Five Million People Need a Grab Bar and Don’t Have One

The study is by Lam, Shi, Boscardin, and Covinsky, using the National Health and Aging Trends Study across its 2015 to 2019 waves (JAMA Internal Medicine, 2021). It covered 2,614 participants with a mean age of 80.5, weighted to national estimates.

What counted as needing equipment?

The researchers did not ask people whether they felt they wanted a grab bar. They identified participants who would unequivocally benefit from specific equipment — grab bars, a shower seat, a raised toilet seat — based on reported difficulty with bathing or toileting tasks. Then they checked whether that equipment was present.

An unmet need, in this study, means the person met the criteria and the equipment was not there.

Who has the gap?

This is the part of the study worth sitting with, because the pattern runs backwards from what you would expect. Unmet need was highest among the youngest and healthiest of the group:

• By age: 49 percent at 65 to 74, 37 percent at 75 to 84, 29 percent at 85 and over
• By health conditions: 55 percent among those with none, 39 percent among those with three or more
• By hospital history: 46 percent among those with no recent hospitalisation, 37 percent among those with one
• By prior injury: 46 percent among those with no prior hip or knee fracture or surgery, 35 percent among those with one

Every one of those pairs points the same direction. The equipment is most likely to be present in the homes of people who have already had the event that made somebody install it.

Does it arrive eventually?

Often not. The researchers followed participants for four years. At the end of that period, 35 percent of those who needed bathing equipment and 52 percent of those who needed toileting equipment still had none.

So for roughly half the people in the toileting group, four years of identified need produced nothing at all.

How common were grab bars to begin with?

The only broad prevalence figure available is old, and we are going to date it clearly rather than pass it off as current. A 2004 Home Safety Council survey, cited by the CDC in its 2011 bathroom injury report (MMWR, June 2011), found that 63 percent of US homes used bathtub mats or nonskid strips, and 19 percent had grab bars.

That is a twenty-two-year-old figure from a survey whose original publication is no longer online. We include it because it is the only traceable number of its kind, and because the ratio it describes — three times as many households reaching for a five-dollar mat as for anything fixed to the wall — is consistent with everything in the 2021 study.

What does the CDC say about waiting?

Two statements from the CDC’s Facts About Falls page are relevant to the pattern above. The first: “Falling once doubles your chances of falling again.” The second: “When a person is less active, they become weaker and this increases their chances of falling.”

We are quoting those as published statements from the CDC, not extending them into a claim about anybody in particular.

What is on a RenewItHQ shower?

Three knurled grab bars, on every shower we build. They are not an upsell, not a line item, and not something that has to be remembered and asked for. The bars are 1.5 inch outer tubing with a 400 pound load rating; section 609.8 of the 2010 ADA Standards asks a public building for a bar that resists 250 pounds of force, and the 1.5 inch diameter sits inside the permitted 1-1/4 to 2 inch range.

Blocking goes in behind the wall while the wall is open, whether a bar is going in that position on day one or not. That timing is not a preference. Section 609.8 applies its 250 pound requirement to “the bar, fastener, mounting device, or supporting structure,” which makes the wall the limiting component, and there is no way to introduce proper backing into a finished wall without opening it again.

A seat is available, and where it goes gets decided in the room with the person who will use it rather than off a page in a catalogue.

The one thing this changes that we can actually claim

Not a health outcome. A timeline.

The study above describes a population waiting for an event that installs the equipment for them. The reason our work takes three to five days from the date of sale and one day on site is that we carry the panels, the bases, the doors, the bars and the fixtures in stock. That is an inventory fact, and its only relevance here is that it removes the four-to-ten-week wait that turns “we should probably do something about the bathroom” into a decision that gets postponed again.

We will not tell you a grab bar prevents falls. No study supports that, and the best evidence available — a 2023 Cochrane review by Clemson and colleagues (Cochrane Database of Systematic Reviews) — examined professionally delivered home assessments rather than any single product, and found no effect at all in people not already at higher risk. What a grab bar does is hold when it is grabbed, and ours is rated to 400 pounds into blocking we set ourselves.

Where the numbers come from

Unmet equipment need: Lam K, Shi Y, Boscardin J, Covinsky KE, Unmet Need for Equipment to Help With Bathing and Toileting Among Older US Adults, JAMA Internal Medicine, 2021. Historical grab bar prevalence: 2004 Home Safety Council survey as cited in MMWR, June 10, 2011. Grab bar requirements: 2010 ADA Standards, section 609. Falls statements: CDC, Facts About Falls.