural alterations, and whether a grant is available to help cover costs Type of floor, i. Additional safe heating in the bathroom may be required The possible therapeutic benefits of bathing in warm water, e. The storage and cleaning of any equipment required.
Other factors to consider Any additional head support the child may require Safety for children with poor sitting balance or head control Safety for children with sensory loss Children with epilepsy and the risks to them whilst bathing. Children with epilepsy who use a bath chair or hammock may need quick release fastenings on the equipment The size of the bath and whether it can accommodate supportive bathing equipment Drying and dressing your child once they have bathed; do they need a safe space to sit or lie down during this process?
For older children who prefer more independence, consider installing a wall mounted body dryer. Using simple methods of increasing independence such as automatic soap dispensers, lever taps and shower controls that are easy to reach and operate.
No child should be left unsupervised in the bath even if in a supportive bath chair. Similarly, young brothers and sisters should not be left in charge of a child in a bath seat.
Showering equipment Getting an older child in and out of a bath can be difficult and showering can offer a safer and more manageable alternative. Showering may also make it possible for the child to be more independent. The needs of other family members must be considered, particularly if there is not enough space for separate bath and shower facilities.
It is sometimes possible to build an additional bathroom or adapt an existing space to provide secondary washing facilities, with the help of a Disabled Facilities Grant. Shower facilities can be provided: For children who can shower in a supported sitting position Shower chairs and stools These provide support for children who can sit to shower. Wall mounted options are available see below. There are a range of styles and models, so check: For more supportive seats see the section below on mobile shower chairs.
Supportive shower chairs can make it difficult to access and wash the areas of the body supported by the backrest, seat, straps and side supports.
Many areas have an Equipment Demonstration Centre or similar facility, allowing people to view products before they purchase them, so it may be worth enquiring as to whether they have supportive shower chairs to view. Information about Equipment Demonstration Centres can be found here: When using a shower chair there needs to be plenty of room around it so that the parent or carer can move around freely, move the chair or help the child, without injuring themselves or getting soaked in the process.
Portable half-height shower screens are available to protect the carer from splashes. Static shower chairs and stools These are freestanding, so can be lifted in and out of the shower as required. They are more appropriate for an older, more independent child. Stools tend to have little or no back support; chairs have a higher, more supportive backrest.
Selecting the correct height is important. Arm rests can provide additional security and enable a child to stand independently. Ensure that all toiletries are within reach to encourage independence and reduce the risk of slipping. Wall-fixed shower seats This style of shower seat fixes to the wall, usually via hinged brackets, so that they can be folded up out of the way of other family members who want to use the shower.
Bear in mind that this will change as they grow. A limited number of adjustable height seats are available which could accommodate growth. Mobile shower chairs A range of wheeled shower chairs are available for those requiring more postural support. These range from simple shells to more complex modular seating including support for the pelvis, chest and head. User-propelled and attendant-propelled versions are available.
Larger wheels can make it easier to push the chair in and out of the shower but will take up more space. Shower chairs with a toileting facility Many mobile shower chairs offer a toileting facility. They can either be positioned over a toilet or used with a commode pan. This type of chair reduces the number of transfers that need to be made between the bed, toilet and shower. Larger children who are physically less able may need to be hoisted into the chair. Before choosing a shower chair with a toileting facility consider the following: What is the clearance gap over the toilet?
The chair must fit easily over the toilet bowl, but too wide a gap means splashing may occur. Check the height and position of the toilet cistern and the push handles of the chair to ensure that positioning of the chair is not impeded. The size of the seat and aperture. If the child is to be hoisted in or out of the equipment, is there enough access to be able to fit and remove the sling? It may be beneficial to use a mesh bathing sling.
Shower chairs for children generally have a range of supportive accessories including: An assessment with a reputable company rep is recommended to make sure that the chair offers the right level of support. Larger children or children requiring less support will be able to use an adult shower chair which can be fitted with cushion inserts to reduce the internal seat dimensions. Always make sure that their feet are well supported.
For children who need to be showered in a lying or semi-lying position Shower cradle There is a small range of shower cradles that comprise a mobile chassis onto which a nylon mesh cradle or a hammock-type bath support is fixed. The angle of the mesh cradle is fixed on some models and adjustable on others. The more upright the support, the less space it will occupy.
If a cubicle is to be used, check its size as many of these supports are too long for a standard cubicle. On some cradles the mesh supporting the head can be detached and folded down to make it easier to wash the hair.
Accessories are often available to assist with head and body positioning and safety. Some tilt-in-space models offer a toileting aperture.
These also offer a toileting aperture. These chairs could be considered as an alternative to a shower cradle and generally take up less space in the bathroom.
They are made of a perforated material and can be used over a bath - folding down to rest on the bath rim - or in a shower area with two supporting legs which rest on the floor.
On some, the angle of the backrest can be adjusted, while the height of others can be adjusted electrically to position them at a comfortable height for the parent. How the parent will lift the child onto the shower stretcher must be considered. A hoist may be required.
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Always try to work out a washing and dressing routine that involves the fewest moves from one item of equipment to another as this saves time and effort for the child and parent. They are large and not often used in the family home because they are difficult to manoeuvre in a restricted space. Toileting equipment Toilet training can be an extremely stressful time. Parents can feel pressurised into getting their child out of nappies in time for the start of playgroup or school. It is important to begin toilet training only when the child is developmentally ready, and then there should be a co-ordinated approach between all parties involved with the child.
Children with a developmental delay will generally take longer to learn the toileting routine. The child must be able to: Due to the intimacy of toileting tasks, the aim is to encourage and enable children to be independent so that as they get older they can have as much privacy as possible. Consider the following difficulties: Equipment to reduce back strain for parents or a carer There are many different tasks and activities associated with toileting.
The twisting and bending involved in these actions can increase the risk of back injury and this should be reduced where possible. This could be done in the following ways: For young children who need additional support on a potty An increasing range of potties are widely available from shops with an integral backrest and arm rests for additional support - they are more like a chair as they are higher from the floor. These may provide adequate support for a child with mild difficulties and enable them to transfer on and off without support.
Potties with oval apertures provide a more comfortable and supportive seat than a round aperture, in which children with narrow hips tend to get their bottom stuck.
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