By Robin Tuffley, Marketing Manager, Closomat
As a nation, we don’t discuss toilets; if it comes up, it’s usually accompanied by giggles. But it affects all of us. We go to the loo on average eight times a day. If you need help to go/‘go’, it can become a major factor in your life.
Research reports that using functional rooms- including the toilet- is the second-biggest problem faced in daily life for families with a severely disabled child.
Using the toilet is a bigger issue among children than most people realise: continence affects 1 in 12 young people, according to children’s continence charity ERIC,.
Even able children can struggle to sit on and use the toilet, facing issues of height, balance.
To go to the toilet, and be properly clean afterwards, with little or no help, has a huge impact on a child’s feelings of independence, self-respect and acceptance, and their self-care skills. It also has similar, corresponding benefits for the child’s carers and family.
Choosing toilet aids
The choice of toilet aids is influenced by a number of factors:
how long will the child need it
how capable is the child at transferring on/off the toilet
what level of support system may be required
can the child sit in the correct position on the toilet>
can the child balance unaided on the toilet
can the child wipe clean themselves
can the child operate the toilet
Those considerations with regards to toilet aids need to be addressed in the present, short and long-term future.
Is the child using a conventional WC or a wash and dry toilet?
Whichever type of toilet or toilet aid, is being used, the child needs to feel secure and stable. They should be sat comfortably, with their back supported against the cistern, and their torso and legs forming a 90° angle. Buttocks need to be supported but slightly parted to enable effective bowel evacuation
If a carer’s support is required, the carer needs to able to provide appropriate intimate care easily.
An automatic toilet aid eliminates that requirement for comprehensive intimate care. It combines a toilet, bidet and drier in one unit. The toilet cleans and dries the user after use, removing the need for manual cleansing with toilet tissue, and all the associated hygiene and contamination issues. It also enhances the child’s independence and self-care skills. At home, it can also be used by the other family members; at school, by other users of the educational establishment.
Cleaning with toilet tissue requires manual, mental and physical dexterity, flexibility, and balance. It requires intimate hand: body contact, either by the user or their carer. Cleaning with a shower requires only the ability to sit in the right place, and trigger a mechanism.
Selection of a wash and dry unit will be influenced by need, budget, location and length of need. The cost is not just that of whichever unit is chosen, but what adaptation- if any- will be required to accommodate the unit, and ensure it works, and the length of time it is envisaged the toilet will be needed. There is also the associated reduction in care cost/ time.
Not so obvious benefits are the child’s health & wellbeing: cleaning is consistent with almost no risk of faeces being left behind to cause skin irritation, there is no hand:body contact, and the child feels more independent, ‘grown-up’ as help isn’t required. And potential for the child to smear is eliminated too.
For most disabled children, some variant of a toilet aid support system will be required, to provide them with security and stability when sat on the toilet, regardless of their personal mobility. Whatever support system is chosen, it needs to fit them comfortably, now, and in the short-term, and have the flexibility to adapt as the child grows, or be cost-effectively replaced.
Supports can be fixed or removable; the choice may be influenced by how many other people in the household- or school- need to use that WC.
Lateral body supports fitted to the WC provide stability on both sides, and fold away when not required. If trunk support is required, an orthopaedic system fixed to a mechanism mounted on the back of the toilet will provide the required stability and security without impinging on the child’s seating position over the pan.
These will require substitution/replacement with larger versions as the child grows, and need to be removed for the toilet to be used by other members of the family.
Options are available that will also encompass head support. Lap straps are also available for added security when in use.
Shower chairs roll over the toilet, enabling the child to ‘go’ without carer having to clip a support system onto and off the WC. The latest evolution is a HTS (hygiene & toileting aid system). Most can be tailored to each child’s needs, with lateral supports and security straps and rests.
Seek, and heed, professional advice. There have been instances where quite expensive toilet aid equipment has been chosen, bought, installed, and as soon as the youngster has tried to use it, slipped off onto the floor! So it’s always sensible to ‘try before you buy’ if possible: many Disabled Living Centres have demonstration units, and often have working toilets and toilet assistive technology and toilet aids available to use.
And research in advance: there is a raft of information if you are looking at a toilet aid, including guidance and case studies on the website www.closomat.co.uk or alternatively at ukcareguide.co.uk/caring-childs-toilet-needs.