Effectiveness of Shower Adaptations (Adults) A Survey completed by Oxfordshire County Council Housing Occupational Therapists

Recipe for success? Take 6 Housing OT’s Add 1 very enthusiastic OT Service Manager and a pinch of grants officers Sprinkle with a little Maria and Frances Mix thoroughly and bake in a slow oven for 2 years!

Why was a new recipe needed? Evidence to support: – keeping people at home cost effective. – housing adaptations produce savings to health and social care budgets. No specific research completed in area of interest (the effectiveness of shower adaptations/satisfaction levels). Local evidence required by commissioners in Oxfordshire.

Aims of Study Investigate effectiveness of shower adaptations Identify if adaptations were cost effective Find out if installation of a shower enabled disabled people to better manage personal hygiene Establish people’s level of satisfaction Ease of use Materials used

Methodology Postal questionnaire Piloted Questionnaire modified Sent to 701 participants who had shower adaptation completed within 2 chosen years – 2007 and 2010.

Over to you!

Key Findings Overall Satisfaction :

Key Findings Overall Impact

Key Findings Overall impact – keeping clean

Key Findings Overall impact - safety I don’t worry about falling in or out of the bath as I did before. It’s totally changed my life”

Key Findings Overall impact – staying put “I feel more confident about being in my own flat” “Being independent and being able to stay in my own home”

Key Findings Impact on need for care "I don't need support now with the shower. I needed someone here every time I had a bath" "I don't need support now with the shower. I needed someone here every time I had a bath" "I could not get in and out of a bath without help. The shower allows me to be independent" "I could not get in and out of a bath without help. The shower allows me to be independent" "Before the wet room my wife was having to help me step in and out of the bath as I have M.S, but she is also disabled herself".

Key Findings Carers needs 142 respondents received help to use shower. 13 reported carer had some difficulties supporting them to use shower. 2 – non-specific 5 - possible poor design 4 – issues related to medical conditions/disability 2 – falls/fear of falling

Key Findings Potential cost savings on care provision Average cost of a shower adaptation- £5K Average cost of a care package of 2 hours per week to help with strip washing - £ per year per person. Potential saving of public funds over a 4 year period = £2900 per person who might otherwise have required care. 126 (88%) needing less help - potential saving on care costs of £248, per year

Key Findings Type of help required:

Key Findings Repairs and maintenance 2007 – 51% reported need for repairs/maintenance – 33% reported need for repairs/maintenance. 5 highest components needing repair: Shower Component Total number needing repair or maintenance Percentage of all respondents Shower unit4814 Extractor Fan4513 Shower Head4112 Flooring329 Shower Curtains298

Limitations of survey Possible under reporting of dissatisfaction due to concerns adaptation might be removed. Over reliance on respondents recall especially regarding repairs and amount of help required. Question about floor level of adaptation would have been useful.

Limitations of survey Cost savings are potentials based on assumptions of amount of care person may have required (without shower). Some questions too open to interpretation. Survey did not identify whether changes in level of care due to changes in medical conditions or as result of shower adaptation. Data only available post 2007.

What have we done since? In conjunction with technical officers Housing OT’s have started to carry out local research to find out whether –there are other drainage pump options. –there are other shower traps that are easier to manage –There are alternative (quieter) extractor fans that could be used. In process of compiling an information leaflet. Recommendation made to update Oxfordshire OT Toolkit to include criteria regarding provision of body driers.

Iced…… but no cherry! Survey results published within Oxfordshire. Presentation to Oxfordshire OT Professional Forum. Abstract sent to BJOT. Presentation at COTSSH conference!

Personal Reflections

What else have we learnt A new word:

And Finally!!