Raising the standards: benefits of height-adjustable baths for children and adults with Profound and Multiple Learning Disabilities (PMLD)

Children and adults with Profound and Multiple Learning Disabilities (PMLD) experience complex health needs such as, epilepsy and respiratory problems, physical disabilities that greatly limits their ability to undertake everyday activities due to restricted mobility, limited or no verbal communication, sensory processing challenges, and mental health difficulties.

A combination of intellectual disabilities with physical and complex health needs can make bathing difficult and sometimes a distressing activity if not supported appropriately. Every child and adult with PMLD are unique, their wants, wishes, and preferences should always be at the forefront of every bathing approach. This means that bathing should always be approached with insight, creativity, and compassion.

Quite often for many, Disabled Facilities Grants (DFG) provide funding for accessible showering or wet rooms not baths despite legislation stating that a bath or shower (or both), can be grant funded. However, there are some clear benefits of bathing using height-adjustable baths for adults and children living with PMLD.

Height adjustable baths, also referred to as High-Lo baths such as, the Gemini MX or the Virgo in the Abacus range are designed to meet the needs of adults and children with limited mobility. The baths are raised electronically helping carers assist in a safe and ergonomically way. They include powered transfer seats, height adjustment and integrated changing and drying platforms with additional adaptive features and postural supports.

Benefits

  1. Promotes safety and reduces risk – height-adjustable baths such as, the Gemini MX reduces the need for manual handling as it enables bathing, drying, and changing in one easy transfer which lowers the risk of injury, aligns with hoist and other transfer equipment required.
  2. Enhances comfort and safety – adjustable features can further support person-centered planning and ensuring bathing is aligned to the preferences of the client. This ultimately makes the experience more enjoyable, comfortable and relaxing. Smooth and slow lowering into water provides a weightless movement that can sooth muscles, joints, and reduce pain in the body.
  3. Supports sensory processing preferences – many height adjustable baths provide additional features such as, integrated hydrotherapy jets and temperature control systems. Understanding sensory preferences of the child or adult you are supporting will ensure bathing supports regulation as opposed to increasing sensory dysregulation.
  4. Promoting choice and independence – I feel this fits nicely with the theme of Learning Disability week 2025, ‘do you see me?’. Small adjustments to enable the client to choose their water temperature and colour of lighting can have a powerful impact upon self-esteem and engagement. As mentioned above, the wants and wishes of the client to be at the forefront of the bathing approach.
  5. Fosters communication and relationship development – Bath time is a valuable moment for communication and relationship building with a caregiver. 1:1 attention during assisted bathing can allow for caregivers to engage more meaningfully with the person they are supporting. In my clinical practice, I have too often observed loss of dignity and participation when routines become rushed, purely task focused, and depersonalised. Always gather the clients voice, always offer choices, offer education and advice to caregivers to understand communication cues and always advocate for the needs of the client. Do not presume preferences based upon our personal or clinical experiences.
  6. Routine and predictability – when incorporated into a daily routine, regular bathing can offer a sense of predictability and security.
  7. Dignity – with height adjustable options this can support privacy and modesty with easier positioning and less physical strain on both the individual and caregiver.
  8. Improved confidence of carers and families – having the right equipment to support the activity enables the carer to focus upon the individual and their needs as opposed to the logistics of the task. This further allows more time on meaningful interaction.

The combined impact of an intellectual disability with other disabilities is multi-faceted resulting in increased levels of care and support with most or all aspects of daily life. Height adjustable baths are more than a piece of equipment; they’re an investment to improve the quality of life for adults and children with PMLD. For carers, therapists, family members or anyone supporting someone with PMLD, height adjustable baths can offer relief, improve confidence, and the ability the provide compassionate care.

These baths are a vital part of inclusive, person centred and holistic care.