It is important to provide support and assistance to older adults when using the toilet. This may involve helping them get to the bathroom, providing support for their mobility, and ensuring that the restroom is safe and easily accessible.
In some cases, it may be necessary to use assistive devices, such as grab bars or a raised toilet seat, to make it easier for the older person to use the toilet. Encourage the older person to communicate their needs and assist them with personal hygiene, if necessary.
Assisting a loved one with toileting may be one of the most challenging aspects of being a caregiver. There may be initial discomfort and awkwardness, but with proper techniques and safety measures, the toileting routine will become more comfortable for both of you.
Below, we’ve outlined some of the essential things you need to know about toileting. Learn more about how to make the bathroom safer, proper handling, necessary safety equipment, and more.
- Making the Bathroom Safer for an Older Person
- Signs That a Loved One Needs Help With Toileting
- Caregiver Safety When Assisting an Elderly Person With Toileting
- Common Bathroom Issues for Older Adults
- How to Transfer Safely From Bed to Toilet
- Step by Step: How to Toilet an Elderly Person
- Safe Toileting at Night for an Older Person
- Essential Toileting Equipment for Older Adults
- Incontinence Supplies for the Elderly
Making the Bathroom Safer for an Older Person
The bathroom is an important area in your home that needs to be secured when you have an older loved one. According to a CDC report, one in four older Americans in 2018 reported a fall. About 8 million of those resulted in an injury or a hospital visit. Because the bathroom can be dangerous for seniors, it is crucial to make it a safe and hazard-free zone.
Here are some tips to make the bathroom safer for an older person:
- Install grab rails on the shower area and the toilet area.
- Install non-slip flooring or place non-slip bath mats on the floor.
- Consider upgrading to a walk-in bathroom for more space.
- Have a shower chair or bench to make bathing more manageable.
- Install a raised toilet seat.
- Move essentials to a storage area that’s easy to reach.
- Always keep the area clutter-free.
- Mop and clean the bathroom floors regularly to keep them dry.
- Invest in bathroom safety tools and equipment.
- Keep the bathroom well-lit and make sure light switches are easily accessible. Install motion detection lights for nighttime use.
Signs That a Loved One Needs Help With Toileting
Your loved one may not want to (or not be able to) verbalize their needs clearly, especially when it comes to private issues like toileting.
Look for the signs below, which might indicate they need help in the bathroom:
- Taking too long inside the bathroom.
- Avoiding talking about their bathroom habits or becoming irritated when the topic comes up.
- Indirectly asking questions about bathroom tools and issues.
- History of falling and slipping.
- If you notice that they are having a difficult time getting up from a sitting position.
- If they have mobility or balance problems.
- Soiled clothes and declining personal hygiene. Accidents and bowel and bladder incontinence are signs that an older person is struggling to reach the restroom in time.
- Experiencing pain or discomfort when using the restroom.
It’s also important to encourage your loved one to let you know what they need and to assist with personal hygiene if necessary. By providing the proper support and assistance, you can help prevent accidents, improve comfort and hygiene, and reduce the risk of falls.
Caregiver Safety When Assisting an Elderly Person With Toileting
When you are assisting your care recipient, it is also important to keep your own safety in mind. Knowing how to properly guide your loved one in the bathroom reduces the risk of injuries for both of you.
Some caregiver safety tips to keep in mind:
Be there for support.
When assisting an elderly person in the bathroom, you are mostly there for balance support. Please encourage them to move on their own, but make sure you are close by and ready. If your care recipient has mobility issues, you must provide a more hands-on approach.
Be mindful of your posture.
To protect your back from injury, bend your knees slightly while supporting their weight. Avoid bending from the waist when lifting, as this can strain your back.
Use a gait or transfer belt.
It is ideal to use a gait belt when transferring a person from one surface to another. Never pull their arms or lift them under the armpits. This can cause harm and injury to older adults.
Use clear communication.
Clear and direct communication is necessary when guiding someone with such a personal task. Use simple, short sentences that explain and provide expectations of what you will be helping with in the bathroom.
Develop a routine.
Have a daily routine that you can easily follow. Scheduled bathroom breaks can help prevent accidents and incontinence. By providing regular opportunities to use the toilet, older adults are less likely to experience accidents or discomfort due to urinary or fecal incontinence.
Common Bathroom Issues for Older Adults
It is common for older people to have difficulties in the bathroom. Knowing about these issues can help you better handle their toileting needs. Some of the bathroom-related issues seniors face include:
Your senior care recipient may find it hard to pass their bowels because of inactivity, medication, digestive diseases, and other conditions. Without proper treatment, this can lead to more health problems like hemorrhoids, stomach pain, and anxiety.
