A non-weight bearing (NWB) injury presents a significant challenge to daily tasks, making hygiene frustrating. The inability to place pressure on the injured leg, often due to a fracture or surgery, means a high risk of falls on wet surfaces. However, with careful planning and the right tools, a safe and thorough shower is achievable. Preparing the bathroom and understanding the mechanics of a seated shower are the first steps toward regaining independence.
Essential Safety Equipment and Bathroom Setup
The goal of the bathroom setup is to eliminate the need to stand or balance on one leg while wet. A sturdy shower chair or bench is the most important piece of equipment, allowing the user to remain seated throughout the process. For bathtubs, a transfer bench is preferable, as one side sits outside the tub, facilitating safe entry and exit without stepping over the high edge.
Stability is enhanced by professionally installed grab bars, placed on wall studs for leverage during transfers. Temporary suction-cup grab bars are not recommended for full body weight support. A handheld shower head is also necessary, allowing the user to direct the water spray while seated and keep the injured leg away from the stream.
Non-slip mats should be secured both inside and outside the shower area to reduce the risk of slips. All potential trip hazards, such as rugs, shampoo bottles, and towels, must be cleared from the floor. The entire setup should be tested for stability and proper placement before showering.
Waterproofing the Non-Weight Bearing Limb
Protecting the cast, surgical dressing, or wound site from moisture is necessary to prevent complications like skin infection or structural damage. The most reliable method involves using a specialized, reusable waterproof cast cover. These covers are made of a durable material with a tight, self-sealing diaphragm that creates an airtight and watertight seal above the injury.
While commercially available covers are the safest option, DIY methods using plastic bags and tape carry a high risk of water seeping through weak seals. Water seepage can compromise the dressing or cast integrity, cause skin irritation, and impede the healing process. Even with a waterproof cover, the limb should be positioned elevated and outside the direct spray of the water throughout the shower.
Step-by-Step Guide for a Seated Shower
Once the equipment is set up and the limb is securely waterproofed, the transfer into the shower must be performed slowly. The user should approach the bench or chair with their mobility aid. They then use the grab bars and the strength of their non-injured leg and arms to lower themselves onto the seat. If using a transfer bench, the user sits outside the tub, then scoots across the seat until they are fully inside the shower area.
The non-weight bearing leg should be carefully lifted over the tub threshold or shower curb, using a leg lifter strap if necessary. It should be propped up on a small, stable stool or the edge of the tub to keep it elevated. This elevated position prevents water from pooling around the cast cover seal and maintains comfort. The handheld shower head is then used to wash accessible areas, allowing for precise control of water flow and temperature.
Throughout the washing process, the user must maintain a stable position. Use a long-handled brush or sponge to reach the feet and lower legs of the non-injured side. After washing, dry off as much as possible while still seated to minimize the risk of slipping during exit. The exit process reverses the entry, using the grab bars for support while slowly standing up onto the non-injured leg.
Quick Cleaning Alternatives
On days when a full shower feels too exhausting or impractical, quick cleaning alternatives maintain hygiene effectively. A sponge bath is a simple solution, performed by sitting on a secure stool and using a washcloth with mild soap and warm water. This method allows for targeted cleaning of the underarms, groin, and feet without the risk of slipping.
No-rinse body wipes or specialized bathing wipes offer a convenient way to quickly freshen up and remove sweat or bacteria. For hair care, dry shampoo can absorb oil from the scalp. Alternatively, hair can be washed over a sink basin using the handheld shower head or a cup, often with assistance. These methods conserve energy and reduce the frequency of high-risk transfers.