Bathing frail seniors at home: Home care providers' approaches

Background Home care providers assisting with seniors' personal care often experience high rates of musculoskeletal disorders, particularly affecting the lower back. Assisting with bathing is consistently identified as one of their most physically demanding activities. Objective To identify and describe care providers' procedures for assisting a frail senior to bathe that are likely to contribute most to the development of back injuries. Methods Eight community-based personal support workers (home care aides) assisted a frail senior (actor) to bathe in a simulated home bathroom. Video recordings of the activity were coded according to providers' postures and to characterize techniques for providing care. Results Exposure to severe trunk flexion and high posture-induced back loads was greatest during transfers in and out of the bathtub. In particular, lifting the legs over the rim of the tub, assisting the client to shift across the bath transfer bench, and providing care to the legs and feet involved the care provider spending substantial time in highly flexed postures. No observed techniques for these activities showed substantially lower exposures. Conclusions Further tools and/or techniques must be identified or developed to improve caregiver safety during these strenuous activities.