Age-related changes in the urinary tract can lead to incontinence. Some diseases and medications can also cause incontinence.
Slipping and falls are common occurrences that pose a significant danger to the elderly. Mobility issues, balance problems, and vision loss can increase the risk of falls. Fall hazards like clutter and slippery floors can also create a dangerous environment.
What Helps an Elderly Person Have a Bowel Movement?
Constipation is a common issue for older adults, and various factors can cause it. Changes in diet, decreased physical activity, and the use of certain medications can all increase the risk of constipation.
Constipation can cause discomfort and pain, and it can also lead to other health problems, such as fecal impaction and bowel obstruction.
Older adults should drink plenty of fluids to prevent constipation, eat a high-fiber diet, and get regular physical activity. In some cases, a healthcare provider may recommend the use of laxatives or other medications to help relieve constipation.
Try these remedies below for constipation. If these do not help, it is best to consult with a physician.
- Encourage light exercises and physical activity.
- Increase dietary fiber intake.
- Regularly eating fruits and vegetables.
- Increase water intake to help soften stool.
- Establish a regular bathroom schedule.
- Take a soluble fiber supplement.
What Is a Toileting Schedule?
A toileting schedule is a plan for providing regular opportunities for an older adult to use the toilet. The schedule may include specific times of day for using the restroom and reminders to drink fluids and eat foods that help prevent constipation.
How to Transfer Safely From Bed to Toilet
Follow these step-by-step instructions to safely transfer your loved one from the bed to the toilet.
Before the transfer, make sure to clear any clutter, cords, and loose rugs around the area to establish a clear path. Communicate the transfer steps to your care recipient so they know what to expect.
- Set the wheelchair beside the bed. Position the wheelchair at a 30-45 degree angle to make the transfer easier.
- Ensure the brakes are locked, with the footrests and armrests out of the way.
- Help them get to a seated position on the bed. Ideally, it is best to position the transfer towards their strong side.
- Guide them to scoot to the edge of the bed so that their feet are in contact with the floor. This way, they will be able to assist the transfer by using their own strength.
- Loop and secure a gait or transfer belt around their waist. Don’t pull them up by the arms or shoulders as this can cause an injury.
- Instruct them to push with their hands off the bed to stand up. You can do a countdown for the lift-off for better coordination.
- Lift them up through the gait belt while they stand and pivot to the wheelchair seat. Remember to bend your knees and use your legs while doing this kind of transfer. Protect your back!
- Secure them in their wheelchair and make sure they are comfortably seated. Put their feet back on the footrests.
- Push the wheelchair to the restroom and prepare for the toilet transfer.
Step by Step: How to Toilet an Elderly Person
Once you and your loved one are safely in the restroom, it’s time to get down to business (no pun intended). The bathroom is the most common area in the home for falls. Safety and hygiene are the next crucial elements to keep you and your loved one safe.
- Position the wheelchair at an angle next to the toilet.
- Secure the brakes and move the armrests and footrests out of the way.
- Again, let your care recipient know the next steps before helping them transfer to the toilet.
- Instruct them to push off from the wheelchair seat using their hands and stand up slowly. If they feel more comfortable pushing off from the armrests, let them.
- Assist by lifting them up using the gait belt. Maintain good posture when lifting, with your knees bent and your feet apart.
- If a grab bar is installed next to the toilet, have them grab onto the rail while standing. If they are facing the toilet, talk through and assist with turning around.
- Gently pull down their pants and undergarments while they are holding onto the grab bar. Remember to communicate the steps you will take before performing them.
- Gently direct them to lower down to sit on the toilet seat.
- When they are comfortable and secure on the seat, give them time and privacy to do their business. Stay close by within earshot so you hear when they are done on the toilet.
Hygiene: How to Wipe
- Before cleaning them, make sure to wash and disinfect your hands first. Dry your hands completely and wear disposable gloves.
- When they are done toileting, have them lean forward and scoot over to the edge of the toilet so there is space for you to clean their behind. Have them hold on to the grab bar for support.
- Clean their bottom with moist tissues or wet wipes. A handheld bidet can make this process much easier and more pleasant for your loved one. If there isn’t enough space, you may need to have them stand up to clean them thoroughly.
- Throw soiled wipes and gloves in the trash bin.
- After cleaning, pat dry with tissues or a clean towel.
- If the sink is easily accessible, instruct your loved one to wash their hands. You may have to wait until they are back in the wheelchair before they can reach the sink. Wash your hands again.
How To Lift Someone off the Toilet
Once you have sufficiently cleaned yourself and your loved one, it’s time to transition back to the wheelchair from the toilet.
- If they are sitting down, have them lean forward to prepare for lift-off.
