CLINICAL EVIDENCE SUMMARY

Assisted Hygiene andWellness solutions

Introduction
Since the creation of Arjo over sixty years
ago, improving the hygiene care experiencefor patients, residents and caregivers has
been at the very heart of what we do.

Our journey began when Arne Johansson, the original company
founder, built the first height adjustable bathtub driven by adesire to improve care for his wife who had impaired mobility.
This innovation was the first of many, all designed to improvesafety and efficiency for busy caregivers, while focusing on the
dignity, comfort and wellness of residents and patients during
the showering and bathing process. This clear vision led Arjo
to becom the global market leader in the provision of hygiene
solutions; a position it retains today.
We recognise that clinical decision making is complex andshould be based upon the best available evidence. We invite
you to review this clinical resource providing examples ofevidence supporting the use of hygiene and bathing solutions

Assisted hygiene and wellness
Hygiene care is more than just keeping the skin clean. For many
people having the opportunity to shower or bathe can have asignificant impact on their general well-being and quality of life.
For a patient during either a short or long term admission to ahealthcare facility, continuing their personal hygiene habits often
established over a lifetime can be challenging. Time pressured
staff, cold unwelcoming hygiene facilities and often rigid routines
mean the focus is frequently on getting the person clean as quickly
as possible, rather than on person centred hygiene care that takes
account of individual preferences. Providing personalised hygiene
care can lead to a more relaxing and enjoyable hygiene experience
with benefits for the person’s well-being.

2  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONSPerson centredhygiene care

Assisted hygiene
care challenges

When entering a care environment for a short or long term stay,reliance on others to assist with personal hygiene may have asignificant and potentially detrimental effect on the individual,
who should always be involved in decisions regarding how their
hygiene needs will be met.

Hygiene care tasks place a significant and increasing burden ontime pressured caregivers as the number of frail, elderly, heavy
or dependent residents and patients with complex health issues
continues to rise.1 Decisions regarding how people access hygiene
facilities are made each day depending on the level of assistancerequired by each resident or patient. These decisions can impact the
dignity and comfort of the care receiver, as well as both the physicalload and overall workload for caregivers. Here are just some of theconcerns that may influence these everyday decisions.

Caregivers need to assess if a patient or resident can bathe or
shower independently, if help is required and if so the type ofassistance needed including equipment that may be required tosupport the activity in safety and with dignity.
Depending on the facilities available and the care needs of theindividual, choices for providing hygiene care are centred on
showering, bathing in a tub, or bathing within or at the bedside.

Decisions are often influenced by the caregiver’s available time
and the perceived ease of carrying out the different hygiene
procedures. The quality of care received and the quality ofwork performed by the caregiver is reliant upon having the rightenvironment, using the right equipment and utilising the rightcare skills. This is represented by the Arjo Positive Eight.

The Positive Eight
Promoting resident/patient mobility is the driving force behind
the Positive Eight – our philosophy for generating long-term
benefits for patients, caregivers and care facilities. Investingin the right environment, suitable assistive equipment andadopting the best caregiver practices can provide the optimal
conditions to promote and enhance mobility. Promoting
mobility can reduce the need for support, reduce caregiver
injuries and improve efficiency. Ultimately this all leads toimproved care and financial outcomes.

Improved vitalfunctions
PATIENT/RESIDENT

Caregivers

Residents and Patients

Facility

Showering and bathing tasks expose
caregivers to a high risk of back andshoulder pain and injury. 2 Lack ofappropriate showering equipment
increases the risk for inefficiency
and physical strain experienced bystaff. Efficiency of providing hygiene
care is dependent upon the mobility
level of resident or patient, type ofequipment available and appropriate
training received. 3 Finally, there may
be a perception that taking a person
to the bath/shower takes longer and ismore physically demanding compared towashing the person within their own bed.

Showering or bathing can have a significant
impact on a person’s well-being, buthygiene events are often rushed with afocus on getting the patient or resident
clean as quickly as possible. Risk offalls on wet bathroom floors can beparticularly hazardous especially for
those with restricted mobility 4, oralready classed as at risk from falls.
Risk for cross infection of using sharedbathtubs without robust decontamination.
For preventive skincare, there is a need tokeep the skin clean. 5 Last but not least,
the concern to maintain one’s dignity
during the hygiene and bathing process.

The need for healthcare efficiencies andlack of storage space within facilities
often means that under-utilisedbathrooms are used as storage spaces
for equipment, impacting the working
space available to move lifters and otherequipment required for hygiene tasks.
Space within bathroom areas can besmall and not ergonomically designed
for people with increasing demands forassistance during hygiene care. Limited
space for transfer, a lack of appropriate
lifting and showering equipment, and alack of clear processes and protocols forassisted hygiene activities may increase
the risks of patient and caregiver injury.

4  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

Mobility

Reducedconsequencesof immobility

Quality of life
Environment, equipment
and care skills

Reduced needfor support

Improved care andfinancial outcomes

Reduced injuries
and improved
efficiency

Reduced sick leave,
turnover andcompensation claims

The right environment, equipment and care skills need to bein place to allow the benefits of the Positive Eight to flow

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   5  

By matching the righthygiene solution to theneeds of residents andpatients, Arjo hygiene
equipment can provide alevel of support designed
to maintain and, where
possible, encourage andpromote mobility.

Solution chart

Supporting carechoices
Having the right hygiene equipment
for residents and patients who are
self-reliant will support their continued
independence and help ensure well-being
is maintained.
Providing assistive devices and hygiene equipment for the
more dependent person will enable access to shower orbathing facilities as preferred, as well as reduce the exposure tounacceptable levels of physical overload and risk of injury to the
caregiver.

The Arjo Mobility GalleryTM
The Mobility Gallery, as a functional assessment tool, can beused to assist facilities and caregivers to identify the hygiene
requirements of residents and patients for whom they provide
care and support decisions related to showering, tub bathing orbathing at the bedside.

Mobilitylevel

Different mobility levels requirea range of hygiene solutions
Arjo hygiene solutions are designed to assist in reducing riskof injury to caregivers and patients, and make hygiene tasks
comfortable, efficient and dignified for the residents andpatients. Our showering and bathing solutions are developed
to meet both the needs of the individual, and their caregivers.
Having a comprehensive range of solutions allows the caregiverand the resident/patient to have a choice to best suit theirfunctional needs and preferences.

