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Two age groups are especially susceptible to bathroom injuries. Persons aged 15 to 24 are especially likely to be injured in bathtub or shower. People over the age 85 of age are especially likely to be injured on or around the toilet.

Elderly Most Likely to Be Injured in the Bathroom

Every year, the Centers for Disease Control (CDC) tell us, over 235 thousand Americans are treated in the emergency room for injuries they incur in the bathroom. Over 30 thousand of the injured will have to be hospitalized.

Two age groups are especially susceptible to bathroom injuries. Persons aged 15 to 24 are especially likely to be injured in bathtub or shower. People over the age 85 of age are especially likely to be injured on or around the toilet.

In 2008, the most recent year for which data are available, not a single person over the age of 15 drowned in the bathtub. A variety of other kinds of bathroom injuries appears in the CDC report:

  • 81% of bathroom injuries were falls.
  • 9% of bathroom injuries involved overexertion.
  • 6% of bathroom injuries involved being struck by a falling or moving object.
  • A little more than 1% of bathroom injuries involved cutting or piercing.
  • Less than 1% of bathroom injuries involved burns.

In the study most emergency room visits after a bathroom injury, about 31% of all bathroom injuries, involved a head or neck injury. Other injury sites were less common:

  • 20% of bathroom injuries involved the upper trunk.
  • 18% of bathroom injuries involved the lower trunk.
  • 17% of bathroom injuries involved a leg or foot.
  • 13% of bathroom injuries involved an arm or hand.

The rates of bathroom injuries increased with age

  • 58 out of every 100,000 people aged 15 to 24 suffered a bathroom injury.
  • 73 out of every 100,000 people aged 25 to 34 suffered a bathroom injury.
  • 76 out of every 100,000 people aged 35 to 44 suffered a bathroom injury.
  • 70 out of every 100,000 people aged 45 to 54 suffered a bathroom injury.
  • 85 out of every 100,000 people aged 55 to 64 suffered a bathroom injury.
  • 112 out of every 100,000 people aged 65 to 74 suffered a bathroom injury.
  • 214 out of every 100,000 people aged 75 to 84 suffered a bathroom injury.
  • 535 out of every 100,000 people (a little more than 1/2%) of people 85 and over suffered a bathroom injury.
Cuts and scrapes, as well as sprains and strains, were the most common diagnoses in the ER. Only about 10% of bathroom mishaps resulted in internal injuries, and only about 2% resulted in concussions.

The study found that women of all ages were at greater risk of falls in the bathroom than men. The study also found, not surprisingly, that falls were most likely to result in broken bones among people over the age of 65.

In the 15 to 24 age group, falls were the leading injury, and loss of consciousness was the leading cause of falls. A study in New Zealand found that alcohol use was the leading cause of loss of consciousness in household, particularly bathroom, injuries. Up to 20% of injuries among working age adults were linked to alcohol use in the New Zealand study.

How to Make Your Bathroom Safe

For every age group, the most common bathroom injuries were falls, especially getting in and out of the bath and getting on and off the toilet.

The CDC found that 63% of American homes have bathtub mats or non-skid strips in the shower stall or tub, but fewer than 20% have grab barsthe user can grip to maintain balance when getting out of the tub. Since 98% of injuries occur when getting out of the tub or shower, rather than when going in, grab bars might prevent most bathtub and shower injuries.
For adults over the age of 65, getting on or off the toilet is a source of many injuries. Many older adults experience a condition called vasovagal syncope when defecating. Older people tend to get constipated. It can be hard to push the stool out to complete a bowel movement. Straining at stool reduces circulation through the veins in the abdomen that bring blood back to the lungs and heart to be sent to the head, and fainting results. Many older people faint and fall off the toilet onto to their heads, causing potentially serious injury compounded by serious embarrassment.

Treating constipation prevents the straining that cause lead to passing out and injury. It also helps to know that changes in blood pressure medicine can result in fainting, more specifically, postural hypotension, in which blood pressure falls when moving from a seated position to a standing position. Many injuries to older people occur when postural hypotension causes a momentary blackout when getting off the commode. Dehydration can also cause loss of consciousness.

Tell-tale signs of trouble to come are easy to spot in the bathroom. There might be dents in the wall where a door has swung hard after a senior lets go of a door knob used for support. Or the towel rack may be coming loose on the side nearest the commode, where the older person has been grabbing on to it for support.

How can families make toilets safe for seniors?

  • Raise the commode seat. Either replace the commode, or use a plastic "booster seat," or place the entire commode on a platform raising it off the floor.
  • Provide a gripping rail at the right height for the primary user of the toilet.
  • Make sure the bathroom floor is free of mats and throw rugs.
  • Provide a night light that comes on automatically when natural light dims.
  • If possible, install a door that is at least 36 inches (92 cm) wide, for easy entrance and exit with strollers, wheelchairs, and gurneys.

Ways to make showers and tubs safer

  • Remember that most falls in the shower or tub occur during shampooing, when the eyes must be closed. Simply providing a senior or a person who has balance problems with another opportunity for a weekly shampoo may prevent a fall.
  • Provide a hand held shower spray and a bench to sit on while bathing.
  • If budget permits, install a door to the side of the tub so users can step out of the tub without having to lift legs over the edge.
Nearly all seniors prefer to take care of their own bathroom business no matter what their age. For independent older people, it is always a good idea to have a flashlight, in case power goes off, and a cell phone, in case of an accident, near at hand. The ability to summon help is critical when bathroom injuries occur.
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  • Centers for Disease Control and Prevention, "Nonfatal Bathroom Injuries Among Persons Aged ≥15 Years --- United States, 2008." Mortality and Morbidity Weekly Report, 11 July 2011.
  • Photo courtesy of summitdesignremodeling on Flickr:

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