bathing-aids-older-adults
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Bathing aids for older adults include suction cup handholds, rim-mounted tub rails and permanent grab bars. Most readers want to know whether these devices work. The two sources checked for this guide answer that question only in part. A laboratory study asked older adults to install a temporary handhold and temporary tub rails, then tested whether the devices held under load. A systematic review looked for trials of bathing interventions and found one study. Neither source measured falls, so neither can say whether a bathing aid prevents them.
Quick answer
- In the installation study, 20 adults over 65 installed a suction cup handhold and one of two rim-mounted tub rails. The paper reports that 85% of the handholds met the loading requirement after installation.
- The paper’s results report that 19 of 20 rim-mounted tub rail installations failed load testing. Its abstract says that no rim-mounted tub rail was successfully installed. The paper does not reconcile these two statements.
- More than half of the participants put the handhold on the back wall, which the paper describes as an unusable location for entry or exit transfers.
- The systematic review found one study of bathing interventions and describes its results as modest and to be read with caution. No source checked measured falls as an outcome of a bathing aid.
What the sources mean by a bathing aid
The installation study uses the term for three kinds of device: suction cup handholds, rim-mounted tub rails, and permanent grab bars. The paper states that “Suction cup handholds or rim-mounted tub rails are commonly used as temporary, low-cost alternatives.” It contrasts them with permanent bars, which the authors describe as the usual long-term recommendation. The paper lists the barriers to permanent bars as cost, existing wall structure, inability to change a rented home, and fear of stigmatisation.
The study tested one suction cup handhold and two rim-mounted tub rails. The devices were chosen from a scan of products sold in Canada, and the paper does not name them. The handhold has two rubber disks on springs and a lever. Its indicators change from red to green when the device is attached. One tub rail uses a rubber-lined clamp with a knob, and the other uses a polypropylene dial and release lever. The paper states that “None of the instructions for the devices tested indicated where the device should be installed.”
The installation study
The study recruited participants through newspaper ads and posters. To be included, a person had to be over 65, speak English, attend a session in person, and be able to step into and out of a bathtub without help. Each participant installed the handhold and one of the two tub rails, in random order, in a laboratory alcove with a full-size steel bathtub. The tub was 152.4 cm long, 76.2 cm wide and 41.3 cm tall. The authors chose a smooth acrylic surface over grouted tile, and they state that this was done “to allow more flexibility of handhold installation location, and greater potential for handhold installation success.”
The paper says the participants’ demographics were similar to the older adult population in Canada, though the sample was small. The table below gives figures the paper reports for all 20 participants.
| Characteristic (as reported in the paper) | Value |
|---|---|
| Participants | 20 (10 men, 10 women) |
| Mean age | 73.4 years (SD 5.7) |
| Reported having fallen while bathing | 20% (4 of 20) |
| Currently use a grab bar while bathing | 35% (7 of 20) |
| Confident they could install a handhold or tub rail before the task | 90% (18 of 20) |
Participants were asked to install each device “as if you were about to use it to enter the bathtub”, and they were given no help from the researchers. They could read the manufacturer’s manual as often as they liked. Video recorded each session, and the researchers then checked the placement and measured the load each device could take.
Did the devices hold under load?
The load test used a downward force of 112.5 N for the handhold and a downward and lateral force of 280.5 N for each rail. The authors say these values match the loads that a previous study recorded during a bathtub exit, with a vertical grab bar and with a rim-mounted tub rail, scaled to a 95th percentile man. A device passed if it did not move when the load was applied.
Results differed sharply between the two types of device. Three of the 20 handhold installations failed, which gives the 85% pass rate in the abstract. The results section reports that “19 (95%) of Rim-Mounted Tub Rail installations failed mechanical load testing.” The abstract and discussion say that no rim-mounted tub rail was installed successfully. Both cannot be exact: if 19 of 20 failed, one rail passed, which contradicts the abstract. This guide reports both figures and does not choose between them.