Showering

Reclining sit
bath solutions

Sit bath withintegrated chair

Foldable
seat

Reclining
sit bath

Sit bath withintegrated chairBathlift chair

Recumbent
bath

ALBERT

BARBAR A

CARL

Recumbentbath solutions

Foldableseat

High-lowhygiene chair

Reclining
sit bath

Sit bath withintegrated chairBathlift chair

Recumbent
bathHigh-lowhygiene chair

Multi-purpose
hygiene chair

Reclining
sit bath

Sit bath withintegrated chairBathlift chair

Recumbent
bath

Bath
lift trolley

Recumbent
bath

Bath
lift trolley

Recumbentbath

Assisting someone to maintainhis or her personal hygiene
needs can contribute to the

DORISMulti-purpose
hygiene chair

EM MA

Showertrolley

Reclining
sit bath

comfort, safety, well-being anddignity of the individual.6

6  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   7  

SHOWERING PRODUC TS

Reducing caregiverrisk during assisted
showering
Showering may be preferred for frequent personal
hygiene procedures, and is regularly used in hospitals
to prepare patients prior to surgical procedures.

ALBERT

BARBARACARLCARINODORISCARENDOEMMACAREVO

Appropriate showering equipment
promotes better posture and better care
Every day, caregivers assist residents and patients to take ashower. For the caregiver, the risk of physical overload fromworking in positions which involve bending, stooping andtwisting, often using fixed height hygiene chairs, also known as
shower chairs, means they can be subjected to high levels of
static (postural) overload, which subsequently increases theirrisk of musculoskeletal injury.
The correct use of suitable adjustable height showering
equipment can reduce the need for adopting awkward posturesand can assist toward reducing injury related absenteeism,

Using the Carendo resulted in theas well as improve working efficiency during the showering
procedure.7

caregiver adopting 77% neutral backThe suitable supportive equipment will also offer a more
pleasant, comfortable and dignified shower experience for theindividual. Knibbe et al undertook a laboratory study which
illustrated the percentage of time caregivers spent in healthy
working postures when showering patients using a variety ofassistive devices. 8 The highest percent of neutral back postures
were seen when caregivers used the Carendo hygiene chair.

Percentage of observations of caregivers with neutral back postures for 6 typesof equipment (N=79.968 observations, N=112 Procedures), Knibbe et al8
Equipment% of neutral
back postures (all)*% of neutral back(mobility class C)*

High-low hygiene chair with profiling seat

77.3

73.9

High-low hygiene chair

66.4

67.1

Ergonomic high-low shower trolley

59.5

61.8

Fixed height hygiene chair (normal)

66.0

57.4

Fixed height hygiene chair (high)

65.9

56.4

High-low profiling bed

48.6

53.6

*Differences (Kruskal-Walls Test) statistically significant P < ,05,

8  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

positions compared to only 48% when
washing a person within their bed.8

Reducing static load
A study has shown that using the Carevo, an ergonomic andadjustable height shower trolley, reduces the static physicaloverload experienced by caregivers compared to when they use
a standard shower trolley.9
The use of height adjustable devices when bathing or showering
patients enables caregivers to work at their correct ergonomic
height, reducing the static load on their musculoskeletal systemand subsequent risk of injury and long term damage.
The design of the Carevo shower trolley is to enable the caregiverto get closer to the resident/patient and hence further reduce
caregiver static load while showering patients. Results of theserecent studies illustrate the advantages of using this equipment
over washing a person within their bed and also on a standard
width and static height shower trolley.
CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   9  Time consumption in minutes

50
40

When using a Carendo

30

multipurpose hygiene

20

chair with a C patient

10

there is a potential of0
Barbara

Carl

Doris

saving 14 minutes forEmmaeach showering event,
Although there is a widespread belief that washing a
resident or patient in bed is faster, a height adjustableshower or hygiene chair can be 35% more efficient.
Source: Schimmel G, Knibbe NE, The Smart Shower Chair, Final
Report of the Zorg voor Beter (Better Care) Smart Shower Chairs
project, 2005.

Increase efficiency inassisted showering
Using known average timings for washingin bed and washing with an appropriate
shower device10, a study undertaken ina French long term care facility showedthat a total of 314 minutes or 5.2 hours
could be saved daily if carers usedappropriate height adjustable hygiene
equipment instead of washing C, D and E
patients within their bed. This equated to apotential annual saving of 20,000 euros.
Enabling efficient working
Washing, showering and cleaning patients is one of the mosttime-intensive care activities that caregivers can perform.
Research showed that carers in a nursing home devoted 22% of
their total working hours to washing, dressing wounds, showering,bathing and dressing. 10 With a shortage of caregivers andincreasing dependency levels of residents and patients, finding
more efficient ways of working has never been more important.

Total
Totalnumber
numberofoftransfers
transfers

Washing in Carendo
Washing in Carevo

1600
1600
1600

- 39%
-- 39%
39%

1400
1400
1400

1200
1200
1200

400
400
400

- 100%-- 100%
100%

350
350
350

1200
1200
1200

300
300
300
250
250
250

800
800
800

200
200
200

600
600
600

150
150
150

400
400
400

100
100
100

200
200
200

5050
50

1616
monthsmonths
later
later

- 83%
-- 83%
83%

1000
1000
1000
800
800
800
600
600
600
400
400
400
200
200
200
00
0

00
0

Baseline
Baseline

washing a C patient

NumberNumberofoftransfers
transfersperformed
performed
ininananunhealthy
unhealthyway
wayTransfers
Transfersperformed
performed
withwith22caregivers
caregivers

1000
1000
1000

when compared towithin their bed.10

450
450
450

1800
1800
1800

00
0

Washing in bed
Washing in Carino

Baseline
Baseline

1616
monthsmonthslater
later

Baseline
Baseline

1616
monthsmonthslater
laterTime saving
Although there is a common perception that washing a resident
or patient whilst they are within their bed is the fastest method, arecent study has shown that using a height adjustable hygiene or
shower chair, a profiling hygiene chair or a shower trolley with
’C’ mobility level residents and patients can be 20% – 35% more
efficient.10

