Walk-in Tub or Walk-in Shower: Which Is Best?

Bathrooms are often the focal point for home modifications. The Centers for Disease Control and Prevention (CDC) acknowledges that the bathroom is a prime location for falls that result in injury. It also reports that most older adults who fall do not mention it to their doctor, suggesting that the number of injuries from falls is significantly underreported. It further predicts that the older adult population resulting in injuries will increase to 12 million by 2030. Fall prevention will become increasingly important.

More than the desire to avoid falls, the bathroom is the area of the home where we most want to maintain independence. Unfortunately, mobility limitations often reduce our autonomy, impacting our ability to bathe without assistance. To maintain independence with bathing amid mobility limitations while preventing falls, is a walk-in tub or shower better? As each person and situation is unique, various factors and considerations will influence the answer to this question.

The basics of walk-in tubs

Walk-in tubs are generally considered the safer method for bathing. The user avoids climbing in and out of a traditional or standard tub, reducing the fall risk. They are also preferable to stand-up showers as users can remain seated. While walk-in tubs are primarily marketed to older adults, they are a bathing option for anyone with mobility limitations.

With a walk-in tub, users can experience the benefits of bathing that are not provided by a shower. A primary benefit is that baths relax muscles, which may benefit those with chronic pain issues. Bathing in a tub can help with depression and also exfoliate skin. Salts and oils can be added to the water for additional skin benefits.

Walk-in tubs come in various types, including wheelchair-accessible, bariatric, hydrotherapy, and standard soaker tubs. Most models have standard safety features, including grab bars and non-slip flooring. Some models include the option to shower as a sit-down shower, sit-down shower tub, or stand-up shower. There are even two-seat models for those who want to bathe together.

🫧 Editor’s choice for senior walk-in tubs

Potential concerns with walk-in tubs

Despite their numerous advantages, there are also concerns with walk-in tubs. Before deciding on a walk-in tub, review the following concerns.

Thresholds

Although most walk-in tubs have a low threshold, not all do, and this can present a significant barrier to safe use. Thresholds for walk-in tubs can range from three to seven inches. Choosing a model with a three-inch threshold will help ensure continued use if mobility limitations increase.

Hygiene

Baths are often more therapeutic than hygienic. For optimal hygiene, it is usually recommended to rinse off with a shower after bathing. A walk-in tub with an added showering feature will best facilitate this for those with mobility limitations. Walk-in tubs need to be cleaned, which can present an extra challenge for someone with reduced mobility.

Inefficiency

Bathing in a tub may take more time and water than showering. With a walk-in tub, this includes the time it takes to drain the tub, as the user must remain in the tub until it is empty. Selecting a model with dual drains can help reduce this waiting time.

Lightheadedness

Baths can exacerbate lightheadedness. This may result in an unsafe bathing situation. A shower provides quicker water temperature adjustment or complete cessation of water, if necessary, to alleviate lightheadedness.

Installation time

Under ideal circumstances, installation can be completed in a single day. However, most installations take multiple days. If a larger-capacity water heater is needed for the particular model of walk-in tub selected, this will also affect the installation time.

The preference for showers

Most adults, many of whom bathe daily, prefer showering. Due to this preference, homes are more likely to have multiple showers than multiple tubs. Known for being cleaner and more hygienic, showers are better than baths for getting rid of germs and bacteria. Improved circulation and a boost for the immune system are additional benefits. Similar to baths, showers can also help with depression. Showers are efficient and conserve water. They can also be highly efficient for space usage. A stand-alone shower typically occupies less floor space than a bathtub/shower combination.

Space efficiency often comes at a cost when mobility is limited. Traditional stand-alone showers may make bathing assistance necessary and challenging. The median rate to hire a home health aide for bathing assistance is $33/hour according to the Genworth Cost of Care Survey. Minimizing the amount of bathing assistance needed is preferable and cost-effective.

Walk-in showers for older adults

A walk-in shower is a solution for maximizing independence for older adults. According to a survey by the National Association of Home Builders (NAHB), installing curbless showers was the second highest-ranking aging in place remodeling project completed by contractors. In contrast, installing walk-in tubs ranked twelfth.

