02/16/2026
Bathing Is More Than “Can the Resident Get in the Shower?”
In the SNF setting, occupational therapy evaluation of bathing extends well beyond assessing strength and balance. Bathing is a complex ADL that requires physical capacity, cognitive processing, sensory tolerance, safety awareness, and the ability to sequence and complete multiple steps safely.
Subtle changes in executive functioning, judgment, initiation, or safety awareness can significantly increase fall risk and impact hygiene, even when a resident appears physically capable of stepping into the shower. Additionally, factors such as fatigue, pain, wounds, lines/tubes, weight-bearing precautions, or new medical equipment often require modification of the bathing environment or routine.
OT assessment also considers psychosocial factors, including privacy preferences, cultural considerations, established habits, and overall dignity. Intervention may involve environmental adaptations (e.g., shower equipment, positioning, energy conservation strategies) or restructuring the bathing routine to maximize safety and independence within the resident’s current level of function.
In a skilled nursing setting, OT is often an appropriate referral when bathing performance declines, as the goal is not only physical access to the shower, but safe, dignified, and functional participation in self-care!