Improved efficiency
The use of appropriate hygiene equipment often enables
caregivers to work more efficiently, reduce the number oftransfers and potentially work without the assistance of a second
caregiver. The one-to-one person focused interaction between
patient/resident and caregiver is perceived as important inrelation to aiding communication and reducing stress for residents
and patients, especially when caring for people with dementia.11

10  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

Increased efficiency was demonstrated
in an observation study
A study in Denmark11 identified 64% of transfers performed in along term care facility as potentially risky and unhealthy for thestaff, of which 74% were in the hygiene area. The study pointed to
one main gap related to time consumption and ergonomics, which
limited access to ergonomic hygiene equipment for showering.
This resulted in the organisation’s implementation of the Carendo
hygiene chair, and together with a detailed training programme
the follow-up after sixteen months showed an 83% reductionof transfers performed in an unhealthy way. The total numberof transfers had decreased by 39%, and the number of transfers
requiring two members of staff was eliminated. Members of staff
reported to be more satisfied since unnecessary or potentially
dangerous transfers had substantially decreased, due to amore efficient way of working. The investment in the Carendo
multipurpose hygiene chairs saved the equivalent time of one fulltime caregiver.

In a long term care facility 78% ofcaregivers agree that using Carendo
improves their ability to perform washingand hygiene of all areas of the body
including skin folds.11

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TYPICAL SHOWERING WORKFLOWWITHOUT A CARENDOTRANSFER

IN THE BED• Diaper & cloths removed• Sling Applied

TRANSFER

TRANSFERSIT TING IN A
COMMODE CHAIRRESIDENTBACK IN BED• Sling removed• Sling removed• Showering• Diaper & cloths on• Drying• Sling applied

IN THEWHEEL CHAIR• Sling removed• Sling applied

TYPICAL SHOWERING WORKFLOW
USING A CARENDOTRANSFER

The hygiene careenvironment

TRANSFERSIT TING IN
HYG IENE CHAIR

IN THE BED• Sling/clothes/
diaper removed

IN THEWHEEL CHAIR• Sling Applied• Showering & drying• Sling removed• Cloth/diaper/
sling onThe hygiene care environment within healthcare can vary
between an en-suite facility dedicated to use for one person,or a centrally located bath or shower room which is shared.
Ensuring that a shared bath or shower room is suitable for anumber of individuals is important. The more flexible in design,
the better the environment can be adapted for individual needs,
for both assisted and independent showering or bathing. The
possibility to make just small adaptations can be the difference
between independence and loss of functional ability.
The Arjo Guide for Architects and Planners (2019) 13 provides
further information related to both showering and bathing
environments and space requirements for different mobility
levels of residents and patients using a variety of assistive
hygiene devices.

To find out more please visit arjo.com.

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CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   13  

Table of evidence - showering
AuthorDesignKey Findings

Knibbe et. al.
Evaluating different methodsof showering and washingpatients; assessing ergonomic,
time and quality aspects,
Am J SPH, Vol. 6, No 2, 2016.

Laboratory study. The aim of the study was toprovide a quantitative insight into postural load
during hygiene tasks using video analysis andsurvey. 112 standardised hygiene procedures
performed by 4 nurses, using six different typesof equipment, and two washing techniques on
acting patients with varying levels of mobility.

Patient mobility, type of equipment, and washingtechnique were related significantly to hygiene careduration. The skill of the nurse, type of equipment, andmobility were linked to the postural load on the back,overall, lower satisfaction with procedures on thehigh-low bed. Recommendations for reducing durationand extent of static load are given but more researchis needed.

Hallström K. Wiese N.
Improving Quality of Care andWorkflow by Optimising theWorking Conditions. A Case
Study from a Danish Nursing
Home. Proceedings 19th
Triennial Congress of the IEA,
Melbourne 9-14 August 2015

Case study. The aim of this study was toestablish a more efficient and safer process for
managing resident transfers. The objectives
were to reduce the static load, and to reduce
both the number of transfers classified
as potentially risky or dangerous. Fourphysiotherapists assessed the resident transfers
for a period of twenty-four hours. Methods used
included mobility level classification, NIOSH
equation, and static load analysis.

The baseline assessment identified 64% of thetransfers as potentially risky and unhealthy for thestaff, of which 74% were in the hygiene area. The
observation identified limited access to ergonomic
hygiene equipment for showering. A new process
was implemented incl. the use of Carevo® together
with ceiling lifts and training. The follow-up after
sixteen months showed an 83% reduction of transfers
performed in an unhealthy way. The total number oftransfers was decreased by 39%, and the numberof transfers requiring two members of staff waseliminated.

Knibbe N.E. et. al.
How Smart is the Carevo®?
Results of a Study on a New
Shower Trolley Generation.
The Ergonomics Open Journal,
2013, 6, 1-5.

Laboratory study. The purpose of the study was
to compare the traditional height adjustableshower trolley with Carevo®, a shower trolleywith a new design. The study involved 4 nurses
carrying out 5 shower activities, with D and E
patients all postures observed were filmed andanalysed using OVAKO.

Differences seen when caregiver works with Carevo®,
compared with the traditional trolley: 10% improvementin time spent in a neutral safe back posture, 3%
improvement in time spent in a non-flexed, non-twistedback posture, 9% improvement in time spent in a neutral
safe neck posture. In addition caregivers spent more timestanding close to the patient’s hip level, which resulted in
13% reduction in static load.

14  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

AuthorDesignKey Findings

Freitag S. et. al.
Frequent Bending—
An Underestimated Burden
in Nursing Professions, Ann.
Occup. Hyg., pp. 1–11, 2011.

The aim of the study was to quantify the total
duration per shift in which nurses work in a forwardbending position over 20°. In addition theinfluence of several factors on the occurrence ofsagittal trunk inclinations in nurses was investigated. Trunk postures were recorded for nine
nurses from four nursing homes and 18 nurses fromseven hospitals using the CUELA measurement
system. A total of 79 shifts, 27 in nursing homes and
52 in hospitals, were analysed. All measurements
were supported by video recordings.

