Where are grab rails positioned?

Although primarily used in the bathroom and toilet, grab rails can be positioned anywhere in and around the home to provide support. Conveniently placed rails will provide help in four ways:

• to push or pull against when standing up;
• to provide a steadying support while sitting down;
• to provide a firm grip when transferring from one position to another;
• for balance when standing, walking or dressing.

Most are attached to the wall, although floor to ceiling rails are available. The type required will depend upon the situation and the hand or arm strength of the person. A combination of vertical and horizontal rails is often helpful.

Provision of Grab Rails

Grab rails are generally regarded as daily living equipment, and may be provided by an occupational therapist at the social services department in England and Wales, the social work department in Scotland and the health and social services boards or trusts in Northern Ireland.

If you decide to buy grab rails privately, then SafetyStyle grab rails are available from a network of mobility shops nationwide.

Telephone 0121 766 6464 for your nearest stockist, or if you would like to become a stockist..

Types of Grab Rail

When choosing a grab rail there are many factors to consider.

• Check that the rail is comfortable to hold and there is sufficient room between the rail and the wall to allow the person to secure a strong handgrip.
• It is recommended that there should be a space of about 1 1/2" to 2 1/2" between the wall and the rail.
• Ensure that the rail is comfortable to hold especially if the person has weak or painful hands. It is recommended that the rail should have a diameter of between 1" to 1 3/4".
• Coloured rails that contrast with the wall colour are useful for people who have a visual impairment.

STRAIGHT RAILS

These are wall-fixed rails which run in one direction only. They can be fixed in a horizontal or a vertical position, or at an incline.

ANGLED RAILS

These are wall-fixed rails. The top portion is fixed in a vertical position and the lower, angled part acts as a forearm support whilst pulling up.

This enables the body weight to be distributed through his/her forearm which is useful for someone with painful hands or wrists.

RIGHT ANGLED RAILS

These are wall-fixed rails with a 90° bend to give both a horizontal and a vertical handhold. Useful in confined spaces.

FLOOR TO CEILING RAILS

These are vertical rails which are attached to both the floor and the ceiling. They are particularly useful when positioned on the outer edge of the bath to provide support when turning round to step in or out.

Finish of Rail

The finish of the rail may be important from an aesthetic point of view and also for the grip surface it provides.

CHROME PLATED FINISH

This finish is attractive and hard wearing but may be quite slippery to hold, especially when hands are wet.

EPOXY FINISH

This provides a warmer feel to rails, is hard wearing and will reduce the effects of condensation. Choice of colours allows for colour co-ordination of bathroom accessories.

STAINLESS STEEL

Provides a hard wearing, corrosion resistant grab rail, ideal in damp environments, for interior and exterior use. There is a choice of bright or satin finishes to coordinate with bathroom fittings.

SLIP RESISTANT/ KNURLED/RIBBED FINISH

This is a moulded/coated textured surface which provides extra grip even when wet. This finish may be uncomfortable for those with sensitive hands.

POSITIONING OF GRAB RAILS

Correct positioning of grab rails is important to ensure that they provide the support, where necessary, to perform specific tasks.

GENERAL

Horizontal rails

These help when pushing up from sitting and provide support when lowering, e.g. on to a toilet. Most people find it easier to push down on a rail rather than pull on one, so horizontal rails are more commonly used.

Inclined rails

Rails that are fixed at a slight angle to the horizontal enable someone with weak or painful arms or wrists to support his/her forearm on the rail whilst pushing up, thus spreading the body weight over a larger area.

Vertical rails

These help when pulling up into a standing position.

One rail fixed at an angle of 45° is not a good compromise as it is not easy either to push or pull on.

FOR GETTING IN AND OUT OF THE BATH

The bather will often use one wall-fixed grab rail and the outer rim of the bath to push against to help him/her stand up.

