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Bathing adaptations in the homes of older adults (BATH-OUT): results of a Feasibility Randomised Controlled Trial (RCT)

Whitehead, Phillip J.; Golding-Day, Miriam R.; Belshaw, Stuart; Dawson, Tony; James, Marilyn; Walker, Marion F.

Bathing adaptations in the homes of older adults (BATH-OUT): results of a Feasibility Randomised Controlled Trial (RCT) Thumbnail


Phillip J. Whitehead

Stuart Belshaw

Tony Dawson

Professor of Health Economics

Marion F. Walker


Background: Housing adaptations have been identified as an important environmental and prevention intervention for older adults, which may improve health and quality of life. The onset of disability in bathing can act as a warning for further disability in other activities and may therefore be a judicious time-point for intervention. The aim of this study was to determine the feasibility of conducting a Randomised Controlled Trial (RCT) of bathing adaptations, to evaluate whether they improve older adults’ perceived health status and quality of life, prevent further functional deterioration, and reduce the use of other health and social care resources. This study was conducted in preparation for a powered RCT.
Method: Eligibility criteria were aged >65 and referred to local authority housing adaptations service for an accessible flush-floor shower. Participants were randomised to either usual adaptations (3-4 month wait) or immediate adaptations (no wait). Outcomes were assessed at three, six and nine months and included perceived physical and mental health status, health and social care related quality of life, independence in activities of daily living (ADL) and bathing, and falls. Data on costs and the use of health and social care resources were collected during follow-up in order to inform a definitive health economic evaluation.
Results: Sixty participants were recruited and randomised, 31 to immediate adaptations and 29 to waiting list control. Mean age was 77(SD8), 58% women and 58% living alone. Follow-ups were completed with 90%, 85% and 72% at three, six and nine months respectively. Adaptations were delivered to 65% of participants within the requisite timescales as there were delays with some privately owned properties. There were improvements from baseline in both groups on all outcome measures following the completion of the adaptations.
Conclusions: This is the first RCT of housing adaptations in the UK. We demonstrated the feasibility of using a waiting list control, subject to minor alterations to the timescales for privately owned properties. A powered trial would evaluate the impact on older adults’ quality of life and investigate the impact of waiting times on functional outcomes and health and care resource use.


Whitehead, P. J., Golding-Day, M. R., Belshaw, S., Dawson, T., James, M., & Walker, M. F. (2018). Bathing adaptations in the homes of older adults (BATH-OUT): results of a Feasibility Randomised Controlled Trial (RCT). BMC Public Health, 18, 1-11.

Journal Article Type Article
Acceptance Date Nov 6, 2018
Online Publication Date Nov 26, 2018
Publication Date Nov 26, 2018
Deposit Date Nov 6, 2018
Publicly Available Date Nov 27, 2018
Journal BMC Public Health
Electronic ISSN 1471-2458
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 18
Article Number 1293
Pages 1-11
Keywords Housing, Adaptations, Older adults, Bathing, Prevention, Randomised Controlled Trial, Health economics
Public URL
Publisher URL
Additional Information Publication ID no: 129
Contract Date Nov 27, 2018


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