- Communicate your next steps and countdown the lift-off for coordination.
- Have them grab onto the grab bar or rail with one hand or your shoulder if there is no grab bar for support.
- Assist them as needed by grabbing onto their gait belt. Instruct them to stand up and coordinate the pivot with a countdown.
- While they are standing and holding the grab rail, pull up their undergarments and pants. If their clothes are soiled, put on a clean pair of underpants.
How to Toilet a Person With Alzheimer’s or Dementia
Assisting an elderly person with Alzheimer’s or dementia can be a little more challenging than someone who does not have cognitive deficits. It is important to exercise care and extend your patience when working with a person who has Alzheimer’s or other dementia.
Follow the steps below to help a person with Alzheimer’s use the toilet. Before anything else, make sure that your bathroom space is equipped with the proper safety equipment.
- Offer help
If you notice signs a loved one needs to use the bathroom, gently approach them and let them know you are there to help.
- Give them time
If they are resistant, wait 10 minutes and try again. Use encouraging words to persuade them to go with you to the bathroom.
- Guide and assist
Guide them to the bathroom and raise the toilet seat cover. Assist them in removing their clothes, if needed. Remain respectful and relaxed at all times.
- Offer distraction and privacy
To help them remain seated on the toilet, give them a book, magazine, or a fidget toy for adults to keep them occupied and keep their hands busy. Give them privacy while they are on the toilet but stay close.
- Help with wiping and cleaning if needed
When they are finished, clean up with wet tissues or a bidet. Use wet wipes or a bidet to clean the area completely. Remember to communicate what you are going to do in a casual and fun tone to keep the mood upbeat. You may need to have them stand up and grab the rail so that you can clean and wipe comfortably. Take your time and ensure a thorough cleaning.
- Redress and wash hands
Re-dress your loved one when you are finished cleaning. Make sure you both wash and dry your hands. Provide rewards and positive affirmations to end the experience on a high note.
Helpful Tips to Avoid Bowel and Bladder Accidents
Bathroom accidents become more common as people age but they are avoidable. Here are some tips you can do to lessen your loved one’s bathroom accidents:
- Maintain a regular bathroom schedule that’s easy to follow.
- Install safety equipment like grab bars and raised toilet seats in the bathroom.
- Make the bathroom a warm and relaxing space so they are less intimidated.
- Have them wear loose clothing that’s easy to pull up or down.
- Don’t allow coffee drinking at night, as this can cause urinary and bowel accidents.
- Be mindful of how much liquid they drink, especially at bedtime and at night.
- If the bathroom is too far away, keep a urinal or commode easily accessible in their bedroom.
- Remove planters or pots that can be mistaken for a urinal.
Safe Toileting at Night for an Older Person
Using the toilet at night can be hazardous for an elderly person. Without the proper safety equipment in place, a simple trip to the bathroom can lead to falls and injuries. Here are some tips to make toileting at night safer for your loved one:
- Install night lights on the floor that illuminate the path to the bathroom.
- Use automatic night lights that can be plugged into wall outlets.
- Use motion-sensing lights so they won’t have to turn on or turn off the lights during nighttime visits to the bathroom.
- Remove carpets and rugs that can be potential trip hazards.
- Install grab bars beside the toilet.
- Brighten up the toilet with an LED night light.
- Have a commode ready beside the bed to reduce trips to the bathroom.
- Place a waterproof mattress protector on the bed.
Essential Toileting Equipment for Older Adults
There are several must-have products that can make toileting easier for your elderly loved one. While this equipment can help reduce the risk of slips and falls, keep in mind that it is still best that they always have someone assisting them when toileting.
Toilet seat riser
A toilet seat riser is an accessory attached to the toilet. It adds 3-5 inches of height to a standard toilet bowl. This reduces the need to get low, making it easier to sit down and stand up. There are also toilet seat risers with handles or arms for added support.
Raised toilet seat with safety frame
This piece of bathroom equipment also doubles as a stability tool. An elevated toilet seat has attached rails that can be used for added support when standing up and sitting down. It offers a sturdy design and more stability than the regular toilet sear riser.
A commode is a portable toilet with an attached pot or bucket under the seat. Often used by the elderly, people with disabilities, or those recovering from surgeries, this eliminates the need to walk to the bathroom. It can be placed by the bed for easier access.
Grab bars or safety rails are necessary safety equipment for the bathroom. These bars are mounted on the wall in places like the bathtub, toilet, and shower area. They can help in maintaining balance and stability when sitting down and standing up, especially when the floors are slippery.
Incontinence Supplies for the Elderly
Bladder and bowel accidents are bound to happen. While you may not be able to stop them from happening, being prepared can make cleaning easier. Having the best incontinence supplies for the elderly accessible in your home will make your loved one less stressed about their incontinence.