Horizontal and inclined rails

• A rail 24” long can be fixed horizontally to the wall 4” above the bath rim. It should be positioned between 12” and 36” from the head end of the bath, (i.e. the non tap end).
• Alternatively a 36” straight rail can be fixed at an angle of 13° upwards towards the head end of the bath to provide an inclined support. The lower end should be positioned 1” above the bath rim and upper end 10”.

Vertical rails

• A rail can be fixed vertically on the wall, 20” from the tap end of the bath, with its lower end 8” above the bath rim.
• Alternatively, a rail which attaches to both the floor and the ceiling on the outer edge of the bath may provide support when the person is turning round to step in or out. It is recommended that it should be sited 16” from the tap end of the bath where it can be reached from a sitting position in the bath. However, its position could impede someone using a bath board who finds it difficult to bend his/her legs.

Horizontal rails

• A rail can be fixed on to the wall at the side of the shower seat, approximately 8” above the height of the seat. As well as being useful to help someone to stand up, it will allow wheelchair users to pull on it in order to transfer across onto the seat from a wheelchair.
• In addition it may be useful to have a horizontal rail fixed on the wall opposite the shower seat at a height of 36" from the ground.

Vertical rails

• A rail at least 15” long can be fixed at the entrance to the shower compartment on the wall opposite the seat. It should be fixed between 36” and 50” above floor level.
• However, the distance between the front of the seat and the rail must be less than 22” if it is to be used successfully.

Fixing of Grab Rails

Grab rails are only as strong as the wall to which they are fixed and the fixings that are used. Unfortunately many modern houses which were built as cost effective, thermally efficient buildings, do not have internal walls that are ideal for the installation of wall fixtures such as support rails and shower seats.

You will need to ensure that you are using the correct type of fixing for the material of the wall.

TRADITIONAL BRICK AND CONCRETE BLOCKS

• Good quality traditional masonry and bricks should cause no problems if the recommended fixtures and procedures are followed. A plasterboard or tiled surface should not effect the fixing, although ensure that the whole depth of the fixing is supported by the masonry.
• Most dense concrete blocks are strong enough to support rails. However, care should be taken as their composition may make it difficult to drill a straight hole through them.

LIGHTWEIGHT AERATED AND HOLLOW BRICKS

• If the wall is made of lightweight, aerated and hollow brickwork, even the most appropriate fixings may not be able to withstand the loads which can be suddenly applied to rails and hinged arm supports.
• The insides of the hollow blocks are often filled with a polystyrene type insulating material which will not provide enough support for fixtures screwed into it.
• Similarly, aerated concrete blocks, which are often used in bathrooms and toilets as the waste pipes are carried through their cavities, are made of a very lightweight substance which limits their fixing support qualities. Supporting fixtures should be attached to this type of wall using specific wall- mounted support products.

PRE-FABRICATED PARTITIONS

• Even if a partition or stud wall is physically strong and stable and has a suitable flat surface to take a grab rail, the addition of a backboard on the outside wall is advised when fixing a grab rail to it.
• This should be a flat, unknotted piece of wood, which is screwed into the vertical joining pieces of the partitions. The grab rails can then be attached to the board. Self-tapping screws should be used when attaching rails to metal stud partitioning.
• Particular care should be taken when attaching rails to domestic sandwich partitions, e.g. plasterboard with a hardboard facing.

Earthing of Grab Rails

The Institute of Electrical Engineers has published regulations which aim to promote safety and reduce the risk of injury from electrical accidents. They require that any metal parts of a building which could become live should be earthed.

If you are installing a metal grab rail in a wet area such as the bathroom, you must ensure that there is no possibility that any metal part which may be touched by the person, including fixing screws, will come in contact with electric cabling. The following types of metal grab rails do not have to be earthed:

• metal rails which have a plastic or other non-conductive coating, and a snap- over cover plate providing an insulating layer over the wall-fixing screws;
• metal rails where the screws are fixed through plastic seats, and covered by a plastic cap, effectively isolating the screw from touching the rail;
• metal grab rails which are fixed to a non-conductive material, such as brick or timber, which definitely has no conductive parts running in it, e.g. metal pipes which could make contact with the rail via a fixing screw.