The total duration of inclinations per shift was significantly
affected by the working area. Nursing home nurses worked
about twice as long per shift in a forward bending position
compared with hospital nurses (112 versus 63 min) andthey assumed almost one-third more inclinations per
shift. Another factor was the extent of personal basic care,including hygiene tasks, performed by the nurses. It is very
likely that future preventive measures, focusing on reducing
the huge amount of inclination, would reduce the physicalstress in everyday nursing work substantially.

Brinkhoff A., Knibbe N,
The ErgoStat Program . Pilot
study of an ergonomic intervention to reduce static loads
for caregivers, www.asse.org
Professonal Safety,
Ergonomics, May 2003

Pilot study. An evaluation of an Ergonomic
intervention to reduce static loads for caregivers.
Measurement of postures before and after the
program using OWAS.

After the intervention, a significant increase was observedin the percentage of time that caregivers spent working in ahealthy position. The most notable improvement was seen
in performing direct care tasks – demonstrated in particularwith the improvement in the head position.

Schimmel G., Knibbe N.E.
The Smart Shower Chair Finalreport of the Zorg voor Beter[Better Care] Smart Shower
Chairs project, Opella andLocomotion 2003.

Pilot study. An evaluation of an Ergonomic
intervention to reduce static loads for caregivers.
Measurement of postures before and after
the program using OWAS.

The time savings as a result of using a smart shower chairor hygiene chair, Carendo® are 14 minutes (Mobility ClassC) and 6.5 minutes (Mobility Class D) per shower, and at
the same time the static load is lower when using Carendo®.
The threshold for working with Carendo® appears to be
fairly high, according to this project. Training, instruction andworking regularly with the smart shower chair is therefore
necessary in order to use the aid in an optimal manner.

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BATHINGG PRODUC TS

Reducing
caregiver risk
during assisted
bathing

ALBERT

FREEDOMBATH

BARBARACARLRHAPSODY/SY TEM 2000

MALIBUDORIS

PARKER

ALENTI *EMMARHAPSODY/SY TEM 2000
MIRANTI **Compatible hygiene lifts

Bathing promotes health benefits and can play an importantrole in nurturing wellness and improving quality of life. It has
been recognised as a pleasurable relaxing experience for
centuries. Bathing is a basis for hygiene, in addition it canpromote a sense of well-being. A warm bath can relax bothmuscles and mind.13

Bathing is becoming even more important for individuals
with impaired mobility and cognitive function. During thebathing process the resident/patient can be encouraged
to take part and wash as much of himself as possible. This
provides an opportunity to help maintain dignity and a level of
independence.

”But what are the bathing challenges for caregivers and residents?”
FOR RESIDENTS
GET TING IN AND OUT OF THE BATH IS A CHALLENGE- The resident may feel cold if left wet and exposed during transfers- The resident may be fearful of slipping- Getting in and out of the bath may trigger undesirable behavior- Dignity aspects related to undressing and dressing, this should happen
in the bathroom to ensure dignity

Risk of caregiver injury during bathing
procedures - appropriate bathing equipment
promotes better posture and better care
Lifting residents and patients into and out of a bathtub,
leaning over into the tub to reach the person to provide
hygiene assistance as well as managing patient falls within
the bathroom have long been accepted as potential causes ofphysical strain and cause of injury to caregivers. Choosing theright bathing equipment for the resident/patient as well as
giving consideration for the needs of the caregiver will assist theorganisation to pro-actively tackle the problem associated withsuch heavy handling and adoption of poor working postures.
The extent of the physical stress experienced by the caregiveris dependent upon a number of factors, the mobility level of theresident/patient, the skill of the caregiver, the environment inwhich the bathing is taking place and the equipment which isavailable to use.7,14

Enhance mobility
FOR CAREGIVERS
THE BARRIER IS TIME AND SPACE- There may be a risk of static overloaded for a caregiver- There may be a perception that bathing takes long time
- Assisted bathing involves a high number of assisted transfers- Often no space to dry and dress- The facility does not have the right equipment to support or transfer the resident/
patient to/from the bath or provide sufficient support whilst immersed in the water

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Maintaining and promoting mobility is a crucial part of goodquality care. Immersion in warm water may ease muscle
tension and increase blood circulation. 13,15, 16 Importantly,
being immersed in water makes the body feel lighter, it cantherefore reduce the load on joints, and movement may become
easier. Bathing may offer a natural and pleasurable way to help
patients and residents maintain their existing mobility as part ofa mobility maintenance program. In additional bathing in warm
water could be an important benefit for people with limited joint
mobility and trying to regain mobility during rehabilitation.17

Bathing a resident or patient using a highlow bathtub can reduce static overload
to the caregivers back by over 15% whencompared to using a fixed height bathtub.18

Equipment

Percentage of time caregiver
spent in healthy posture.
(Higher score is less harmful)

High-low chair

58,8%High-low bath

56,6%High-low shower trolley

53,0%

Fixed bath41,6%High-low bed

39,4%

Fixed shower trolley

38,6%

Fixed hygiene chair

31,4%Conclusion

With respect to postural load, the high-low bath and otherheight adjustable equipment place significantly less stresson the musculoskeletal system, especially when comparedto the fixed bath, fixed shower trolley, fixed hygiene chairand high-low bed.18

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3 STEP BATHING WORKFLOW
TRANSFER

TRANSFER

PREPARE BATH
EQUIPMENTENTER
BATHTUB• Transfer to bath lift
• Transport to bathroom• Undress• Bathe• Exit bathtub

PRE-BATHINGWASHING IN THE BATH TUB

DRY AND
DRESS• Dress• Transport from bath lift
• Transfer from bathroom• Clean and disinfectequipment

POST-BATHING

Increase efficiency inassisted bathing

Have a secluded place for getting to the toilet

Getting out of the bath

It is a good idea to empty their bladder and bowels before
bathing or showering. The toilet area could be integrated with,or be adjacent to, the bathroom.

