Bathroom safety for seniors: what to fix first

Stand in your parent's bathroom doorway and look at it the way an occupational therapist would. Forget the towels and the tile color. Look at the floor between the door and the toilet, the height of the toilet seat, the rim of the tub, and what your parent would grab if a foot slid out. Most bathrooms were built for someone who steps over a tub wall without thinking. Thirty years later, the same room asks a lot more of the same person.

Falls are the leading cause of injury and injury death in adults 65 and older, and about one in four report a fall each year, according to the CDC. In a CDC-led study of 2015 emergency room visits, 22.7 percent of falls at home, where the room was recorded, happened in the bathroom, close behind the bedroom and the stairs. For people 85 and older the bathroom's share was 26.1 percent.

The encouraging part is that the room can be changed. A 2023 Cochrane review found that reducing hazards at home probably cuts the rate of falls by about a quarter overall, and by 38 percent in people already at higher risk of falling. Here is what to change, in roughly the order your parent uses the room.

Why the bathroom is hard on older bodies

Two things combine in a bathroom. The floors and surfaces are often wet, and almost everything your parent does there involves shifting their weight: sitting down on the toilet and getting up again, stepping over a tub wall, turning on damp feet. Each of those moments asks for balance and leg strength just when there's the least to hold.

Where the injuries happen changes with age. In a CDC study of bathroom injuries, most injuries in young adults happened in or around the tub or shower. Among people 85 and older, 51.7 percent happened on or near the toilet. If your parent is in their late eighties or nineties, the toilet deserves as much attention as the tub.

Light the path from bed to toilet

Night trips carry extra risk. Your parent is half asleep, the hallway is dark, and blood pressure can dip on standing up quickly. The National Institute on Aging recommends night lights and a light switch close to the bed, and a light left on in the bathroom or a night light that comes on by itself in the dark.

Plug-in motion-sensor night lights do this well: one near the bed, one in the hallway, one at the bathroom door. Each comes on as your parent walks past, so there's no switch to find. Make sure the bathroom light switch can be reached from the doorway without stepping into a dark room, and keep a phone within reach of the bed.

Take up the rugs and make the floor grip

Take up loose throw rugs between the bedroom and the bathroom and inside it. They bunch under slippers, slide on tile and catch walker wheels. If your parent wants a mat outside the tub, choose one with a rubber backing that grips the whole floor, and replace it when the backing wears.

Put nonslip strips or a nonslip mat inside the tub or shower, as the NIA recommends for every surface that gets wet. If there's a raised threshold at the bathroom door, a beveled transition strip makes it easier to clear. If you're replacing the floor, ask for matte tile rated for wet areas; polished tile is slick when wet.

Raise the toilet seat

Standard toilets are about 15 to 16 inches from floor to seat. The ADA standards for accessible toilets call for 17 to 19 inches, and many older adults find that height much easier to sit on and stand up from. There are three ways to get there:

• A raised toilet seat fits onto the existing bowl and adds a few inches. Many have armrests to push up from.
• A toilet safety frame stands around the toilet and gives your parent armrests on both sides.
• A comfort-height toilet replaces the bowl with a taller one. It's the permanent fix and looks like any other toilet.

Whichever you choose, check that your parent's feet still rest flat on the floor when seated. Add a grab bar on the wall beside the toilet. If your parent gets up several times a night, a bedside commode can spare them the walk altogether; Medicare covers one when a doctor orders it as medically necessary. A bidet seat can help someone who struggles to twist and reach when wiping.

Make the tub and shower safer

Stepping over a tub wall means standing on one leg on a slippery surface. If the bathroom has a tub with a shower, three additions handle most of the risk without a remodel:

• A tub transfer bench has two legs inside the tub and two outside. Your parent sits on the outside end, swings their legs over the tub wall while seated, and slides across. Nobody has to step over anything.
• A handheld shower on a hose lets your parent wash sitting down, or lets a caregiver help without both of them getting soaked.
• Nonslip strips or a nonslip mat on the tub floor.

