How to safely shower seated

It is important that the shower chair fits the capabilities and limitations of the user. Additional adaptations in the bathroom may be necessary to create a safe situation. This guide focuses solely on selecting the best shower chair and does not address other bathroom modifications that may be required.

The guide consists of four questions to provide a good recommendation. These questions focus on the user's capabilities, starting with those who are highly independent and mobile and ending with those who require assistance and/or care during showering. For each question, the guide describes the possible suitable shower aids with their advantages, disadvantages, and price range.

Before answering the above questions, it is helpful to go through a few preparatory questions. This will make it easier to answer the guide's questions and find a suitable shower chair. The preparatory questions are as follows:

1. Is the aid necessary only during showering or also during toilet use?
2. Is support needed from a caregiver or healthcare professional, and if so, what do they require? Consider space requirements as well as the proper positioning they need during shower assistance.
3. What is the patient's weight? Is it within the maximum user weight limit of the aid?
4. Does the patient want to be able to take the shower chair to another location, such as a vacation destination?
5. What is the budget?

After answering the above questions, the following questions can help in selecting a suitable shower chair. Each question provides explanations about the shower chairs that may be suitable for that specific question.

Question 1: Do you transfer independently, with some assistance, or with the help of a standing aid?

There are three options available:

1. A shower stool without a backrest and armrests.

With a shower stool, you can independently sit and shower. The user should be able to sit down and stand up independently or with a little help.

Advantages of a shower stool:

• Takes up relatively little space in the bathroom.
• Relatively inexpensive.
• Portable and easy to carry.
• Available in many different variations.
• Most shower stools are height-adjustable.

Disadvantages of a shower stool:

• Does not have a backrest and armrests.
• Not movable on wheels.
• Not equipped with ergonomic seating.
• Tendency to tilt when uneven pressure is applied.

Price range of a shower stool:

A shower stool can be purchased starting from €46. More expensive, higher-quality shower stools are also available.

2. A shower chair with armrests and/or a backrest.

There are various types of shower chairs available with armrests and/or a backrest. The choice depends on the specific support needed during showering.

Advantages of a shower chair:

• Armrests provide support when sitting down and standing up.
• Armrests offer lateral support and prevent sideways slipping.
• Folding shower chairs are also available for use in other locations.
• Portable and easy to carry.
• Most shower chairs are height-adjustable.
• Some shower chairs have a recessed seat with a commode pan underneath, providing a toilet function. The recess also offers more space for washing and rinsing the coccyx.

Disadvantages of a shower chair:

• Takes up more space due to the backrest and armrests.
• Tendency to tilt when uneven pressure is applied.

Price range of a shower chair:

The cost of a basic shower chair with armrests starts from €120. If you choose a folding shower chair, the price is usually higher than €150.

3. A wall-mounted shower seat.

There are also shower chairs available with wall mounting, commonly known as a shower seat. It is important to know the weight-bearing capacity of the wall to which the shower seat is attached. If the wall lacks sufficient strength, installation is not safe. Additionally, it is crucial to consider the client's transfer method, as repositioning may not be possible later on. Various transfers are possible, including transitioning from active standing to sitting, supported brief standing, or a short seated transfer from a wheelchair.

Advantages of a wall-mounted shower seat:

• They are foldable, taking up minimal to no space in the shower cabin after use.
• The height can be adjusted according to personal preference (once).
• Some shower seats have a recess, allowing the use of a commode. This provides a toilet function and also offers more space for washing and showering the tailbone.
• Some shower seats come with additional support legs to increase weight-bearing capacity or relieve stress on the wall.
• Certain shower seats feature armrests.
• Some shower seats are swivelable, making the transfer process easier.

Disadvantages of a wall-mounted shower seat:

• The wall must have adequate strength and weight-bearing capacity.
• They are not portable and cannot be taken to another location.

Price range of a wall-mounted shower seat:

Shower seats range in price from €60 to €800. The price is higher for swivelable shower seats.

Question 2: Should the shower chair be movable by someone else within the bathroom, or should it be used for combined toilet and shower purposes?

1. A wheeled shower chair with small wheels

If there are no thresholds present within the bathroom and someone can assist in locking the shower chair's brakes, a wheeled shower chair with small wheels is an option. If the distances to be covered are longer, it is advisable to consider a shower chair with large wheels.