Time savings and bathing

Plan for the whole bath session:

Plan a safe way to enter the bathtub

Even if the resident/patient did not need support to enter thebath, exiting could be difficult. After the bathtub the resident/
patient is warm, wet and maybe feeling very relaxed. Using alifter to reduce the risk for the resident/patient falling and to
avoid strain on the staff is to be recommended in most cases.

Although there is very little reliable research on the time taken
to assist a resident or patient to take a bath, ’time’ or ’perceived
lack of it’ is the most frequently heard reason for not assisting
residents to bathe in a tub. The whole bathing process can bedivided into 3 different ’steps’:

When planning the bathing area and the bathing process, it’s
important to keep the whole bathing session in mind.
The workflow needs to be planned; from undressing, to bathing,showering, toileting and re-dressing. In the planning of a central
bathing area and the bathing process several aspects need to betaken into consideration.

Entering the bathtub should be carried out in a way that is safefor both the resident/patient and the caregiver, reducing therisk of slipping and subsequent falling.

• Pre-bathing (preparation of the environment and patient)• Washing in the bathtub• Post-bathing (drying and dressing)
Knibbe et al (2016) showed in their study, that it is the caregiverthat often determines the time taken for washing, depending
upon the perception of the subjective feelings of the resident/
patient and went on to suggest that when bathing andshowering, caregivers will often make the most of the ’wellness
opportunity’ rather than just performing the assisted cleaning. 8
Having functions on the bathtub which provide caregivers withtime savings on the pre-bathing stage, such as pre-fill function
on the tub can only assist to provide more time for positive’well-being’ opportunities with their residents and patients forthem whilst they are in the tub itself.

Plan how resident/patient gets to the bathroom
It is a good idea to be able to get to the bathroom dressed,
ambulating or sitting in a wheel-chair/hygiene chair or bathchair. As this preserves the resident/patient dignity andensures that the person stays warm

Where to get undressed & dressed
The preferred solution is to be undressed and dressed either inthe bedroom or in the bathroom. Many residents and patientsneed some level of assistance; here an active lifter, a bath liftchair or trolley could be good options. Enough space, dignity
and risk for the undressed person getting cold are key aspects
to be kept in mind.

18  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONSCreate a safe working environment
During bathing the caregiver should be able to provide
assistance to the resident/patient using in a safe working
posture, the tub and patient seat should be at a comfortableheight while the resident/patient relaxes comfortably.

Offer a shower
The resident/patient may prefer a shower prior to, or after thebathing session. To support independent or assisted showering
as an alternative to bathing, there should be a separate
showering area; this area could also be used to clean theresident/patient in the event of the resident/patient needing toempty their bladder/bowels during the bathing session.

Drying and dressing
A heated area for assisted drying is good to plan for. It is
important that the resident/patient can relax and doesn’t get
cold after the bath. A warm towel is a welcome detail thatenhances the feeling of well-being and maintains the persons
dignity.

Relaxation
It is also important to plan for an area where the resident/
patient can sit and relax for a while. A bathing session can benice, but also exhausting, and a short time of recovery after thebath is often appreciated.

Cleaning
To avoid the risk of cross-infection, the bathtub and equipmentused during bathing or showering will need to be cleaned anddisinfected. A bath or shower panel with built-in cleaning
disinfection function is a welcome time-saving feature for the
caregivers.

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   19  

The action of the
bubbles bursting
against the skinremoves dirt particles
from the skin in agentle brushingaction.28, 29, 30

Bathingto enhancewell-being

Reduce pain and induce relaxation

Stimulate the senses

Hydromassage

Regular bathing can reduce pain when part of a pain
management programme15,19 and also increase relaxation. 20,21
Bathing with bathing oil can also be a gentle and effective way
to clean a resident with sensitive skin.

SnoezelenTM multi-sensory environments are often speciallydesigned to deliver stimuli to various senses of the person,
using lighting effects, colour, sounds, music, scents, etc., they
are by nature, relaxing spaces that help to reduce agitation
and anxiety, but they can also engage and delight the user,
stimulating reactions and encouraging communication.
The bathing session could give an excellent chance for sensory
stimulation, the temperature and tactile feeling from the water,
the smell of bath oils, colour, light and music could be used tostimulate the resident.

It is possible that HYDROMASSAGE can assist in pain
management, 26,27 in particular chronic pain, as well as
contribute to the reduction of lower limb stiffness. 28
Hydromassage works by creating millions of small bubbles
and has the effect of creating agitation in the bathwater.
This in turn provides a gentle massaging effect which isintended to support relaxation as well as give a pleasantsensory experience.

The use of light, sound and smell can be used to gently
stimulate the senses to create either a relaxing or stimulating
environment. Music during bathing may calm the resident
and lessen aggressive and agitated behaviours. 24 But we needto keep in mind all residents and patients are different andwhat works well for someone could cause anger or frustration
for someone else. This means the bathing session and bathenvironment need to have a person focused care approach.

The use of HYDROSOUND, a low frequency ultrasound, hasbeen shown to be able to cleanse the skin through the gentle
mechanical action of streaming microbubbles. Low frequency
ultrasound has also been shown to improve peripheral circulationand has been used in wound care to remove non-viable tissue.
The action of the bubbles bursting against the skin removes
dirt particles from the skin in a gentle brushing action. 30,31,32

Bathing in warm water in general has a naturally calming
effect. The warm bath water supports the body in a nearweightless state, helps relieve muscle tension and induces
relaxation. The relaxing nature of bathing in warm water has
been shown to achieve positive clinical results, potentiallydiminishing the need for painkillers and sedatives. 22
It may also be beneficial in reducing stress and anxiety andto improve sleep. 21,
Goto et al in their randomised controlled trial suggests thatroutine immersion bathing has positive effects on both mental andphysical health, such as lowered stress and anxiety levels as wellas increasing hyperthermis action which increases blood flow.12

SIGHT(COLOUR)HEARING

Wellness
TOUCH

SMELL

A study using the Parker® Spa bath within a palliative care environment
concluded that using a spa bath with such patients was a simple way fornursing staff to enhance the comfort of their patients within the normal
course of their duties and without the need for additional training.23

20  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONSUsing SOUND & VISION may engage the senses and potentiallyenhance the bathing experience for the resident/patient. It has
been shown that the use of music can contribute towards thelessening of aggressive and agitated behaviours in older people
with Dementia. 24, 25

Support skin care
The skin protects the body and bathing may help to protect theskin. However, what you put in the bathwater can complement
or counteract good skin management. Making good choices inbath liquids and choosing Hydrosound® as a washing method
are two factors that can contribute to optimum skin care.

