Assisted toileting products facilitate independence and privacy in the toilet, and can assist with toileting where the individual is unable to manage unaided.
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Automatic shower toilets
The ultimate solution to independence in the toilet for many disabled people is the automatic shower toilet, which combines a toilet, bidet and warm air drying in one unit. In this way, no manual intervention is required.
There is a range of accessories and options that make these units even more responsive to different needs, for example: height-raising plinths; no-touch and remote controls; a strengthened seat for sideways transfers from a wheelchair; octopus support arms; back bar operation; padded seats for pressure relief.
One of the most recent accessible toileting developments is an adjustable height shower toilet, which has been designed particularly for multi-user situations, as it can be easily adjusted to suit people with differing height requirements. The integral support arms can be moved up out of the way for a sideways transfer from a wheelchair, and they move up and down with the rest of the unit so that their relative position is maintained.
These are all, of course, specialist units which require qualified installation and commissioning.
Toilet bidet adaptations
The alternative to a dedicated shower toilet unit as above, is to fit an add-on bidet unit to an existing toilet, such as PDS Hygiene’s WRAS-approved Bio Bidet toilet seat, shown here.
This retrofit toileting option is much cheaper, and can be installed by any competent plumber or even DIYer.
The range of bidet seats now available provide all the features associated with a dedicated shower toilet. By combining the bidet and toilet in a single unit, you save the need for a transfer from one to the other, and also save space, which is often limited in a bathroom. Remote control units, supplied with top of the range bidet seats, enable more people with limited mobility and dexterity to use the toilet in privacy.
Another possibility is a handheld portable bidet unit. Operated using a built-in rechargeable battery with USB charger, the reservoir is simply filled with water at the temperature required, and activated by a comfortable soft button. It doesn’t include a warm air drying function, though.
Toilet plinths and supports
Raising the height of a toilet can make it much easier to use independently. There are various ways to achieve this. If you are installing a new toilet, make sure that you opt for a higher toilet pan. On an existing toilet, a neat plinth which fits between the floor and the pedestal can raise the height permanently in a discreet manner. The plinth shown here provides an extra four inches of height, ideal for wheelchair users and those with limited mobility in hips or knees. Alternatively, a raised toilet seat can give extra height of between two and six inches, depending on the model selected.
Alternatively, a support frame, such as the one shown on the left, can give firm toileting support as the user moves from standing to sitting position and up again. This portable unit is particularly well designed, employing the weight of the user on the foot plates to increase its stability, without the need for any permanent wall or floor fixings.
If there are users who need more help than can be provided with raised seats and support frames, a powered toilet raiser could be the answer.
There are various models offering differing degrees of assistance. Some just tilt the seat forwards, to give a gentle boost to the user as they attempt to rise; while others also rise and lower in height, so that anyone who is unable to bend unaided at the hip or knee can be supported from and back to standing height.
Comfort and pressure relief
Pressure damage currently costs the health service more than heart disease. Most of it is preventable with the right pressure care regime.
Chronic digestive conditions can entail extended periods seated on the toilet, and it is good practice to extend the pressure relief management to this area, for those patients who require it.
This sturdy inflatable rubber toilet seat eases pressure effectively, and can be fixed and removed as required.
Mobile shower/commode chairs are useful for moving from bed to bathroom, shower or toilet.
Provided that the commode chair has a wide enough space between its wheels, it can be positioned over the toilet, saving the need for a transfer. Alternatively, with the use of a removable pan, it can be used as a self-contained commode unit.
A sturdily built static commode chair can also do duty as a removable toilet support frame, with the pan removed.
Some are designed to be stackable, to save storage space.
Look out for features such as corrosion resistance, anti-bacterial protection, and designs that are easy to keep clean.
With the general increase in obesity, there are now commodes available designed particularly to meet the needs of heavier users. You can see more in our specialist bariatric section.
Please note that we also have a general continence section, which you can access here.
Doc M Packs
Doc M packs are put together by some bathroom suppliers, as a convenient way of providing the necessary products for an accessible toilet or cloakroom facility. Doc M refers to the part of the Building Regulations (Document M) which deals with accessibility for disabled users.
The pack may contain only the grab rails and supports required for accessibility, or – like the toilet pack shown here – may include all elements: comfortable height toilet; easy flush cistern; wash basin with lever taps; as well as the grab rails and hinged supports.
The Changing Places campaign, run by the Changing Places consortium which includes PAMIS and Mencap, is probably the most important initiative in the disability access field for the last 20 years. By focusing on provision of fully accessible public toilets, it supports the rights of people with profound and multiple learning and/or other physical disabilities, to access their community. Without such assisted toileting facilities, people may be restricted to their own homes, or face the indignity of being changed on the toilet floor.
Changing Places facilities provide more space (ideally 3 metres x 4 metres) than a normal accessible toilet, so that there is adequate room for all the extra equipment required and space for two carers to help the user.
The extra toileting equipment expected in these facilities includes:
1. Overhead room coverage hoist systems
2. Height adjustable changing benches
3. Height adjustable wash hand basins
4. Showering facilities
5. Peninsular toilets
6. Privacy screen
We have a section of Independent Living dedicated to the campaign for Changing Places, where you can read a lot more!