Bathing adaptations in the homes of older adults: A randomised controlled trial, economic evaluation and process evaluation (BATH-OUT-2)

Phillip Whitehead In progress  


When people become unable to use the bath or shower at home an occupational therapist may recommend that a ‘walk-in’ shower is provided. Changing or ‘adapting’ the bathroom often means that the person can continue to manage their personal care without help. They may also be less likely to have an accident or fall. However, there is limited research on how walk-in showers help people to manage as they get older.

There are often long waiting times for walk-in showers to be installed. Waiting times vary across the country and may be up to two years in some local authorities. Difficulties with bathing can often be followed by difficulties with other daily activities such as dressing, toileting or walking. Older people may lose some of their independence with these activities while they are waiting. This might also mean that they end up needing more help from family, friends or paid care workers.


This study aims to explore whether having a walk-in shower improves or maintains older people’s health, safety, quality of life, and ability to manage their personal care. It will also explore whether delayed installation has a negative effect on older people’s physical and mental health and independence, and also leads to more costs.

The study will answer two important questions: is the provision of walk-in showers effective? If so, is quicker provision more effective?


This study will be conducted in four regions where the current waiting times for walk-in showers are longer than four months. Three hundred and sixty people aged 65 and over, who have been referred to the council’s adaptations service for a walk-in shower, will join the study. Half will be randomly allocated to begin the process for walk-in shower installation immediately; the other half will have the usual wait of between 4 and 9 months before the shower is installed. The two groups will be compared 4 weeks after the first group has received their showers; the groups will also be compared 4 weeks and 3 months after the second (usual wait) group has received their showers.