If the person you care for becomes more ill, they may need some help using the toilet. If you can, there are ways you can help them use the toilet safely. It’s OK if you’re not comfortable doing this – there are other options and people who can support you.
This page is for people caring for someone at home. If the person you’re looking after is in a care home, hospital or hospice, it’s best to ask the professionals for help.
Safety first
It’s important to be safe when helping someone move. It’s a good idea to talk to their GP, district nurse or occupational therapist before you help someone. They’ll guide you through how to help them move safely. They may suggest aids or equipment if the person you’re helping has complex needs. You should not try to lift someone. You risk injuring yourself and them. You should only ever safely assist someone to move on their own.
If you need urgent support, or the person’s mobility has suddenly got worse, call 111 for advice. They will be able to get you the right assistance.
Carer's assessment
You can get a carer’s assessment from your local social care services. This is not to assess how good you are at caring, but to ask you about your needs and how being a carer impacts your life. The person you care for can also ask for an assessment.
You may find that you’re entitled to equipment or a home adaptation to help you provide care. Social services can offer training and provide equipment for moving and handling. You can also find equipment online.
Toilet adaptive equipment
The GP, district nurse, occupational therapist or physiotherapist can give information about suitable equipment. You could ask about:
- waterproof mattress protectors and bed pads
- a commode, bedpan or urinal
- a removable raised toilet seat
- a lift assisted commode
- handrails near to the toilet
- bed or chair raisers
- bottom wiping aids
- walking aids to help access the toilet or commode
- a hospital bed (if appropriate).
A commode is a chair with a removable container inside it. You can place the commode close to the bed and empty the container after use. You can get a commode screen to place around it for privacy.
A toilet seat in a bright colour can be useful if the person has sight loss or dementia. Some people with dementia have difficulty making out objects. It may be easier for them to see where the toilet is if the seat is a different colourviii to the rest of the room. You can also buy lights that go inside the toilet which make it easier to see at night.
Bottom wiping aids are tools with a long handle that assist someone to wipe their own bottom. Toilet paper or wipes can be attached to the end. They reduce the amount of stretching needed and help to maintain independence.
Helping someone go the toilet or commode
The person you care for may be able to use a toilet or commode if they can get out of bed. But they may need some assistance from you, if you’re able to help.
If they use a commode, ask them where they’d like it placed.
You may need to help them undo fasteners or remove their clothes.
If they need to sit down on the toilet or commode, they might need something secure to hold onto, like a rail to lower themselves. They may also need to hold onto something to get off the toilet and stand up again. It’s unsafe to use sinks or radiators to assist because:
- they can become loose from their fittings
- radiators can cause burns
- hands may slip on a sink
- they risk causing injuries.
If a rail is not available, contact the person’s GP, occupational therapist, physiotherapist or district nurse to request one.
Give them some privacy while they use the toilet or commode. Turn away from them if you need to stay in the room. If you leave the room, stay close in case they need your help. Always ask them to let you know when they finish and are ready for your help again.
You may need to support them by:
- passing them toilet paper or wet wipes to clean themselves
- helping them stand up
- helping them to put on or button up clothes
- cleaning them with toilet paper or wet wipes if they cannot manage
- helping them clean their hands.
How to wipe someone’s bottom
Wipe from the front to the back to prevent germs being spread and causing infection. Urine infections can be caused by spreading germs from the anus (part of the body where poo comes out) to the urethra (part of the body where pee comes out).
Only flush toilet paper down the toilet. Other products, such as wet wipes should be disposed of in a plastic bag or in a rubbish bin.
Helping someone with a syringe driver use the toilet
If the person you’re caring for uses a syringe driver (or syringe pump), you may need to help them to take the syringe driver with them to the toilet.
Syringe drivers are usually kept in a clear locked box, which can be carried in a bag. Syringe drivers are not waterproof. So, it’s a good idea to put the syringe driver in a waterproof or plastic bag to keep it dry while you’re in the bathroom, or near water.
To help someone go to the toilet and move around safely, try to make sure the syringe driver:
- stays connected
- stays clean and dry.
If you have any concerns about this, speak to the person’s doctor or nurse.
Making it easier to use the toilet
These tips can make it easier to use the toilet:
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Allow plenty of time so the person does not feel rushed. Work around their routine.
