A commode is a portable toilet substitute designed to increase accessibility for individuals who experience difficulty reaching or using a standard bathroom due to limited mobility. The primary purpose of integrating a commode into daily care is to enhance user safety by reducing the risk of falls associated with navigating to the bathroom, while also maintaining personal independence and dignity.
Preparing the Commode for Use
Before a commode is used, its structural integrity and placement must be carefully checked. Adjust the commode height so the user’s feet can rest flat on the floor, ensuring their hips and knees are bent at approximately a 90-degree angle for optimal sitting and standing leverage.
The commode must be placed on a level, non-slip surface, and the area around it should be clear of clutter or rugs that could present a tripping hazard. If the commode is equipped with wheels, the locks must be firmly engaged before the user approaches the device. Finally, secure the waste receptacle snugly beneath the seat and line it with a disposable commode liner or a small amount of water to ease disposal.
Safe Transfers and Positioning
For independent users, the process involves backing up slowly until the backs of the legs touch the commode frame. The user should then place their hands firmly on the armrests, lean their torso forward slightly to shift their center of gravity, and slowly lower themselves onto the seat.
When assisting a user, the stand-pivot technique is commonly employed. Position the commode at a slight angle to the bed or wheelchair, and place a gait belt securely around the user’s waist for a safe handhold. The user should scoot to the edge of the seat with their feet flat on the floor and knees bent, angling their heels toward the commode.
The caregiver should use their legs, not their back, to facilitate the movement, maintaining a wide base of support. The user is encouraged to push off the surface they are leaving while the caregiver provides steady support with the gait belt. A controlled pivot of 90 degrees brings the user into position to back up to the commode seat.
If the user has weakness in their legs, the caregiver can use the “knee block” technique, placing their own knees outside or between the user’s knees to prevent them from buckling. The user should then reach back for the commode armrests before being gently lowered onto the seat, ensuring they are centered and stable. Upon completion, the user repeats the sequence in reverse, leaning forward to stand.
Essential Hygiene and Cleaning Protocols
Immediately following use, the waste receptacle should be removed and emptied into a standard toilet. Rinse the bucket thoroughly with hot water, then sanitize the interior and exterior using a mild disinfectant or chlorine-based solution.
For routine cleaning of the commode frame, caregivers should always wear disposable gloves and an apron. First, use a neutral detergent and warm water to remove visible soil. This must be followed by a disinfectant, such as a 1,000 parts per million chlorine solution.
Cleaning should be executed systematically, starting from the top of the commode and working downward to the legs and wheels. High-touch areas, including the seat, lid, and armrests, require extra attention and adequate contact time with the disinfectant. All surfaces must be wiped until dry or allowed to air-dry completely before the next use, as moisture can support bacterial growth.