Mobile Shower Commode Chairs for Older People Living at Home

Aging is an inherent human experience. As we get older, we experience many physical, psychological and social changes. Increasingly, as we get older, we want to remain in our own homes as long as possible – sometimes well into our later years.

As people age, they may start having challenges with toileting or bathing/showering, or both. It may become difficult to complete these activities – and the many tasks involved – safely and independently.

Both toileting and bathing/showering are remarkably complex activities. Each involves a series of different tasks and requires functional capabilities, including mental and physical dexterity, balance and flexibility.

On average, adults go to the toilet seven times a day. Toileting requires us to become aware of the need to go, then being able to mobilize to the toilet, remove clothing, position the body over the toilet, reach for supplies such as toilet paper or tissue, intimate hygiene and then rise from the toilet, flush the toilet, reclothe, exit the room, and return to what we were doing. There are additional steps for handwashing after going to the toilet.

Bathing/showering also requires many steps, including the capacity to mobilize to the bathroom or washing area, remove clothing, hold different positions in order to reach for cleaning products (such as soap or shampoo) and to clean the body, dry and dress, and mobilize away from the washing area.

We know from research that losing the capacity to bathe independently is devastating for older people. The onset of bathing disability is associated with fear and embarrassment. Research consistently shows that losing the capacity to clean ourselves independently causes significant reductions in our self-reported quality of life. In the United Kingdom, researchers Miriam Golding-Day and Philip Whitehead describe this as a “seminal point in the disabling process” for older adults.

Similarly, losing the capacity to go to the toilet safely and independently has a dramatic and negative impact on our quality of life. Challenges in toileting, or experiencing incontinence, is devastating and challenging for many older people. Depending on circumstances, it can also be a point where an older person is no longer able to live independently and must transition to supported living facilities.

Because these activities of daily living are so important to function and quality of life, they are an important focus of research. Recent research has started to identify specific interventions and services that can address bathing and toileting difficulties, and to support people remaining at home. These interventions can include home adaptations, home care support, and provision of assistive technologies for bathing, showering, and toileting.

Assistive Products for Bathing, Showering & Toileting

Many assistive products are available for bathing, showering, and toileting. Indeed, chairs for toilet, bath, and shower are listed on the WHO’s Priority List of Assistive Products, which reinforces the importance of such products for enabling people to live healthy, productive, and dignified lives.

Assistive products for toileting can range from simple items such as padded toilet sets, to risers, over-toilet frames, and static or mobile commode chairs. For bathing and showering, assistive products can range from simple tub seats, transfer benches and stools to mobile shower chairs. Some older people may also require additional assistive products for transferring and mobilizing between different surfaces, such as standing aids, turning aids, hoists, and mobility equipment. The rest of this article will focus on one assistive product for toileting and bathing/showering: the Mobile Shower Commode Chair (MSCC).

Benefits of MSCCs for Toileting

MSCCs are a good option for people who require assistance to mobilize to the toilet and/or need support to sit comfortably and safely on the toilet. MSCCs have wheels, so they can be propelled and maneuvered by either the older person or an assistant. MSCCs can also benefit older people by:

— Reducing the total number of transfers between other seating surfaces, mobility equipment, the toilet, and showering chairs.

— Eliminating the need for awkward or difficult transfers in the confined space of a toilet (water closet).

— Increasing safety during toileting through positioning and postural supports. Reducing fatigue is especially important where toileting takes time, for example in bowel movements. Sitting comfortably and with good support allows the older person’s body to relax.

— Providing options to manage skin integrity and pressure distribution to protect fragile skin. MSCC seats are generally larger than padded toilet seats (as they are designed to fit to the MSCC frame) and can provide more area for distributing body weight. Further, MSCC designs may have options for cushioned and contoured seats, which are designed to enhance comfort and support. Cushioning and contouring can support and cradle the pelvis, thereby maximizing support under the older person’s thighs and greater trochanters.

— Enabling privacy and dignity in toileting, if the older person can sit safely and not require constant supervision or assistance as they go to the toilet.

Benefits of MSCCs for Bathing & Showering

MSCCs have many benefits for bathing and specifically for showering.

If the person’s home is equipped with a step-less shower, or a showering cubicle designed for roll-in chairs, MSCCs are worth considering in place of separate toileting and bathing/showering equipment.

Unlike toilet-only mobile commode chairs, MSCCs are designed to get wet and to handle commonly used showering products, such as soaps. MSCCS allow the older person to be seated and mobile while in the shower area. Depending on the brand and model, MSCCs can be configured and adjusted to address unique postural, positioning, and pressure/skin integrity management needs of the older person.

By contrast, static shower chairs tend not to have as many options for adjustment or configuration. A well-configured and well-adjusted MSCC will allow the older person to sit comfortably and safely in the shower, as well as on the toilet. Similar benefits for pressure and skin integrity management, postural support, and reduced numbers of transfers may also be realized in the shower. MSCCs can increase comfort and reduce experiences of discomfort and possibly distress during showering. Enabling relaxation and enjoyment in showering is possible too.

Finally, if the older person can sit safely and not require constant supervision, MSCCs can enable the older person’s privacy and dignity in showering.

MSCCs are a multi-use assistive product for bathing, showering and toileting. MSCCs are designed to get wet and to be used for showering. MSCCs are a good option for people who’ve had home adaptations completed, such as replacing a bathtub with an accessible (roll-in) shower. MSCCs can be used as commodes and also be rolled back over a toilet. Well-configured and well-adjusted MSCCs can help older people to shower and go to the toilet safely and comfortably. MSCCs are a good option to address challenges in bathing, showering, and toileting and to allow older people to remain living in their own homes as they get older.

Editor’s Note: This story is sponsored by Raz Design.

About the Author

Emma Friesen, Ph.D., is the Clinical Director for Raz Design Inc., a rehab shower commode manufacturer in Toronto, Canada. Emma is a Chartered Biomedical Engineer with expertise in complex rehab equipment, product usability and measuring outcomes of seating and positioning interventions.

In Support of Upper-Extremity Positioning