Across both devices, 22 of the 40 installations failed the load test: three handholds and 19 rails. The paper’s discussion says that “most of the devices did not meet our loading criteria or anticipated positioning”, which is consistent with that count.
The paper also notes a condition that may affect the handhold result. “Soap scum and mineral or dirt build-up would reduce the suction quality.” It adds that “Suction performance may decrease over time and with exposure to liquids, hygiene products, and changes in temperature and humidity.” The authors describe the handhold results as “a best-case scenario, and may not reflect real-world performance.”
Where people put the handholds
The Canadian standard the authors cite recommends two bars for a bathtub. One is vertical on the control wall, for entering and leaving the tub. The other is horizontal on the back wall, about 180 to 280 mm above the rim, for support while bathing and for getting down to and up from the tub floor. The study had no instruction on placement, so participants chose for themselves.
Only 40% of participants placed the handhold on the control wall or opposite it. The paper reports that 55% placed it on the back wall, at a height above the one the codes expect. Some placed it where it would help with hair washing or with tipping the head back. The authors write that “this location presents a safety concern if used for entry/exit transferring purposes as the user must lean over in order to reach it” They also note that greater trunk flexion “can increase the risk of falls”, citing earlier work.
The paper’s conclusion is that bathing tasks other than entering and leaving may carry a perceived risk for these users. The authors suggest that “the development of other resources would be valuable for directing users to appropriate grab bar configurations.” They do not test any such resource.
Steps, instructions and the suction indicator
The manufacturer’s handhold instructions ask the user to clean the suction disks and the surface, press the disks on, and push the lever down to latch. The study recorded how closely people followed these steps. Adherence to every step was 60% for the handhold and 80% for each tub rail. One quarter of participants did not clean the bathtub surface before installing the handhold, and the step most often missed for the rails was testing that the rail was secure.
Several of the instructions were unclear to the authors. The handhold instructions say that “The user is instructed to test whether the device is secure before each use, but no specific instructions about how to do this test are given.” For the rails, the instructions asked for a test but gave no method. The authors also note that it is unknown how well the colour indicator works. “Several participants noted that they were unable to determine from the indicator whether the handhold had been installed properly.” The paper says the indicator may be too small to see clearly, and it is not known how it performs on tiles of different texture or in different humidity.
The paper also says that “Many bathtub and shower tiles are grouted, or have surface texture, porous material, or beveled edges. These factors interfere with suction and may make suction-cup handhold installation less feasible.” This matters for readers whose tubs are tiled, because the study’s surface was smooth acrylic.
Confidence did not match performance
Most participants felt confident. The abstract says “Participants were confident that the devices had been installed effectively.” Ninety percent said before the task that they could install a handhold or rail, and 75% felt confident in the handhold installation afterwards. Confidence did not track the test results. The discussion calls this “an overarching theme” of the study, which it describes as “a mismatch between perceived risk and ability, and actual safety and performance.”
The authors give several possible reasons. Participants had low fall-risk scores on a confidence scale, so they may have thought the loads on a rail would be low, or they may not have planned to use it at all. The paper suggests that “It would be valuable to have anticipated loading performance, as well as clear methods for evaluating loading performance, included in product materials.” The study does not test this suggestion.
What the systematic review found
The second source is a systematic review of interventions to reduce dependency in bathing for community-dwelling older adults. Its search ran on 18 October 2016, and it included randomised trials, non-randomised controlled trials and controlled before-and-after studies. The review states: “The search process identified one study for inclusion in the review.” That study evaluated a bathing intervention delivered by an occupational therapist after discharge from hospital.
The review’s own summary of that study is limited. “Overall, the findings suggest modest improvements in functional ability in favour of the intervention group although the results should be interpreted with caution.” The authors conclude that “there is a dearth of evaluative or interventional research studies”, and they note that “Further robust research is warranted, including studies of randomised and controlled design”
The review also cites an observational cohort of 754 adults over 70 who were followed for six years. In that cohort, “those who developed a disability in bathing were five times more likely to develop a disability in another activity of daily living the following month.” The review describes this as a sign that bathing disability “may be an indicator and potential precursor of further disability.” This is an association in an observational study, and it does not show that a bathing aid would change that outcome.
