Shower chairs, grab bars, and nonslip mats may not be the sexiest items on your sales floor, but they are crucial from both a business and a customer perspective. As they are rarely reimbursable, most bathroom safety items represent a welcome source of cash sales.

And for aging or disabled customers, a grab bar positioned near the tub or a raised toilet seat can prevent dangerous and costly falls.

However, the rewards of providing bathroom safety products can often be obscured by the challenges that accompany this niche. Customers may be reluctant to purchase these products because they must pay out of pocket and because the items themselves represent a loss of independence.

“I think it is more about the dignity involved than it is a financial thing,” says Howard Coggeshall, customer service representative for AABCO Equipment and Supplies of Dallas. “It is disquieting for some to have a contraption in the bathroom.”

As disquieting as they may be, basic safety devices in the bathroom become a necessity for many who want to continue living safely at home. The burden therefore lies with providers to educate their clientele about the importance of investing in a few supplies.

Gerontologist Kimberly Carlson, owner and founder of the Assisted Living Store Inc, Cottage Grove, Minn, knows the importance of client education—especially in rural areas where customers may have trouble getting these products.

While working with the University of Minnesota Extension Service and the Minnesota State University-Mankato to provide educational programs for professionals in the field of aging, she realized that rural people often lacked the resources to assist them with their adaptive needs. “It was very difficult in small communities to find products such as sock aids, button aids, and lifts that can be installed beneath the toilet,” she says. “It was even harder to find these products at a reasonable price.”

Three years ago, when Carlson and her husband, Tom, started the Assisted Living Store, they made sure to include resources for these items. “Most often, customers have questions about what product would be best to purchase for their particular circumstances,” she says. “I always explain that the bathroom is one of the most dangerous rooms in the home, as it is designed for the young adult only. It is not made for infants, children, or older adults. The lighting is bad, the toilet seat is too long, the bathtub wall is too high, and there are an abundance of slippery surfaces. The bathroom is one of the first places where modifications should be made.”

Coaxing the Reluctant Customer
Barbara Hatton, who owns Allcares Inc Home Health Supplies, Bloomington, Ind, likewise finds that her staff ends up doing a lot of education on the sales floor about what products customers can purchase and what the items can help prevent.

“A lot of falls happen in bathrooms,” she says, and the statistics back her up. According to the Centers for Disease Control, one of every three Americans over the age of 65 has a fall each year, and many of these happen at home.

“Bathroom safety items keep people in their homes longer,” Hatton says. “But at the same time, the items represent giving up some of their dignity. Sometimes we have to talk that through as a group on the sales floor, and our customers have to be coaxed into buying products that will help them.”

From an education standpoint, Carlson says HME providers should have good information on universal design and how best to modify the home without making it too institutional.

“It is also important to understand the biology of aging and what changes take place as the body ages, and how those changes affect daily living,” Carlson says.

Within the realm of bathroom safety products, most needs are already taken care of from a design standpoint. The most common issues are whether individuals can safely get onto and off of the toilet, and whether they can get into and out of the bathtub or shower safely. If they have difficulties in these areas, there are a range of products from the simple to the complex that can address such needs.

“For instance, we sell grab bars, long-handled shower hoses, transfer benches, bariatric shower seats, toilet safety rails, shower chair commodes, and raised toilet seats,” Carlson says. “The most popular items are the shower seats and transfer benches.”

While explaining that a shower stool will make a big difference in customers’ safety and happiness in their homes is one aspect of education, steering customers away from items that may be misused for safety purposes is another aspect.

“When an older or unstable customer comes in, although I know that I could get more money selling them something with a back on it, I know they may rely on that back as a grab bar. That becomes a safety issue, too,” Hatton says.

Education may also be limited to the items sold by each provider. AABCO does not really get involved in the grab bar business, preferring to refer clients to a reputable seller and installer in Dallas. The company does, however, sell clamp-on bars for tubs, raised toilet seats, shower or tub benches with or without backs, and transfer benches.

“Our business is also unique because we don’t take [Medicare] assignment,” Coggeshall says. “That was a hard decision when we first made it, but we are still here. And for us, bathroom products are wonderful because they are cash and carry.”

For that reason, too, AABCO has not had as much success selling some of the newer or higher-end bathroom products. “Those items tend to cost too much money,” Coggeshall says. “The raised seat that clamps onto the toilet and comes with or without arms does the job for most of our customers. Our customers tend to like items that they can open and use without much installation.”

Offer a Range of Options
Hatton agrees that some upper-end bathroom safety items are simply not within customers’ budgets. In a largely cash business, it is important to understand that customers may need access to less expensive options. “One example is the sliding transfer bench,” she says. “Although most people can certainly use those for enhanced safety in the bathroom, they can’t all afford the fancier versions. I always tell my customers that having one in the home is better than none, so they often take what they can afford.”

Bathroom safety products are crucial for Hatton’s business because the products represent cash sales. “It helps not having to bill for some things,” she continues. “In order to assist people in acquiring such necessary items, therefore, we try to keep reasonably priced items on hand.”

Carlson notes that, even in a home-based HME business, one of the biggest challenges is keeping up with new product developments and weighing options in terms of expense for the customer. “It is also difficult to provide excellent customer service at all times, and we work very hard to provide the best and always take care of the customer first,” she says.

And while it may be difficult for customers to discuss their needs in this realm, interest in bathroom safety products is on the rise as the HME customer base ages.

“We have definitely seen an increase in our customer base,” Hatton says. “In fact, Allcares subsequently expanded the bathroom safety product lines it has carried in the last 5 years because of that interest. I find a lot of families coming in and buying equipment for their aged parents.”

Perhaps greater interest and demand will also bring increased pressure on Medicare to cover bathroom safety items. While that would take away the cash business angle, providers like Coggeshall, Carlson, and Hatton are nonetheless supportive of such a change. “I think these items really should be reimbursed more,” Coggeshall says. “Medicare is quick to pay $5,000 for a power chair when they would do more good with a $59 bath bench. I am sure that in some cases Medicare ends up paying for a replacement hip that could have been averted if the patient had a bath bench.”

Until that time, however, providers take pride in the fact that they are educating their consumers to make choices that make sense in terms of their pocketbook and their quality of life.

“The greatest reward is when I receive a phone call or email from a customer or caregiver stating that a certain product has made a big difference in the life of the person using it,” Carlson says. “When the customer thanks us for being out there to help them, that is the greatest reward for me.”

Liz Finch is a contributing writer for Dealer/Provider.