Incontinence underwear is washable underwear that can absorb bladder leaks. They feel like regular underwear but are made of absorbent material for leakage protection. They come in different levels of security and are for women, and men. Some brands offer a unisex style.
Incontinence briefs are designed to look like briefs with absorbent pads for leakage protection. They come in different levels of absorbency and are often designed for men.
Pull-up diapers for adults are similar to baby diapers, except they have an elastic waistband. The stretchable waistband makes it more convenient for older adults to take on and off when changing.
Incontinence pads have a similar design to sanitary napkins. They are highly absorbent and also come in different levels of protection. They usually have a stick-on backing that can be placed on underwear. There are also non-stick options that can be inserted into underwear lining.
Made to wear for extended periods of time, extended-wear briefs have a high level of absorbency. They usually come in a diaper-type design and are absorbent enough for both urinary and bowel incontinence episodes.
This essential product is a lightweight waterproof sheet that can be placed on the bed to protect the mattress from accidents. Mattress protectors come in different sizes and have disposable and washable options.
Disposable wipes or washcloths come in handy when cleaning up. Hygienic wipes are made to clean and deodorize while being gentle on the skin. They come in all shapes and sizes, with wet and dry options to choose from.
Incontinence supplies can be expensive, fortunately, there are a variety of programs to help pay for supplies like briefs, pull-ups, and adult diapers.
What if an Elderly Person Refuses Help With Toileting?
It is not uncommon for an elderly person to refuse help with toileting. Because toileting is such a private experience, they may not want to feel vulnerable and exposed even if they need help.
If this is the case, exercise compassion and patience. Understand where they are coming from and respect their space. Instead of forcing your help, go for a gentle approach.
It’s important to ensure that their health and safety are not at risk. If you are having trouble with your loved one refusing toileting help, it may be beneficial to consult with a geriatric care manager or other healthcare professionals.
There are many toileting challenges you are bound to face when taking care of an elderly person. With proper awareness, an extra ounce of patience, and safety equipment in place, this daunting responsibility can become easier for both you and your care recipient.
When your elderly loved one’s toileting needs are fulfilled, they can go through the day more comfortably and with one less thing to worry about.
Keep in mind the following when it comes to toileting and older adults:
- Toileting is an essential part of maintaining the health and well-being of older adults. Providing support and assistance with toileting can help to prevent accidents and incontinence, reduce the risk of falls, and improve the older adult’s comfort and hygiene.
- Toilet training may involve helping a loved one get to the bathroom, providing support for their mobility, and ensuring that the bathroom is safe and easily accessible.
- In some cases, it may be necessary to use assistive devices, such as grab bars or a raised toilet seat, to make it easier for the older adult to use the toilet.
- It is also important to encourage older adults to communicate their needs and to assist them with personal hygiene, if necessary.
By providing appropriate support and assistance with toileting, caregivers can help older adults maintain their health and dignity.
How to Toilet an Elderly Person Frequently Asked Questions
When assisting someone with dementia, it is best to keep things light and fun. Provide reading material or toys to keep them sitting on the toilet. Keep the bathroom door open. Give plenty of positive reassurance and rewards along the way.
Make sure to always communicate your steps when assisting an older person with toileting. It is ideal to have safety equipment installed in the bathroom to avoid slips and falls. Guide them to the bathroom and help them undress, if necessary. You may also need to help clean them up after they are done on the toilet.
For a safe and comfortable transfer, it is best to use a gait belt when moving an elderly person from the bed to the wheelchair and toilet. Bend your knees when lifting up to protect your back. Do a countdown of the lift-off to coordinate your moves. Always be gentle and never rush the process.
Use the pivot transfer technique to transfer them from the wheelchair to the commode. Start by placing the wheelchair at an angle next to the commode. Squat and guide your care recipient as they push off with their hands and pivot their body to transfer to the commode. Keep your body close to theirs during the transfer. Make sure to bend from your knees and hips to protect your back. Never pull on their arms or lift under the armpits as this can cause injury.
To clean up after toileting, use wet wipes or a hand-held bidet for a thorough clean. Have them scoot over and lean forward so you can wipe their bottom. If this doesn’t give you enough room to clean up, have them stand up and hold onto the grab bars or a stable support surface while you wipe from behind. Dry completely with a clean towel before re-dressing.
Amie Clark, BSW
Aging Advocate and Senior Care Expert
Amie has worked with older adults and their families for the past twenty-plus years of her career. Her senior care knowledge is based on her experience as a social worker, family caregiver, and senior care consultant. Learn more about Amie here.