Case study - how equipment helped Geraldine


Geraldine lives with her husband in a small flat which has a separate bathroom and small toilet. She has rheumatoid arthritis affecting her hips, hands, knees and shoulders which makes managing the toilet independently difficult. Currently she is relying on carers to assist her while she is on the toilet, including flushing the toilet. She had stopped going out to her local town because of the problems of finding an accessible public toilet.

Her concerns

Geraldine finds it depressing relying on people to assist her while using the toilet, cleaning her and flushing the toilet particularly when she has to disturb her husband at night. She is relying on carers to shower her with an overbath shower which means she is not able to shower when she wants.

The solution

She contacted her local social services for a review assessment by an Occupational Therapist. The Occupational Therapist reviewed how Geraldine was managing using her toilet with carers. She agreed to:

  • arrange for a larger flush control which Geraldine could manage herself using her elbow,
  • to provide two diagonal positioned grab rails on the toilet walls to assist her standing from the toilet
  • to provide a bottom wiper

In the longer term, the Occupational Therapist will arrange for a Disabled Facilities Grant to combine the bathroom and toilet together to provide a level access shower, and the installation of a toilet with integral warm water washing and hot air drying facilities.

The Occupational Therapist suggested Geraldine could purchase a portable bidet and gave her information about the RADAR toilet scheme so she can access public toilets when she is out.

Why were these adaptations and equipment chosen?

By using the larger flush control Geraldine can manage the toilet herself using her elbow against the larger surface area. The two diagonal positioned grab rails allow Geraldine to rest her arms on the rails for support, as she stands up from the toilet. The bottom wiper allows Geraldine to clean herself independently and release the toilet paper into the toilet after use. The portable bidet allows her to wash herself and then her carers are able to empty it for her.

The planned level access shower will allow her to shower independently, according to her own timetable but she knows she can receive assistance from carers if she needs it in the future. The installation of the toilet with integral warm water washing and hot air drying (with elbow controls) will enable her to wash, and dry herself independently again.

The outcome

Geraldine was delighted with the Occupational Therapist’s plan. She felt her self esteem and confidence improved almost immediately, as she has a higher level of personal hygiene and the RADAR key gives her confidence to go out again with friends. She is looking forward to the planned adaptations in the future.

To view the equipment solutions and information on the National Key scheme listed above, please click on the product images below.

You can find a map of accessible public toilets from Need a loo.

For further information you may wish to read our advice on:
- An assessment with an occupational therapist
- Equipment provision through local authorities and direct payments
- Funding adaptations
- Cleaning yourself after going to the toilet
- Public toilets
- AskSARA's toilet section.
AskSARA is the Disabled Living Foundation (DLF)'s free online self-assessment tool. If you choose its 'Using the toilet section' AskSARA will ask you questions related to the use of your toilet and then offer relevant advice, product suggestions and supplier details.