As a hand therapist, the number one challenge I hear on a daily basis is related to wiping after using the toilet. Anyone who has ever fractured a wrist, amputated a finger, or undergone hand surgery, understands the simple activities we take for granted.
So how do you use the toilet after a hand injury/surgery?
The easiest way is to use a bidet, adaptive aid, or modify your technique.
Here are my tips and tricks for using the toilet with one hand, no hands, how you might toilet if you can’t reach, and why it matters.
How to use the toilet with one hand
Using the toilet one handed can be easy. The simple way is to modify your toileting by switching to the opposite hand.
It may take time learning how to use the opposite hand, but after 5-6 attempts it won’t be as challenging.
If you main limitation is swelling, arthritis, or stiffness, you may benefit from an adaptive device like a bathroom buddy or tongs. Some of these devices have larger handles to make gripping easier. They are also long to help you reach.
You might also try experimenting with a pair of spaghetti or toileting tongs.
How to use the toilet without hands
If both your upper extremities are injured, the easiest option is to use a bidet. This hands free device can make toileting much less messy. It may be uncomfortable at first, but after time you won’t remember how you lived without one.
I recommend this luxury version with a heated seat, warm water spray, night light, deodorizer, and warm air dryer, but if you’re on a budget click the image above.
You might also modify your toileting technique by using a toilet aide or by changing your technique. First, ask your surgeon or hand therapist about your current restrictions. Be honest with them, and share your concerns. Ask what fingers are safe to use, or if they’re okay with using the opposite hand.
How to use the toilet if you’re unable to reach
Sometimes reaching to wipe can be difficult due to increased body mass, or edema. It might also be impossible to reach after a recent spinal or hip surgery.
Here are some ways to toilet when you’re unable to reach
- Modify your position
Changing your position won’t work for everyone, but you might try reaching from the front or partial stand to increase your reach.
Add safety rails to push up while you wipe or install a grab bar to find a better position.
- Use a toilet aid
Try a bottom buddy or other toilet aid to increase your reach. Toilet aides are a low cost option, but you might find it challenging to load the toilet paper on the device.
The bathroom buddy is one of the better toileting aides. The thumb switch makes it easier to grasp and release tissue paper.
- Use an adjustable bedside commode
Sometimes it’s difficulty to reach because of the shape or position of the commode. For example, a person may not be able to reach because the toilet seat is in the way, or the opening is too small.
If the toilet is the barrier, try an adjustable bedside commode to place over your toilet.
An adjustable bedside commode allows you to change the seat position. This is the opening shaped like a ”u” that allows you to reach in to wipe.
Instead of the toilet opening in the front, you can change it to be on the side or in the back. This will help you to wipe from the side or in the back. See link below.
Why toileting without assistance matters
Toileting is an activity of daily living, and in most cases, this activity should be done without assistance.
Losing the ability to perform your daily activities can be frustrating and may seem unbearable. When we give up and rely on others, we not only put our burden on others, but we become weaker and less interested in doing things for ourselves.
I’m not saying that this applies to everyone, but in my experience as an OT, most of my patients who think they can’t do their daily activities, usually can do them.
When to help with toileting
- Oxygen levels are too low to complete the task
- Cognitively impaired
It’s kind to be helpful, but it’s more helpful when we help others become independent rather than limit their ability to improve.
For someone who isn’t able to toilet themselves, try these techniques and see if any of them make a difference. You might even combine some of these techniques to make toileting easier.
I hope this was helpful. For more tips related to occupational therapy subscribe to my newsletter below.
David is the lead editor of OT Focus. He has been practicing as an Occupational Therapist since 2013. He specializes in acute care, hand therapy, and ergonomics.