Exploring the importance and performance priorities of older adults with a user-centred approach to create a fall-free bathroom

Abstract

Background Fall hazards in bathroom spaces constitute one of the most critical issues in the daily lives of older adults. Bathroom falls are somewhat different and constrained in nature than those in other parts of a home environment. Objectives This study aimed to adopt a user-centred approach to explore older adults' general bathroom needs, with a specific focus on showers and bathtubs as the designated activity area. Methods The authors employed an extended importance–performance analysis (IPA) with a mixed-method research design. Three hundred and eleven older adults participated in a face-to-face IPA questionnaire for the quantitative phase of the study. The authors gathered the qualitative data through open-ended questions from 59 older adults. Results The authors found positive correlation between older adults' attitudes towards an older-friendly bathroom and the potential for their bathrooms to be fall-free. The IPA calculations identify three key items with higher ratings in both importance and performance: The presence of appropriate artificial lighting, efficient mechanical ventilation and an accessible inside towel rail. Thematic analysis yields four themes: comfort, ease of access, error-proof design and emergency management. Conclusions The IPA calculations and thematic analysis confirm that older adults' rankings of importance and performance and their corresponding priority levels within the overarching themes indicate the need for these aspects to perform well and justify ongoing investments. The study concludes that addressing fall prevention requires not only designing specific solutions but also utilising appropriate technology in bathing and toileting activities. Implications for Practice Practitioners in geriatric and gerontological nursing, design, architecture and health care can use the importance and performance priority levels of older adults to guide the development and implementation of fall-free bathroom design. Policymakers can leverage the insights from this research to inform guidelines and regulations related to building codes, accessibility standards and healthcare policies.