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Suggest they take a painkiller 30 minutes before they might need the toilet to reduce pain from movement. This can mean they are less likely to rush.
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Place a chair halfway to the toilet if it’s a long walk, so they can have a rest.
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Keep the floor tidy so they do not trip.
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Keep a light on to help them reach the toilet safely during the night.
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If they have difficulty communicating, they may already have a way of letting you know when they need the toilet. If not, try to find a way to ask them. It can be helpful to have pictures of a toilet or toilet paper to point at.
Coping with bowel and bladder problems
Sometimes people lose the ability to control their bladder or bowel. This is called incontinence. They may:
- need to go to the toilet urgently or often
- leak pee or poo, sometimes without realising
- wet or soil the bed
- not make it to the toilet in time.
If the person you are looking after starts to have bowel or bladder problems, contact their healthcare team. There might be something causing the incontinence that needs medical treatment.
Sometimes things can get messy, and you may find that you need to change the bed, their clothes and your own clothes often. You could consider using disposable aprons to protect clothes.
The person might be anxious about wetting the bed or incontinence. Try reassuring them that you’re there to help. Speak to the GP or district nurse for advice on the best hygiene products and how to manage incontinence.
Helping someone use a penis sheath
A penis sheath is a device that fits over the penis, like a condom. It lets someone pee into a bag connected by a tube. You can empty the bag when it gets full. Your doctor or nurse can show you how to use one.
Signs of skin damage and pressure sores
Lots of factors can contribute to skin damage. When someone moves less, their skin can get sore or damaged more easily. Bladder and bowel problems can also make skin damage more likely.
Skin damage and moisture lesions
Moisture on someone’s skin can cause friction. This can happen if they wet or soil their clothes or bedsheets. Or if they leak pee or poo without realising. This type of skin damage can be called a moisture lesion. Catheters, and other toilet aids, can also cause skin damage. It’s important to check for any signs of damage and ask a professional for help.
If you’re helping someone to go to the toilet, this can be a good opportunity to check their skin for any signs of pressure damage or moisture lesions. The early signs of skin damage caused by moisture could look like any of the below:
- feeling like their skin is wet or sore
- burning-like sensations
- itchy skin
- blisters
- rashes.
Moisture lesions can vary in shape and size. They are more likely to appear in skin folds and creases.
It’s important to keep the person’s skin clean and dry to prevent moisture lesions. Good nutrition and hydration can also help the person to keep their skin healthy. If you need support with this, speak to a healthcare professional. They can show you ways to keep the person’s skin protected.
If you spot any signs of skin damage or moisture lesions, speak to the person’s healthcare team. They can help find and treat the cause.
Pressure sores
Moisture lesions can look similar to pressure sores. Pressure sores are a type of skin damage caused by pressure or friction on different parts of the body, such as staying in the same position for a long time.
If the person has moisture lesions, they are more at risk of developing pressure sores. It’s helpful to know what pressure sores are, so you can get support. Pressure sores can look like:
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Discoloured patches of skin that may not fade when you press them:
- People with lighter skin tones may get red patches.
- People with darker skin tones may get purple or blue patches, or patches that are a different colour than the surrounding area – usually darker.
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An area of skin that is a different temperature or feels harder or softer than the surrounding skin.
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Swelling, pain or itchiness in the affected area.
If they refuse your help or you’re unable to help
Needing help to go to the toilet can feel embarrassing. Some people might feel shy about asking for help, or worry that their relationship with their caregiver has changed. These feelings might make the person refuse help, or hesitate to accept it. It’s important to be patient with the person and ask them how they’re feeling.
As a carer, it can be frustrating if the person refuses help, or you’re unable to help them as you would like. If it becomes a problem, talk to the GP or district nurse. They can guide the conversation and help to find a solution.
Feelings and worries
If the person you’re caring for becomes more unwell, they might need more support from you. This can bring about lots of feelings for both of you. Some tasks might be physically and emotionally hard for you. The person you care for might feel like they’re losing control and confidence. And they might worry about losing their dignity and privacy.
If either of you feels worried or uncomfortable, speak to the GP or district nurse. They can explain your options and arrange for someone to help with personal care. You could also ask for a professional to be there to support you the first time you do a care task. If they’re not able to be there in person, they might be able to help you over the phone.