Toileting safety

Information

People with physical and mental impairments may need to make some changes to their environment to improve their safe access to the toilet. Bathrooms should be adjusted for the person's mobility and self-care skills.

Place handrails near the toilet to help the person transfer to the toilet. Remove any throw rugs from the bathroom and all hallways leading to the bathroom. Make sure that proper lighting is available in both the bathroom and hallways. Night lights may help the person reach the bathroom safely.

Some people may get confused when they wake up in a dark room. Use night lights or motion sensor lights to help the person see their location.

Special raised toilet seats may help people who have trouble using standard toilet seats (e.g. people who have had a hip fracture, or those with arthritis). You can buy these items from a medical supply company, pharmacy, or hospital supply center. Some insurance companies may cover the cost of these devices under their durable medical equipment (DME) provision.

People who need to climb steps or travel long distances to get to the bathroom can use a bedside urinal or commode. A commode is a portable toilet that can be placed close to the bed or chair. The commode should be sturdy and should not slide easily. Adjust the level of the chair so that the person can easily transfer from the bed or chair to the commode.

People who use a walker or wheelchair may need to have their doors and bathroom layout changed to accommodate this equipment. Ask the following questions when designing the layout:

  • Does the door block access to the toilet?
  • Are other bathroom fixtures in the way?
  • Is there enough room to use the walker or wheelchair while in the bathroom?

A rehabilitation therapist may help you determine what changes you need to make.

If you are caring for someone who needs help using the toilet, a call system (such as a bell or buzzer) may be helpful. Often there is little time between the first urge to urinate and an incontinence episode. Therefore, you must pay attention to the person's toileting needs.

People with weakness or movement difficulty (for example, from stroke, spinal cord injury, or arthritis) may need to modify their clothing so it is easier to fasten. Consider choosing clothing with a zipper instead of buttons, which may be difficult to use. Velcro is even easier to use.

Do not wear too many layers of clothing or underwear, which may be hard to remove. If diapers are used, choose devices that are easy to remove.

A vocational therapist or rehabilitation therapist can give you a list of manufacturers that make "ready-to-wear" clothing and assistive devices.

References

Assistive Technologies in the Home. Clinics in Geriatric Medicine. Feb 2009;25(1):61-77.

Hou JY, Reger SI, Sahgal V. Durable medical equipment. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 102.

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Review Date: 11/21/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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