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ADDRESSING THE BIG ISSUE IN INTIMATE CARE

If you are a larger person, one issue rarely addressed, but which is probably more of an issue than you care to admit, is that of using the WC.

The focus when weight is discussed is on one’s health. Wellbeing is not often considered.

Going to the toilet is something we all do, on average eight times a day. It is one of the 10 key ADLs (activities of daily living) that are taken into account when one is assessed for care support.

If you are one of the 25+% of people who are obese, it is something one has to think about. Your size affects your ability to get on and off the WC, to use the fixture properly, to clean yourself effectively. Being able to undertake such a basic function has a huge impact on one’s psychological wellbeing, one’s feeling of independence, of being in control.

A recent survey found that only 40% of care homes had the right equipment to deal with bariatric residents. Of those that do, the chances are they will use a hoist to help a client transfer on and off. Hoists can also be employed at home.

Wherever the location, that can potentially be undignified: as we have been anecdotally told, clients can, in effect, be left suspended in the air whilst their bottom is cleaned, the toilet flushed etc.

Once on the toilet, is your bottom correctly positioned over the pan? Are you sat comfortably? Can you reach to wipe yourself thoroughly? Whether or not you have the mobility and dexterity to wipe yourself, can every fold of flesh be adequately cleaned? Think of the health & hygiene consequences if urine or faeces is left trapped in contact with the skin.

Yet a little thought and a few changes can make the whole process pleasant and hygienic.

Firstly, a toilet lifter can assist in getting on and off, replicating natural movement whilst giving you the support you require. Most have integral arms, to offer support once you are sat over the WC.

If you are not using a toilet lifter, consider changing the toilet seat to a bariatric version, or complimenting it with a bariatric bench.

Either will give you better support, especially around the buttocks, and ensure you are properly positioned over the pan: your body mass inevitably means you are sat further forward, so your bladder and bowels are similarly further forward. Men may even prefer what is known as a horse shoe seat, as that will accommodate their genitals appropriately to help avoid spillage.

For optimum cleanliness, if budgets allow, a wash & dry toilet, also known as a smart toilet, is the business. Basically, and integrated douche sprays water upwards to wash away movement residue.

Bear in mind not all are the same. Some are just shower toilets, that wash your bottom but have no subsequent drying function. Douche and drying performance varies from one make to another, so it may be worth trying before you buy. The more reputable manufacturers have units in locations to enable this, and may even be able to provide a home demonstration.

It is not just the douche and dry performance that varies. The angle of the douche is different depending on manufacturer. This has little-considered consequences if you are a larger person. The spray may potentially either miss the area it is supposed to be cleaning, or your body mass will cover the spray nozzle and prevent effective (or any) cleaning. The douche arm could poke or prod you as it extends.

Think too about not just how effectively it cleans and dries you, but how easy it is for you to use and operate- not just now, but in the future, should your condition, dexterity, mobility deteriorate. Can it be ‘accessorised’ to accommodate changing needs?

Depending on your circumstances, it may be possible to attain funding for it under a Disabled Facilities Grant, particularly as such assessment now often takes into account the client’s health & wellbeing, beyond the clinical need.

After all, would the assessor like a stranger to wipe their bottom? The alternatives are available, that deliver a healthy & hygienic solution that simultaneously enhances the client’s wellbeing.

Closomat is the UK’s leading provider of equipment that delivers independent and hygienic toilet solutions. It was the first to introduce wash & dry toilets into the UK. Today it is the brand leader. It is also the only company in the sector to be based, and manufacture in the UK, and offer in-house nationwide sales and after-sales support.

Its website www.closomat.co.uk is now the ‘go to’ resource for assistive toilet technology.

Some more great blogs from Closomat

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What about if it is a member of the family, a partner providing the care- what about the cost of their time, possibly their loss of income as they are looking after you rather than working for a company?

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