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Rails set at an angle can help a person who needs a steadying support - e.g. to stand from a bath board to shower. The rail can be placed at an angle of 45 degrees up and away from the user. This keeps the wrist in a neutral position. It is not necessary to lean far forward to grasp the rail at the lower end and the hand can travel up the rail to maintain the support once the person is standing. If you are struggling with caring for yourself, or your carer is struggling to provide care for you, consider asking for a health and social care needs assessment. Since the Care Act 2014 (Great Britain. Parliament 2014) came into power in April 2015, anyone who appears to need care and support can request an assessment from their local council, irrespective of their income or savings. The Act also places a statutory duty on local authorities and the NHS to support individuals to take steps to prevent their ill health or care requirements from getting worse. These strategies for prevention can include the early provision of equipment and services to help prevent, delay or reduce the development of further need for care and support, which would include the provision and fitting of grab rails depending on the cost. Consider your daily routine. What movements are you making or what activities are you doing when you feel that additional support, or something to hold on to, would give you extra safety? For example:

Alternatively, if there are no obstructions outside the bath (e.g. the sink or toilet) a vertical grab rail could be installed on the wall at the tap end of the bath. This is useful when stepping in and out of the bath and also to hold onto if standing to shower. As a general guide there are two options for wall mounted rails by the toilet. If you have the same strength on both sides of your body it may be a good idea to have supports fixed on both sides of the toilet so that you can use both arms. This should be a flat, unknotted piece of wood, which is screwed into the vertical joining pieces of the partitions. The grab rails can then be attached to the board. The College of Occupational Therapists recommends a 144mm x 19mm board/pattress with its external corners well rounded and the board itself fixed to the wall at least every 900mm (COT 2006). These provide a horizontal bar in their lowered position. They should be fitted at waist/elbow level and approximately a fist width away from your thigh when sat on the toilet. The rail should be mounted at a height that the user can comfortably reach whilst stood both from outside the bath and from in the bath.

Ensure that the wall is strong enough to take the weight of this type of rail. Care should be taken that the user never bends down underneath the rail (e.g. to reach their feet) when sat in the bath as they could trap their head under the rail. It is recommended that it is run continuously from the bottom to the top of your flight of stairs, including going around the edge of any intervening landings and across window openings. The handrail should be allowed to continue past the top and bottom steps by 300mm. These fix to the wall behind the taps and rest on the bath rims. When sitting in the bath, the rail will be directly in front of the person at about chest height. In this position it will provide stability whilst in the bath. The rail should only have downward pressure applied so the weight is taken by the bath rim, it is not designed for the user to pull on to sit down or stand up from the base of the bath (Pain et al 2003).

When standing from a sitting position in the bath you may find it helpful to hold one horizontal wall-fixed grab rail (placed above the bath) with one hand and use the outer rim of the bath with the other hand to push against. There needs to be a 50-60mm clearance between the wall and all handrails. Grab rails by the toilet are often fixed to the wall alongside the toilet, but if this is not possible (due to the toilet being too far from the wall or a partition wall or a radiator being in the way for example), then a drop down rail that extends from the wall behind the toilet could be used (see below). Horizontal rails may help when pushing up from sitting and provide support when lowering, e.g. on to a toilet. Most people find it easier to push down on a rail rather than pull on one, so horizontal rails are more commonly used.the space you have. It’s no wonder they’re so popular. Choose from a wall-mounted robust rail, a freestanding rail set on castor wheels for easy A 600mm long horizontal rail 680mm from the floor beside, and extending in front, of the toilet pan for use when sitting down on the toilet. This rail can be horizontal or set at an angle of up to 15 degrees. Alternative suggested measurements are a minimum 500mm long rail, at a height of 600mm from the floor, with the rear fixing 400mm from the wall at the rear of the toilet. There are many types of grab rail. The main types are briefly introduced below, before going into greater detail about grab rails and their use in specific areas of the home. Most grab rails are permanently fixed in one position onto the wall, floor, ceiling, or a combination. When fitted securely and correctly they should be able to cope with the push/pull forces of repeated use. Suction grab rails attach to a smooth surface by forming a strong suction grip at each end. Some manufacturers state that they are not weight-bearing and are only intended to assist with balance. Others do not clearly state this, but give a weight limit for safe use. You are advised to read any guidance and seek further clarification if needed before you use these rails. They are highlighted as portable for visits and holidays.

The lower portion is usually set horizontally and acts as a forearm support. This enables the user's body weight to be distributed through his or her forearm which may be helpful for someone with painful hands or wrists.Particular care should be taken when attaching rails to domestic sandwich partitions, e.g. plasterboard with a hardboard facing. Cranked or offset rails are wall-fixed rails which have been designed to fit to frames and spaces to allow the user to step up to and through a doorway or space without releasing grip on the rail. Consider the advice about the different kinds of grab rails. Identify the best types of rail for your particular requirements.