Although bathing gets more difficult with age and declining health, the elderly can largely compensate for their loss of function with grab bars and other bathroom devices, according to a new Cornell University study.

They also can make bathing easier with a good diet and, surprisingly, a few alcoholic drinks a day.

The benefits of using assistive devices, such as grab bars, are so great, says Nandinee Kutty (pronounced Nun-deen'-ee Kute'[rhymes with flute]-ty), assistant professor of policy analysis and management, that if Medicare and other health insurance programs were to cover them, the resulting benefits would likely far outweigh the costs by preventing falls and injuries and reducing the need for long-term care.

As elderly persons move into their 90s from their 80s, they lose a good deal of function, says Kutty. "However, with assistive devices, they gain twice as much function as what they're likely to lose in their 90s."

Likewise, having a severe stroke is a very disabling condition. "People in their 80s who use grab bars, shower stools and other devices, however, gain even more in bathing function than what they would lose if they had a severe stroke," she says.

"Although we can't do much about getting older or reversing chronic health problems, these factors are some of the very few things the elderly can do to dramatically reverse loss of function in old age," says Kutty.

Analyzing data from the "Survey of Asset and Health Dynamics Among the Oldest-Old," a nationally representative data set acquired in 1993-94 of 7,500 people age 70 or older, 2,500 of whom were age 80 or older, Kutty found that assistive devices as well as alcohol and diet stood out as being statistically significant in helping the "oldest-old" continue to function well while bathing.

"Moderate drinking, in fact, has a very strong positive influence on bathing functionality," says Kutty, who points out that this finding is consistent with studies that have found the beneficial impact of moderate drinking on cardiovascular function and longevity. "I'm not suggesting that anyone drink just before they bathe, but that moderate alcohol consumption seems to improve overall health and functioning among the elderly."

The National Center for Health Statistics reports that almost 40 percent of the elderly who do not live in institutions have some limitation of activity caused by chronic conditions. "The most common activity that the elderly have difficulty performing is walking. The second and third most difficult common activities are bathing and getting outside," Kutty points out.

As a housing economist with a particular expertise in economic issues related to the elderly, Kutty is interested in how home modifications can help the elderly. In a study earlier this year, which will be published in an upcoming issue of Applied Economics, she reported that despite the high cost of assistive devices, 40 percent of Americans over age 70, regardless of income, have modified their homes with grab bars, bathroom railings, wheelchair ramps and other aids. She found that the most common types of home modification are bathroom related, such as grab bars or shower seats. Bathroom modifications have been installed by more than one-fourth of Americans over 70.

In this study, recently published as a Bronfenbrenner Life Course Center Working Paper at Cornell, Kutty set out to determine how useful these bathroom modifications really are. Her conclusion: Extremely useful, especially when complemented with good nutrition and moderate drinking (4 or fewer drinks a day for men and 2 or less a day for women; a drink refers to 12 ounces of beer, 5 ounces of table wine or 1 ounce of 100 proof liquor, each containing about half an ounce of alcohol).

"Implementing these factors can enhance the life quality of the elderly and make it easier for them to live in their communities and not need nursing home care. Health care providers should incorporate this knowledge when offering health advice to the elderly," she concludes.

Kutty recommends that policy-makers should recognize home modifications as important means of improving the health and functionality of the elderly. Medicare currently does not cover home modifications, although in some states Medicaid does. Kutty recommends the expansion of Medicare coverage to include specific home modifications that help the elderly cope with disabilities.

The study was funded, in part, by the Bronfenbrenner Life Course Center at Cornell.