Bathing and design: Is it a spa, shower, or therapy room? | I Advance Senior Care Skip to content Skip to navigation

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

February 2, 2010
by Lisa Cini
| Reprints

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.

Lisa Cini

President and CEO

Cini is president and CEO of Mosaic...



Your observation is unfortunately true-many tub rooms have become a convenient repository for equipment. Such is a by-product of insufficient storage or poor design. While the codes which govern tub rooms were likely sufficient many years ago, the needs of the facilities and the residents have evolved. I have seen these tub rooms in active use but sadly, this is the exception and not the rule. It seems that resident rooms which are equipped with their own shower, tub or both tend to get more consistent use than a centralized location. It is incumbent upon the industry to address these issues through facility design and not through a mandate of code enforcement.

There is another solution...I work for a company that makes an accessible bathtub that looks residential, which reduces bather stress, while allowing full-caregiver access if needed. Aquassure Accessible Bathtubs have a full-sized bathtub that is raised up on a cabinet base to chair height, with a sliding door. Many residents can transfer in unassisted from wheelchairs or walkers, preserving dignity. It is also lift accessible for those that need the extra help. The tub has a hand-held shower, for rinsing and washing hair, so it has the convenience of a shower, but the hydrotherapy benefits of a tub without the institutional feel.

The spa room is a great way for marketing a facility. People making the decisions of where loved ones will reside want to make sure that all aspects of daily life would be covered. If they have choice between a spa room with a tub and shower vs just a shower, don't you think they would prefer the tub? As competitive as the market is, a beatiful tub room can only help with filling the beds.