HydrosoundAdding music-assisted bathing
into the activities of daily living
routine may assist in lesseningof aggressive and agitatedbehaviours exhibited prior toand during bathing.32

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   21  

Table of evidence - bathing
AuthorDesignKey Findings

Goto et. al.
Physical and Mental Effectsof Bathing: A Randomized
Intervention Study,
Evidence-Based Complementary and Alternative Medicine,Volume 2018,
Article ID 9521086

Randomised controlled trial. This study compared
the effects on health of immersion bathing,whole-body immersion bathing, and shower
bathing in 38 participants who received 2-weekintervention of immersion bathing in warm water (40 oC) for 10 min followed by 2-week shower
bathing without immersion or vice versa (n = 19each group).

Visual analogue scale scores were significantly betterfor fatigue, stress, pain, and smile and tended to bebetter for self-reported heath and skin condition after
bathing intervention than after showering intervention.
The Health Survey showed significantly better general
health, mental health, role emotional, and social
functioning scores. Scores were lower for stress, tension-anxiety, anger-hostility, and depression-dejection.

Karagulle M,
Real-life effectiveness of spa
therapy in rheumatic and musculoskeletal diseases:
a retrospective study of 819
patients Int J Biometeorol
2017:61

Retrospective observational study. The objective
was to determine the use and efficacy of spa
therapy in 819 patients with a wide spectrum ofrheumatic and musculoskeletal diseases underreal-life clinical practice circumstances. All adultpatients with rheumatic and musculoskeletal
diseases, who were prescribed a spa therapy invarious health resorts in Turkey between 2002
and 2012 were analysed. Patients followed ausual 2-week course of spa therapy. The patientswere examined before and after the spa therapy.

The patients included had the following diagnoses: 536
osteoarthritis; 115 fibromyalgia; 50 lumbar disc herniation; 34 cervical disc herniation; 23 nonspecific low backpain; 22 ankylosing spondylitis; 16 rheumatoid arthritis; 9rotator cuff tendinitis; and 14 other conditions/diseases.
The result showed statistically significant decrease in painscores in all patients except for in the subgroups hip osteoarthritis and rheumatoid arthritis. In addition the result
showed a statistically significant improvement in function
in all patients except for the patients suffering hip osteoarthritis, rheumatoid arthritis and rotator cuff tendinitis.
The study results suggest that real-life spa therapy may
be effective in a variety of rheumatic and musculoskeletal
diseases by improving function and reducing pain.

Goris D. E. et. al,
Quantitative systematic
review of the effects of
non-pharmacological interventions on reducing apathy
in persons with dementia,
Journal of Advanced Nursing,Nov 2016; 72 (11)Quantitative systematic review. The aim of thestudy was to review the quantitative evidence
concerning the effects of non-pharmacologicalinterventions on reducing apathy in persons withdementia. The CINAHL, PubMed, PSYCH info
and Cochrane Trials databases were searched
for research published in English, inclusive
through December 2014, with no early year
limiters set.

In the search, 16 international randomised controlled
trials or quasi-experimental studies were identified. The
review suggested that selected non-pharmacologicalinterventions are effective in reducing apathy among
persons with Alzheimer Dementia Specifically. Music
therapy, tailored personal contact, cognitive stimulation
therapy, multi-sensory behavior therapy (including
Snoezelen), group art therapy and therapeutic conversation all show some effect in reducing apathy without
producing negative side effects. Overall, these interventions are heterogeneous in many ways, including their
method of engaging a person with dementia, the apparent
target of their therapeutic effect (behavioral, emotionalor cognitive domains of apathy) and the extent to whichinterventions were tailored to a specific individual.

Matzer et. al.
Stress-Relieving Effects ofShort-Term Balneotherapy – a
Randomized Controlled Pilot
Study in Healthy Adults,
Forschende Komplementarmedizin 2014;21:105–110

Randomised study. The aim of the study was toevaluate the stress-relieving effects of balneotherapy compared to Progressive Muscle
Relaxation (PMR) 49 healthy volunteers wererandomized to balneotherapy, PMR, or a resting
control group, each intervention lasting for 25
min; subjective relaxation and salivary cortisol
were measured. It was also examined whether
participants with a high versus low stress level
would have a different response.

In a pre-post comparison, salivary cortisol decreased andsubjective relaxation ratings increased in all 3 groups. Study participants in the balneotherapy group rated themselves as more relaxed after the intervention as comparedto the other two groups. Participants with a high versus
low stress showed a similar relaxation response. Findings
suggest that compared to PMR and resting, balneotherapy seems to be more beneficial with regard to subjective
relaxation effects and similarly beneficial with regard to adecrease in salivary cortisol.

22  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

AuthorDesignFalagas M. E.
The therapeutic effect ofbalneotherapy: evaluation of
the evidence from randomised
controlled trials, Int J Clin
Pract. 2009 Jul;63(7)Literature Review. Systematic review with the aim
to evaluate balneotherapy. PubMed, Scopus andCochrane library were searched for randomised
controlled trials, examining the clinical effect ofbalneotherapy (both as a solitary approach andin the context of spa) on various diseases.

29 RCTs were evaluated; 22 investigated the use of
balneotherapy in rheumatological diseases: eightosteoarthritis, six fibromyalgia, four ankylosing spondylitis, four Rheumatoid Arthritis (RA) and three RCTs
in other Musculoskeletal System diseases (MSD) andchronic low back pain. 1720 patients were evaluated inthese studies. Balneotherapy did result in reduced painin patients with rheumatological diseases and chronic
low back pain, in comparison to the control group in
17 of the 25 RCTs examined. This beneficial effect wasmeasured differently and lasted for different periodsof time; from ten days to one year. The available datasuggest that balneotherapy may be truly associatedwith improvement in several rheumatologicaldiseases.