To prevent scalds, the Consumer Product Safety Commission recommends setting the water heater to 120°F. If you're replacing the shower valve, an anti-scald valve limits the temperature at the tap.

If you're remodeling, a shower your parent can walk straight into, with no curb or a very low one, a fold-down seat, a handheld shower and grab bars, is the change that lasts longest. It works with a walker now and a wheelchair later. Walk-in tubs remove the step over the tub wall too, but your parent has to sit inside while the tub fills and stay seated while it drains. They suit someone who loves to soak more than someone who just needs to get clean safely.

Grab bars that hold

A grab bar is only as good as what holds it to the wall. Have bars screwed into the wall framing, or fixed with anchors designed for grab bars where there's no stud, by a handyman or contractor who does this regularly. The ADA standard for public restrooms requires bars and their mounts to withstand 250 pounds, with a grip 1¼ to 2 inches across. Look for bars sold as meeting it.

The NIA recommends grab bars near the toilet and both inside and outside the tub or shower. The ADA puts horizontal bars 33 to 36 inches above the floor, with the bar beside a toilet at least 42 inches long and starting no more than 12 inches from the back wall. In a tub or shower, add a horizontal bar on the back wall for washing and a vertical bar at the entry for stepping in and out. An occupational therapist can fine-tune the positions to your parent's height and stronger side.

Towel bars, soap dishes and the edge of the sink aren't grab bars, though people grab them anyway when they slip. A grab bar that doubles as a towel bar can replace the one nearest the tub.

What to skip

• Suction-cup grab bars. Manufacturers sell them as balance aids and warn against putting body weight on them, and the suction can let go without warning. A falling person puts full weight on whatever they grab.
• Throw rugs, however soft, anywhere on the route from bed to bathroom.
• A medical alert pendant instead of the changes above. A pendant gets help after a fall, which matters, but it doesn't prevent one. Use both.

A door that opens if someone falls

A bathroom door that swings inward can be blocked if your parent falls behind it. Rehanging it to swing outward, or replacing it with a pocket or sliding door, solves that and frees floor space for a walker. If the door locks, make sure the lock can be opened from outside with a small tool, and try it before you need it. For a walker or wheelchair, a doorway needs about 32 inches of clear width.

What to do first

1. This week: motion-sensor night lights from bed to toilet, loose rugs gone, a nonslip mat or strips in the tub and a rubber-backed mat beside it, a phone by the bed, and the water heater at 120°F.
2. This month: grab bars beside the toilet and in the tub or shower, installed by someone who anchors them properly; a raised toilet seat or safety frame; a tub transfer bench or shower chair; and a handheld shower.
3. When you remodel: a step-free or low-curb shower with a seat, a comfort-height toilet, and a door that swings out.

Who pays for bathroom changes

Original Medicare doesn't pay for grab bars, raised toilet seats, bath seats or nonslip flooring, which it considers convenience items. It does pay for outpatient occupational therapy that a doctor certifies is medically necessary, and an occupational therapist can tell you exactly what your parent's bathroom needs.

Other help is patchier. Some Medicare Advantage plans include bathroom safety devices as an extra benefit, though fewer each year: in KFF's analysis of 2026 plans, 21 percent of people in individual plans had the benefit, down from 32 percent. Veterans may qualify for VA's Home Improvements and Structural Alterations (HISA) grant. Rebuilding Together affiliates install grab bars and make other safety repairs free for some low-income homeowners through their Safe at Home program. Your county's office on aging can tell you what else exists locally.

When the bathroom is still hard

Equipment helps only if your parent can use it. Some people need a steady hand for the shower or the trip to the toilet at night, and that's the help our caregivers give through personal care and mobility care. When our nurse visits for the free assessment, they walk the route your parent takes from bed to bathroom and point out the trouble spots. A caregiver can move a rug or plug in a night light; grab bars and a raised seat we'll flag so you can arrange them.

For the rest of the house, see our guide to preventing falls at home, and if your parent gets dizzy when they stand, dizziness in older adults explains the common causes.