Of all the daily activities people perform, toileting is one of the most difficult to discuss and by far the most private. "...it's the ultimate sign of dependency. Someone wiping your bottom," remarks Morrie Schwartz in the book "Tuesdays with Morrie" by Mitch Albom. It is hard to ask for help when it comes to this most private of personal needs.

It's difficult to talk about, but being honest and open about your limitations in the bathroom is the first step toward regaining independence. Once specific needs are clearly identified, you can probably find products that will make it possible to maintain your privacy in the bathroom.

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Tip: Sometimes all that is needed is a little support while sitting or standing. 

The staff at Dynamic Living recommends the following when some extra assistance is necessary:

• Grab Bars
  Grab Bars are available in a large variety of lengths and styles. When installing grab bars, be sure that they are the appropriate length and diameter for your needs and that they are placed where they will offer the most support. Remember to follow all precautions about appropriate wall preparation. If the wall is not strong enough to support the weight, the grab bar will not provide the support you need. Find a professional to do the installation - for your own safety.

• Support Poles
  The SuperPole is a tension pole that is secured between the floor and the ceiling and provides a full range of heights to hold onto while sitting or standing up. Unlike the grab bar, the SuperPole can be installed anywhere there is a floor and ceiling, including in the middle of a room, to provide support exactly where it is needed. By holding onto the pole at a comfortable level, you can use your arm strength for balance and support as you seat yourself on the toilet.
  
  When ceilings are too high or cantilevered, there is also a floor-mounted pole that adjusts up to 32" in height and is secured to the floor for stability. This model features a pivoting and locking horizontal bar to provide additional support while transferring to and from the toilet.

• Toilet Safety Frame
  Toilet Safety Frames can aid as a guide for sitting and as a push-off point for rising, because they provide arm rests on either side of the toilet. For added stability, look for a model that is secured to the toilet with bolts.

• Raised Toilet
  For those who have trouble bending, raised seats can add an additional height of two to five inches to the toilet seat.

There are alternatives to the somewhat clinical look of a raised toilet seat. The Toilevator is a spacer that is installed under the base of your toilet, adding 3.5 inches of additional height to any 14 or 15 inch toilet while still maintaining the appearance of your toilet. Another alternative is the installation of a 17" high toilet, which is several inches higher than the average commode (and ADA compliant).

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Tip: Keeping Clean

For those with a limited range of motion in the upper extremities, cleansing the anal area can be a source of major difficulty. Dynamic Living suggests the following aids:

• Bidet
  Popular in Europe for decades, this low, bowl-shaped bathroom fixture enables the user to straddle the bowl to bathe just the crotch area with running water after toileting. Alternative versions include spray devices that can be attached to the toilet to provide a localized spray of water, with the run-off going directly into the toilet bowl. Or there are also hand-held Personal Bidets that can do the job when you are on the road.

• Toilet tissue holder
  For some cleansing needs, the bidet is not a satisfactory solution. Your arms are too short or your shoulder is too sore or a dozen other reasons may make it difficult to hold toilet paper and adequately cleanse yourself. The Bottom Buddy is designed like no other tissue holder, with a curved handle and rounded head specifically allowing the user to apply pressure to properly clean the anal area.

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Toileting is part of our day, every day. There's no need to be embarrassed when assessing your needs in the bathroom. Particularly if there's a way to help you to maintain your independence. If you are unsure, ask your occupational therapist or physician if some of these aids would be right for you.

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© Copyright 2001 Dynamic Living, Inc.
Dynamic Living Newsletter may only be redistributed in its unedited form. Written permission from the editor must be obtained to reprint or cite the information contained within this newsletter.

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