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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:
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.
Alternatively, many companies offer free assessment at your home. This gives parents an opportunity to learn about the product, see it in situ, and consider if it will meet their child’s immediate and longer-term needs.
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. To support him/herself safely in a sitting position, the child must be able to place both feet flat on the floor. An adjustable height stool/chair can be altered in height as the child grows.
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. The seat should be fixed at a height to suit the child’s needs. 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:
Is wheeled access into and around the toilet/bathroom possible?
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. The seat must be supportive but should also allow the child to clean him/herself or to be assisted with cleaning after he/she has used the toilet.
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:
Pommel/splash guard
Head and trunk supports
Foot supports
Safety belts and harnesses.
An assessment with a reputable company representative 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.
Tilt-in-space/reclining shower chairs
A range of shower chairs for children have a reclining backrest or a tilt-in-space seat unit so that the child can sit in a semi-reclined or tilted-back position. 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.
Shower stretchers
Wall-mounted shower stretchers can also be used as changing tables and fold up against the wall when not in use. 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. 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.
Shower trolleys
These are mobile showering tables, often with a reservoir to catch the water during a shower. They are large and not often used in the family home because they are difficult to maneuver in a restricted space.
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