Toilets can be difficult to use if you have a mobility problem or another disability. This can result in incontinence even when bladder and bowel function is normal.

You may have difficulty using the toilet for one or more reasons; for example if you cannot:

• reach the toilet quickly or safely - this is a particular problem if you have bladder or bowel urgency and leakage

• remove and replace clothing - see section clothing

• sit safely and comfortably on the toilet

• clean yourself - see section on bottom wipers

• get off the toilet.

It is generally accepted that, whenever possible, people should be enabled to use the toilet rather than rely on toilet alternatives or incontinence products.

There are several products designed to assist with using the toilet. These fall into two broad categories:

• products which modify the toilet so that it is easier to use - such as a raised toilet seat or toilet frame

• products which provide alternatives to the toilet - such as commodes, bedpans and hand-held urinals

Click on toileting aids for women or toileting aids for men for detailed information about products to help you.

Installation or updating of facilities and aids in many contexts can help promote independence and continence. However, research has highlighted that even in nursing homes toilet facility design often does not facilitate privacy and can pose risks for safety related to seat height, inadequate handrails and lack of space.

Occupational therapists are well-placed to make recommendations for toilet and bathroom areas, even without the need for an actual home visit, using digital photographs taken by family members and clinical information about the patient.

The toilet environment

Sometimes the toilet environment itself can lead to a reluctance to use the toilet; for example, the toilet may be cold, too small to easily move around in, not private or a long way away. This can be the case in public toilets or those in the workplace.

If you have particular needs regarding toilet use it is reasonable to discuss these with appropriate people at work. For example, if you do clean intermittent catheterisation and need a water supply within the toilet or if you have urinary frequency.