Matz H. et. al.
Balneotherapy in dermatology,
Dermatologic Therapy,
Vol. 16, 2003

Evidence overview. An article describing theevidence behind balneotherapy, which involves
immersion of the patient in mineral water bathsor pools. The major importance of balneotherapy and spa therapy both individually and ascomplements to other therapies lies in theirpotential after standard medical treatments
have failed to give comfort to these patients.

Bathing in water with a high salt concentration is safe,
effective, and pleasant for healing and recovery. Thisapproach needs no chemicals or potentially harmful
drugs. There are almost no side effects during and after
treatment, and there is a very low risk to the patient’s
general health and well-being.

Laboratory Study. The purpose of this study wasto evaluate quantitatively the degree to whichmicroorganisms could be inactivated throughthe administration of ultrasonic energy into
water, 39 +/- 0.3°C. Aqueous suspensions ofspecific bacteria, fungus, and viruses were
exposed to an ultrasonic frequency of 26 kHz.
The pathogens were selected based on theirnormal routes of infection (e.g., skin or intestinal
tract) or their structural similarities to suchagents, likely to be found as contaminants ofwhirlpools and hot tubs.

There was a significant effect on all four bacteria, withpercent killed increasing with increased duration of
exposure. There was a significant reduction in fungal
growth compared with that in the controls, withdecreased growth with increased ultrasound intensity.
Therewas a significant reduction for feline herpesvirus with intensity, but there was no apparent effect ofultrasound on feline calicivirus. These results suggest thatultrasound in the low-kilohertz frequency range is capable
to some degree of inactivating certain disease agents that
may reside in water. The physical mechanism of inactivation
appears to be transient cavitation.

Scherba G. et. al.
Quantitative Assessment of
the Germicidal Efficacy of
Ultrasonic Energy Applied andEnvironmental Microbiology,
July 1991

Key Findings

The major dermatologic diseases that are frequently
treated by balneotherapy with a high rate of success are
psoriasis and atopic dermatitis. The mechanisms behind
spa therapy have not been fully elucidated. They probably
incorporate chemical, thermal, mechanical, and immunomodulatory effects.

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   23  Bathing at
the bedside
A bed bath is not the most effective way of washing patients,
however it may sometimes be the chosen solution. For somepatients who are unable to transfer out of the bed it may be
the only way to meet the hygiene needs of, for example, theunconscious patient/resident or perhaps for a patient receiving
end of life care.

Bed bath versus showering and bathing
Bed bathing can help to maintain the hygiene needs of residents
and patients who are bedridden as a result of acute illness orchronic debilitation. However, in many cases within a generalcare facility, the decision to provide the patient or resident
with a bed bath may be taken as a result of the caregiver
perception that taking a person to the bathroom takes toolong. 8,34 It can also be the chosen because the facility does notoffer the right environment or equipment to allow showeringor bathing to take place. Undertaking patient hygiene in bed
is a strong contributor to excessive static overload on the
caregiver leading to pain and injury. 33,34 Additional studies

have shown that the time a caregiver spends in an unhealthy
posture is higher in the activity of bathing at the bedside whencompared to showering in a height adjustable hygiene chair orshower trolley. Knibbe et al (2016). If the decision to bathe aresident/patient within the bed is taken then consideration of
the use of ‘washing without water’ options, that is the use of
pre-heated wipes impregnated with a special cleansing andcaring lotion have been shown to both improve quality of careby increasing patient satisfaction as well as increasing
efficiency of work for the caregiver when compared to the
traditional process of using soap, water and towels. 34

A final thought....
In this clinical evidence brochure we have indicated manyof the challenges facing caregivers, patients and residents
in providing and receiving hygiene care. Concerns such as
caregiver workplace strain and injuries, time inefficiencies,
equipment and environment provision as well as the concern
for patient comfort, choice and general well-being all
influencing the hygiene care process. We realise that you
have a choice when it comes to your provider of hygiene
solutions, and also recognise that using the right equipment
represents only one important part of effective hygienecare. With adequate equipment and changes to the hygiene
environment, safer, calmer and more ergonomic hygiene
procedures for both the resident, patient and caregiver are
indeed possible.
With Arjo’s many years of knowledge and experience withhygiene solutions we can also support your facility with arange of education, assessment and service solutions. We
can help you to get the right product, to the right patient, at
the right time. We welcome your questions and invite you
to contact us through your local Arjo representative, or visit
our website at www.arjo.com.

Using wash gloves led to a reduction in the number of repositioning activities as opposed tothe traditional bed bathing method with water, soap, washcloths, and towels. The reductionof postural load for caregivers was also significant as less time was spent in ergonomicallyunsound postures. An increase in efficiency was found as a full body wash took an average
7.2 minutes less time than the traditional method.34

24  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   25  

References

1

United Kingdom Office for National Statistics,
3rd November 2015, reference number 004835.

2

Freitag S, Ellegast R, Dulon M et al (2007).
Quantitative measurement of stressful trunk postures innursing professions. Annals of Occupational Hygiene,
51(4): 395-395.

3

CEN//ISO TR 12296 – 2013 Ergonomics - Manual Handlingof People in the Healthcare Sector.

4 CDC (2011). Non-fatal bathroom injuries among persons
aged > 15 years – United States, 2008. Morbidity
and Mortality weekly report, 60(22): 729-730.
5

Prevention and Treatment of Pressure Ulcers:
Clinical Practice Guidelines, NPUAP, EPUAP, PPPIA 2014.

6 Downey L, Lloyd H (2008) Bed bathing patient in hospital.
Nursing Standard 22 (34) Pages 35-40
7

Brinkhoff A., Knibbe N, (2003) The ErgoStat Program.
Pilot study of an ergonomic intervention to reduce
static loads for caregivers, www.asse.org
Professonal Safety, Ergonomics, 32-39.

12 Goto Y, Hayasaka S, Kurihar S et al. Physical and Mental
Effects of Bathing: A Randomized Intervention Study.
Evid Based Complement Alternat Med.
2018 (published online).

21 Silva A, Queiroz SS, Andersen ML, et al (2013).
Passive body heating improves sleep patterns in female
patients with fibromyalgia. Clinics (Sao Paulo)
68(2): 135-139.