There is a small chance that metal pipes within the wall could become live by making contact with a faulty electrical appliance in another part of the building. If one of the fixing screws of the rail is in contact with the pipe, the rail could become live.

If a metal grab rail does need earthing, you will need to attach an earth cable to the rail and run it to the earth terminal in the main consumer unit.

Detailed information on guidelines for installation of metal grab rails in the bath area are covered in the regulations for electrical installations or contact the Technical Officer at local housing authorities/departments.

Other Types of Grab Rail

STAIR OR CORRIDOR RAILS

Long lengths of rail are available to provide support for people when walking up and down stairs or along corridors. An interconnecting system of rails can be slotted through wall-fixed brackets or attached to floor fittings. Various lengths, colours and finishes are available.

Most staircases have a handrail on one side although this may not extend to the full length of the staircase. manufactures 36” long grab rails, which can be used to extend the existing handrail all the way up the staircase if it is required. Adding a handrail or grab rails to the other side of the staircase will provide more support where needed.

Useful Sites

Age Concern – 0208 679 8000
For advice and information on a wide range of issues concerning older people.
www.ageconcern.org.uk

Alzheimer’s Society Help line – 0845 300 0336
For information, advice and local support services for those caring for someone with dementia.
www.alzheimers.org.uk

Association of Independent Care Advisers (AICA) – 01483 203066
Represents member organizations around the country that are helping people decide on the best choice of care. The Association can put you in touch with Care Advisers in your local area.
www.aica.org.uk

Benefits Enquiry Line – Free phone 0800 882200
For information and advice on all benefits for the disabled or elderly and their carers
www.dwp.gov.uk

British Red Cross Society
Local centres available throughout the country. Services include care at home, transport, holidays respite care and equipment loan for elderly people.
www.redcross.org.uk

Disability Information Advice Line – 01302 310 123
www.dialuk.org.uk

Disabled Living Foundation Help line – 0870 603 9177
For advice on equipment for independent living. Product and supplier information can be given.
www.dlf.org.uk

Parkinson’s Disease Society Help line – 0808 800 0303
Provides support and information for people with Parkinson’s Disease and their relatives.
www.parkinsons.org.uk

Public Trust Office – 0207 664 7327 or 0845 330 2900
Provide guidance on Enduring Power of Attorney and Court of Protection
www.guardianship.gov.uk

Royal National Association for the Blind (RNIB) Help line – 08457 669999
Provides information and support for anyone with serious sight problems.
www.rnib.org.uk

Royal National Association for Deaf People (RNID) Help line – 0808 808 0123
Provides information, interpreting service, special telephone service and environmental aids.
www.rnid.org.uk

– 0121 766 6464

British manufacturers of an extensive range of chrome plate, epoxy and stainless steel grab rails. For your nearest stockist, or if you would like to be a stockist, please telephone or email us at info@safetystyle.co.uk.

The Stroke Association Help line – 0845 303 3100
National Charity, which provides an advisery service for people who have had strokes and their families.
www.stroke.org.uk

British Association for Counselling and Psychotherapy (BACP) - 0870 443 5252
A charitable organisation, which has set nationally recognised standards. Members abide by a Code of Ethics and Practice.
www.bacp.co.uk

Department of Health
Legislation and guidance from the UK Government and the NHS
www.doh.gov.uk

Scottish Executive
Information from the Scottish Executive on Health and Community Care
www.scotland.gov.uk/health

Welsh Assembly Government
Information about the Welsh Assembly Government’s Health, Social Care and Wellbeing.
www.wales.gov.uk/subihealth

Department of Health, Social Services and Public Safety in Northern Ireland
Information on health and personal social services.
www.dhsspsni.gov.uk/hss

National Care Standards Commission
An independent public body responsible for the registration and inspection of care services.
www.carestandards.org.uk