Walk-in showers are customizable and built to fit the allotted space. Materials and fixtures are selected to suit the preference of the user. An aging-in-place specialist or occupational therapist can help sort through options.

Walk-in showers are ideally constructed with no threshold or curbless design. When this is not possible during renovation, minimal thresholds are lower than those of a walk-in tub. This makes them more accessible for those with mobility limitations.

For bath safety, older adults prefer a walk-in shower with a seat. This significantly reduces the chances of falling and increases the ability to maintain independence in the shower. Seating options include readily available medical-looking tub benches and stools, fold-down models installed on the wall, and built-in seating to match the shower's overall design.

Providing a seating option is crucial, but the type of seating selected depends on the user. If a person with limited mobility is the only one using the shower, the seating should be specific to that person. While less aesthetically pleasing, medical benches and stools are adjustable. Seating that is built-in or attached to the wall tends to be more attractive but has less flexibility for multiple users of various heights and mobility.

To further facilitate independence, an adjustable handheld showerhead should be provided. A standard-height showerhead is not conducive to bathing from a seated position. A handheld model will allow water control without needing to access the faucet if it is not reachable from a seated position.

Potential concerns with walk-in showers

With their rising popularity, it is easy to overlook the challenges that could accompany walk-in showers. Evaluating the suitability of a walk-in shower for your situation involves acknowledging possible issues.

Size limitations

If the space allotted for the shower is not large enough to allow for seating, the shower may not serve its purpose. Many space-saving bathrooms have a shower stall that is only 32 inches by 32 inches. This is inadequate for someone with mobility limitations to shower safely and does not allow room for assistance from a caregiver if needed.

Safety features

While walk-in tubs typically include safety features, walk-in showers do not. Safety issues will remain if grab bars are not included in the shower. Installing a walk-in shower allows for customizing grab bar locations, and this step should not be overlooked. The Americans with Disabilities Act (ADA) requirements for grab bars do not pertain to personal residences but can be used as a guide. Controls and shelving should be accessible from a seated position. Slip resistant flooring, anti-scald faucets and sufficient lighting should also be included for safety.

Installation time

The installation time for a walk-in shower depends on several factors, including the selected materials. A tile shower will take longer to install than a prefabricated fiberglass unit. If renovations are being made to create a zero-threshold entry, the construction time will be longer. Relocating plumbing will also extend the project timeline. Unexpected issues can arise in any remodeling or renovation project, and the installation of walk-in showers is no different.

Things to consider

Preference will be critical when deciding between a walk-in tub or a shower. Aging in place is about creating a home that suits your needs and preferences. A walk-in tub could be a substantial lifestyle adjustment if you are accustomed to daily showers. Modifications for aging in place should be incorporated to help maintain your current lifestyle to the greatest extent possible.

Cost almost always influences decision-making. It can be a deciding factor if you need to choose the most cost-effective option. Either choice will be self-financed, as Medicare does not cover the cost.

Consider who will be using the bathroom. If only one person is bathing in the bathroom, the decision-making process is easier. If a couple is sharing the bathroom, the needs and preferences of both must be taken into account.

Your existing bathroom is another crucial consideration. Does the bathroom layout allow for the installation of a walk-in tub? If major renovations would be necessary, are you willing and able to undertake this?

If selecting a walk-in tub, ensure it will work adequately in the space provided. Outward-swinging doors are better for accessibility, but they might not work in your bathroom, necessitating a model with an inward-swinging door. This is just one of many considerations when selecting a walk-in tub.

Consider the short-term and the long-term. Mobility limitations can increase with age. You can’t predict the future, but you don’t want to renovate your bathroom multiple times to maintain your independence as you age.

Making the decision

The best option for you will depend on your preference, what you can afford, the mobility limitations being addressed, and who the decision impacts. Many options exist for both walk-in tubs and walk-in showers, although walk-in showers are more customizable. Walk-in showers also have more universal appeal and will positively affect the resale value of your home. Seating should be provided for safety purposes when selecting a walk-in shower.

Ultimately, decisions that facilitate aging in place are most successful when they are specific to the needs and preferences of the person for whom they are intended.