13 The Arjo Guide for Architects and Planners (2019), via the
Arjo website, www.arjo.com.

22 Al-Qubaeissy K, Fatoye F, Goodwin P et al (2013).
The effectiveness of hydrotherapy in the managementof rheumatoid arthritis: A systematic review.
Musculoskeletal Care, 11(1): 3-18.

14 Freitag, S., Seddouki, R., Dulon, M., Keresten, J., Larsson,
TJ., Nienhaus, A. The effect of working position on trunk
posture and exertion for routine nursing tasks:
an experimental study. Ann Occup Hyg. 2014;59(3):317-325
15 Branco M, Rêgo NN, Silva PH et al. Bath thermal waters in
the treatment of knee osteoarthritis: a randomized controlled
clinical trial. Eur J Phys Rehabil Med. 2016;52(4):422-30.
16 Kohara K, Tabara Y, Ochi M et al. Habitual hot water bathing
protects cardiovascular function in middle-aged to elderly
Japanese subjects. Sci Rep. 2018; 8: 8687.
17 Sakurai R1, Yasunaga M, Saito K et al. Effects of acomprehensive intervention program, including hot bathing,on physical function in community-dwelling healthy older
adults: a pilot randomized controlled trial. Aging Clin Exp
Res. 2013; 25(4): 453-61

8 Knibbe JJ, Knibbe NE, Heitink DEBL (2016)
Evaluating different methods of showering and washingpatients: assessing ergonomic, time, and quality aspects.
American Journal of Safe Patient Handling. Vol 6,
Number 2, 49-64

18 Knibbe NE, Knibbe JJ (1996). Postural Load of nurses duringbathing and showering of patients: Results of a laboratory
Study. American Society of Safety Engineers. November. 37-39

9 Knibbe NE, Knibbe JJ, Waijer E (2013) How smart is the
Carevo? Results of a study on a new shower trolley
generation. The Ergonomics Open Journal, 6, 1-5.

19 Fujimoto S, Iwawaki Y, Takishita Y et al. Effects and safetyof mechanical bathing as a complementary therapy for
terminal stage cancer patients from the physiological andpsychological perspective: a pilot study. Jpn J Clin Oncol.
2017 Nov 1;47(11):1066-1072)

10 Schimmel G, Knibbe NE, (2008) The Smart Shower Chair.
Final Report of the Better Care Smart Shower Chairs Project.
11 Hallström K. Wiese N. (2015) Improving Quality of Care andWorkflow by Optimising the Working Conditions.
A Case Study from a Danish Nursing Home.
Proceedings 19th Triennial Congress of the IEA,
Melbourne 9-14 August 2015)

20 Matzer F, Nagele E, Bahadori B et al (2014). Stress-relieving
effects of short-term balneotherapy - a randomized
controlled pilot study in healthy adults.
Forsch Komplementmed 21(2): 105-10.)

26  CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS

23 Staczkowski JM, Langridge J, Oataway J, Wilson C ((2018).
Effect of a spa bath on patient symptoms in an acutepalliative care setting: a pilot study. Complimentary
Therapies in Clinical Practice. Accepted Manuscript
24 Sung HC, Chang AM. Use of preferred music to decreaseagitated behaviours in older people with dementia: a reviewof the literature. J Clin Nurs. 2005 Oct;14(9):1133-40.
25 Sound (music): Ray KD, Fitzsimmons S.Music-assisted
bathing: making shower time easier for people withdementia J Gerontol Nurs. 2014 Feb;40(2):9-13.
26 Fazaa A, Souabni L, Ben Abdelghani K et al (2014).
Comparison of the clinical effectiveness of thermal cureand rehabilitation in knee osteoarthritis. A randomized
therapeutic trial. Annals of Physical and Medical
Rehabilitation Medicine, 57(9-10): 561-9

29 Wollina U, Heinig B, Naumann G et al. Effects of
low-frequency ultrasound on microcirculation in venous
leg ulcers. Indian J Dermatol. 2011; 56(2): 174–179
30 Nichter LS, McDonald S, Gabriel K et al. Efficacy ofdebridement and primary closure of contaminated wounds:
a comparison of methods. Ann Plast Surg. 1989; 23: 224-230
31 Nichter LS, Williams J. Ultrasonic wound debridement.
Journal Hand Surgery. 1988; 13A: 142-146
32 Ray KD, Fitzsimmons S, Music assisted bathing, making
shower time easier for people with dementia. Journal ofGerontology Nurse (2014) Feb 40 (2) 9-13
33 Myny, D., De Bacquer, D., Van Hecke, A.,
Beeckman, D., Verhaeghe, S., Van goubergen D.
Validation of standard times and influlencing factors during
the development of the Workload Indicator for Nursing.
J Adv Nurs. 2014;70 (3):674-686
34 Knibbe, JJ., Matz, M., & Heitink, D. (2017). Effects of Using
Bathing Gloves on Healthcare Recipients and Caregivers.
Int J of SPHM. 7(1):9-19.

27 Tefner I, Kovacs C, Gaal R et al (2015).
The effect of balneotherapy on chronic shoulder pain.
A randomised controlled single blind follow up trial.
A pilot study. Clinical Rheumatology, 34(6): 1097-8
28 Lim KO, Lee DY, Shin WS. The effects of a warm whirlpool
bath on pain and stiffness of patients with chronic stroke
induced knee osteoarthritis.
J Phys Ther Sci. 2013 Jul;25(7):873-5.

CLIN ICAL E VIDENCE SU M MARY: ASSISTED HYG IEN E AN D WELLN ESS SOLUTIONS   27  

Only Arjo designed parts, which are designed specifically for the purpose, should be used on the equipment and products supplied by Arjo.
As our policy is one of continuous development we reserve the right to modify designs and specifications without prior notice. © Arjo, March 2019.
At Arjo, we are committed to improving the everyday lives of people affected by reduced mobility and age-related health challenges. With products and solutions that
ensure ergonomic patient handling, personal hygiene, disinfection, diagnostics, and the effective prevention of pressure ulcers and venous thromboembolism, we
help professionals across care environments to continually raise the standard of safe and dignified care. Everything we do, we do with people in mind.
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