In many cases, the shower chair is also available as a shower/toilet chair, allowing for toilet use. When the shower chair is suitable for toilet use, it features an opening in the seat to roll over the toilet or can accommodate a commode. With a shower chair with small wheels, there is no need for a recessed toilet.

Advantages of a wheeled shower chair with small wheels:

• Also available as a shower/toilet chair.
• The toilet opening can sometimes be closed with a stopper, creating a regular seat.
• Shower chairs with a toilet opening often have a softer padded seat. Available with foldable armrests and/or leg rests.
• Some shower chairs can be ordered in multiple seat heights, but they are not height adjustable.

Disadvantages of a wheeled shower/toilet chair with small wheels:

• Space is required on both sides of the toilet to maneuver the chair.
• It is not possible to roll this chair over thresholds.
• Assistance is needed to lock the brakes of this shower/toilet chair.
• Not suitable for moving over longer distances.
• Assistance is needed to move the chair; the user cannot do it independently.

Price range of a wheeled shower/toilet chair with small wheels:

The price range for a shower/toilet chair is between €200 and €1,800. The price may be higher if you opt for the toilet chair conversion feature. Additionally, the price depends on any modifications you might make to the assistive device, such as an additional backrest.

Question 3: Do you need to be able to independently maneuver a short distance within the bathroom or travel longer distances outside the bathroom? In that case, a shower chair with large wheels is an option.

A shower chair with large wheels provides the ability to self-propel both within the bathroom and outside, or when being moved by someone else between spaces. The shower chair with large wheels resembles a wheelchair but is specifically designed for use in the shower. However, ensure that your bathroom is spacious enough to accommodate the turning radius of the self-propelled shower chair.

Advantages of a shower chair with large wheels:

• Also available as a shower/toilet chair. 
• The toilet opening can be closed with a stopper, creating a regular seat.
• Shower chairs with a toilet opening often have a softer padded seat.
• The armrests can be raised for transfers. The leg rests can be folded away.
• The footrests are height adjustable.
• The chair is suitable for safe movement between different spaces.
• Self-propulsion can increase independence.

Disadvantages of a shower/toilet chair with large wheels:

• The shower chair occupies a significant amount of space.
• A spacious bathroom is necessary to accommodate the large turning radius.
• A recessed toilet bowl is often required to align the toilet opening properly.

Price range of a shower/toilet chair with large wheels:

The price range for a shower chair with large wheels is between €1,500 and €3,000. The price depends on additional features. A shower chair with large wheels that includes a toilet function will be more expensive than a standard shower chair with large wheels without extra features.

Question 4: Does the shower chair need to be adjustable for proper support or for the correct position for a caregiver or healthcare provider? In that case, a height-adjustable shower/toilet chair is an option.

This shower chair offers extensive adjustment options as the tilt angle and height can be adjusted. Setting the proper posture for the user provides comfort. Additionally, the shower chair can be adjusted to the correct position to reduce physical strain for the caregiver or healthcare provider. The adjustments can be made using a hydraulic pump or electric controls.

Advantages of a height-adjustable shower/toilet chair:

• Possibility of a tilting seat for the person being showered to assume a comfortable position.
• Option to choose a model with adjustments for dressing and undressing.
• Caregiver and/or healthcare provider can assume a better ergonomic posture.
• Possibility of leg rests. Armrests with a safety system to prevent sideways falls.
• Improved eye contact with the caregiver/healthcare provider.
• Equipped with wheels for mobility, with brakes. Shower chairs with a toilet opening often have a softer padded seat.

Disadvantages of a height-adjustable shower/toilet chair:

• Takes up a significant amount of space.
• The act of going up and tilting in the shower chair may not be comfortable for some individuals.
• More challenging to use in the presence of thresholds.

The costs of purchase are often higher than a "regular" shower chair.

• Annual maintenance is required for electrically operated models.

Price range of a height-adjustable shower/toilet chair:

The price range for height-adjustable shower/toilet chairs is between €800 and €5,000. The significant price difference is due to variations in options such as electric or hydraulic controls and whether there are features for dressing and undressing. Multiple modifications are possible for these shower chairs, such as different types of armrests, additional back support, and a padded seat.