Letter to the Editor - Letter to the Editor

Nursing Homes, June, 2003

Dear Editor:

The article "Designing a Better Bathroom" (by Patricia A. Maben, RN, MN, Nursing Homes/Long Term Care Management, March 2003, P. 24) brings forth ideas that have needed verbalization for a long time. Having been an RN in long-term care for 28 years, holding various positions from staff nurse to DON, I have experienced the effects of poor bathroom design on residents and staff. We in long-term care have quietly accepted the lack of good design, and have gone about our business trying to make these poorly designed facilities work.

I did not know that current guidelines from the Americans With Disabilities Act were the pattern that modern designers were following. What great insight by Ms. Maben to realize that these guidelines would not necessarily apply to residents in long-term care, who need staff to assist them and room for the staff to work. Nurses and CNAs often have commented in my hearing about the small size of the bathroom; that the toilet is next to a wall and that two people can't get in to help the resident; that the mirror doesn't allow residents to see themselves; that the bathroom makes no allowance for toiletries; and that residents cannot lean back on the toilet. I know of occasions when staff have tried to place pillows between the residents and the pipe in back to allow them to relax and let nature work.

Also, while it is important to prevent commingling of residents' toiletries, is there no way to have a storage area in the bathroom that the resident could be assisted to access? Perhaps a locked cabinet at the resident's level, with a key or keypad entry? Personally, I don't carry all my toiletries into the bathroom every time I use the shower or toilet, so why do we expect our residents to do so?

As a nurse, I have often wondered: Do designers even consult with the staff of a long-term care facility before they design? Or, how about talking to a resident in long-term care, or even having a resident and nurse on staff in the design department as consultants?

Ms. Maben seemed to hit every nail on the head. It was a fantastic article, handling a topic few of us talk about, but one that affects the quality of life for all residents in long-term care daily.

Elena Walls, RNC, CRRN

Director of Clinical Services

Byron Health Center

Fort Wayne, Indiana