Safer home care requires more than better equipment
Only 3% compliance with guidelines for seated showering
What happens when the equipment needed for safe care cannot be used in a client's bathroom?
A new study by TNO, commissioned by the Netherlands Labour Authority and conducted in collaboration with LOCOmotion, highlights this challenge. The research examined compliance with physical workload guidelines in Dutch home care. It analysed assessments from 10 home care organisations, representing 2,628 clients, alongside stakeholder interviews and a literature review.
One finding stands out: of the 931 clients assessed as requiring seated showering, only 25 (approximately 3%) were receiving care in accordance with the physical workload guidelines, using a height-adjustable shower chair. The results reveal a substantial gap between established guidelines and daily practice, with implications for the physical workload of caregivers.
Why is safe showering at home so challenging?
The TNO study identifies several barriers: limited bathroom space, difficulties accessing suitable equipment, and complex application and reimbursement procedures. It also highlights that caregivers' physical workload is not always sufficiently considered when decisions about assistive devices are made. The consequences are significant. When appropriate equipment cannot be used, caregivers may have to work in physically demanding positions, increasing the risk of physical overload.
Interestingly, compliance differs considerably between care activities. Approximately 87% of assessed situations involving compression stockings met the relevant guidelines, compared with just 3% for seated showering.
The contrast highlights an important lesson: clear guidelines, accessible equipment and established working practices can support compliance, but some care activities face barriers that require broader solutions. TNO therefore recommends developing a national decision-making pathway for showering and washing, exploring alternative methods when suitable equipment cannot be used, and investigating more compact and flexible assistive devices.
Lopital's perspective: making ergonomic care possible in practice
For almost 50 years, Lopital has focused on solutions that support healthcare professionals during physically demanding care activities, while contributing to the comfort and dignity of clients.
The research is particularly relevant to Lopital's expertise in hygiene and transfer equipment, including height-adjustable shower-toilet chairs such as the Flexo, Elexo and Reflex. These products are designed to support ergonomic working positions during daily care. But the TNO findings raise an important question: what happens when an ergonomically designed device cannot be used effectively in the space available?
A height-adjustable shower chair must not only provide a suitable working height. It must also fit the bathroom, allow caregivers sufficient working space and meet the individual needs of the client. For Lopital, the research reinforces an important principle: ergonomic equipment must support both caregivers and clients while remaining practical in the environment where care takes place.
That broader perspective is reflected in Lopital's approach to reducing physical workload. Alongside its hygiene and transfer solutions, the company provides advice and supports healthcare organisations through initiatives such as Samen Vitaal, which focuses on physical workload and working conditions.
The findings also challenge manufacturers to continue exploring more adaptable solutions and to involve healthcare professionals in identifying where improvements are needed.
Making safer home care possible together
TNO emphasises that improving compliance requires action beyond individual healthcare organisations. The researchers recommend closer cooperation between healthcare providers, occupational therapists, manufacturers, municipalities, equipment suppliers and insurers. They also call for caregivers' physical workload to receive greater consideration in equipment assessments and reimbursement decisions.
For Lopital, this reinforces the importance of contributing practical product knowledge, listening to caregivers and working with others to improve the conditions in which care is delivered.
Safe working conditions should not remain guidelines on paper. They must be achievable in everyday care.
Read the full TNO research report ‘De urgentie van betere naleving van praktijkrichtlijnen fysieke belasting in de thuiszorg: van knelpunten naar handelingsperspectieven’ (TNO-2026-18052, 16 September 2026).
