Bathing and design: Is it a spa, shower, or therapy room?

Most are aware that certain state health codes mandate a “tub” for residents in long-term care.

The design community has tried to make them into spas. We have added color, beautiful tile, drapes, artwork, and furniture—but still it’s a glorified tub room. Yet owners have bought off on this especially when it comes to the marketing value. I have never seen them used by therapy although they are sometimes marketed that way.
However, when touring existing facilities these tub rooms are often filled with wheelchairs, walkers, potty chairs, and the likes. Very rarely are they used as intended.

It seems that both codes and designers have missed the mark when it comes to the “spa”. We spend lots of time and money designing these spas, but residents still have to get naked in front of one another and be assisted (sometimes with a lift) into a tub. This process, unless performed perfectly, becomes uncomfortable and embarrassing for the resident while also being just plain hard work for the caregiver compared to a shower.

So what is the solution? Spas with a tub that looks more residential when code does not require a 3’ clearance on three sides of the unit. We can then allow tile accents, add drapes to create a sense of privacy over the tub, and reduce the institutional image.

If the home has an actual program to support tub-bathing then it works quite well.

However, most are rarely used due to issues with cleaning, dignity, leaks, or staff just not wanting to go through the effort. These expensive rooms become glorified storage units. Due to this, unless code deems it mandatory, it is preferred to do a wonderful shower room that will be used. Don’t get me wrong—I’m a tub person—but having weighed the issues and after seeing over a thousand tub rooms, if and when I am in assisted living I would rather have the shower.

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