What the sources say about falls
The installation paper opens with the statement that “Grab bars facilitate bathing and reduce the risk of falls during bathing.” That sentence is the authors’ framing. It is not a result of their study, which did not count falls. The paper supports the statement with the sentence that “There is growing evidence that grab bars are effective for bathing mobility and fall prevention”, and it cites earlier studies for that point. Those studies were not checked for this guide.
The paper’s own work found that 20% of its participants had fallen while bathing, and that 55% reported bathing challenges. It also notes that participants “commonly commented that they felt grab bars were important safety devices for other people, but that they, themselves, did not need a grab bar.” The authors suggest that this view needs more study.
Using bathing aids as the sources describe
The sources do not rank products, and this guide does not recommend any. The points below come from what the studies tested and what the authors wrote about it.
- Read the manufacturer’s instructions before installing, and note which steps are unclear. The study found the handhold instructions did not say how to test the device.
- Clean and dry the surface before fitting a suction device or a clamp, because the paper says soap scum and mineral build-up reduce suction.
- Check where the device is fitted against the purpose it is meant to serve. For getting in and out of the tub, the standard the authors cite places a vertical support on the control wall.
- Be cautious with a suction device on grouted or textured tile, because the paper says tile of that kind may make suction less feasible.
- Test each device before each use. The paper found that the handhold instructions ask for this test but do not say how to carry it out.
- Keep in mind that the study tested devices on one bathtub with a smooth acrylic wall. The authors say real-world performance may be lower.
The paper’s conclusion is that older adults who install these devices without an occupational therapist “may require guidance tools for determining where and how to install these devices” The paper points to this as the gap. It does not test whether an occupational therapist’s guidance improves installation.
How we chose
This guide is based on two sources. Both are full-text articles in PubMed Central, and both were opened on 2026-10-28. The installation study was chosen because it tests bathing aids for older adults directly, with participants, load tests and an outcome that a reader can compare with the product’s own claims. The systematic review was chosen because it is the only systematic search of bathing interventions among the sources checked. Other saved pages were checked and left out because they covered bathing adaptations in general, bathtub injuries, or bath chairs that the reviewed text did not discuss.
Claims were limited to what the two sources state. Where the authors interpret their own data, this guide says so.
What the sources do not say
- Whether temporary suction handholds or tub rails reduce falls in bathrooms. The installation study did not measure falls, and the review found no study of these devices.
- How the devices perform after weeks or months of use. The authors say suction may fall over time, but they did not measure it.
- How the devices perform on tiled, grouted or textured surfaces, which the paper says is an open question.
- How the results would differ in homes. The paper states that it evaluated one bathtub, with one ideal wall surface, and three devices, and that installation may differ in real bathrooms.
- Which rim-mounted rail installation passed, if one did. The paper’s abstract and discussion say none was installed successfully, while its results section reports 19 of 20 failures, and the paper does not explain the difference.
- Whether the single study in the systematic review applies to bathing aids. That study evaluated a bathing intervention by an occupational therapist, not a product.
Sources
- Rand M, Pelchat J, Levine IC, Montgomery RE, Greene RM, King EC, Pong SM, Novak AC. Efficacy of Installation of Temporary Bathing Transfer Aids by Older Adults. Gerontology and Geriatric Medicine. 2024;10:23337214241237119. https://pmc.ncbi.nlm.nih.gov/articles/PMC10938608/ (opened 2026-10-28)
- Golding-Day M, Whitehead P, Radford K, Walker M. Interventions to reduce dependency in bathing in community dwelling older adults: a systematic review. Systematic Reviews. 2017;6:198. https://pmc.ncbi.nlm.nih.gov/articles/PMC5637353/ (opened 2026-10-28)
