Commodes are portable toilets mostly used by people with reduced mobility who are unable to use a conventional toilet.
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Commodes are used instead of a toilet and can be positioned in a place convenient for the user, for example, next to the bed, or downstairs in a house where use of stairs is difficult.
Although it is always preferable to use a conventional toilet whenever possible, a commode can be very useful and enable independent living with limited help.
Commodes consist of a frame supporting a toilet seat with a pan (disposable or washable) beneath to receive urine or stool.
They are available in many designs 12 with different features:
Static or mobile – some commodes are solid like a chair and others are lighter and mobile with lockable wheels. Mobile commodes (with their pan removed) can be wheeled over the conventional toilet for more privacy, or used as a shower chair if you have a wet room or accessible shower.
Adjustable height – this can be helpful to ensure that you achieve a comfortable position, particularly for efficient passing of stool.
Discreet appearance – traditional commodes are intended to be discreet by resembling normal furniture. They are often made from materials used for normal home furnishings e.g. wood, fabric, cane.
Easy to clean – other commodes are made from plastic and metal making them easier to clean. This is especially important in hospitals and care homes where contamination with faeces and cross–infection have been found to be a problem. 345
How well a commode would work for you will depend largely on whether you can use the commode safely (with or without help) and whether you find it an acceptable product.
There are some important questions to consider if you are planning to use a commode:
How mobile are you? - commodes are really for people with reduced mobility and can be difficult to get onto. You either need to be able to stand and turn or slide onto the commode. Very immobile people can be transferred using a hoist. Some commodes have removable or drop down arms so that they can be positioned next to the bed or chair for easier transfers.
Can you sit safely on the commode? - you may need someone to hold the commode while you sit down and while you are seated if you have postural instability and risk falling.
Do you feel secure on the commode? - commodes have been found to be rather unstable and uncomfortable 12
Can you manage independently or do you need help? - if you are unable to use the commode safely you will need a helper who can ensure you are seated safely and help you off the commode as soon as you are ready. People with disabilities often have poor upper body control and this is associated with an increased risk of falls 6
Can you fit comfortably on the commode? - some larger, sturdier commodes are available for larger size people but width is often restricted by side handles which are necessary for stability.
Do you find the idea of a commode acceptable? - people often find the look of commodes (even those designed to look like furniture) to be unacceptable especially in social areas, for example, a sitting room. People are concerned about lack of privacy, and embarrassment, unpleasant smells and the poor physical appearance of some designs 7
Using a commode in hospital? - health care professionals should make every effort to assist you to the toilet and to ensure that you are safe on the commode and have sufficient privacy. This is especially important if you are being wheeled from your bedside to the toilet 8
Commodes have a removable bowl or pan underneath the seat which can be lifted out to allow emptying of urine and stool into the toilet.
A full commode pan can be quite heavy and difficult to carry to the toilet without spillage.
Some commode bowls have a spout to make it easier to pour urine into the toilet.
To minimise smell, it is best to empty the commode after every use or as soon as convenient.
Older and traditional style commodes can be difficult to clean and efforts have been made to ensure newer styles are easier to clean thoroughly.
Cleaning commodes is a particular problem in hospitals 35 where cross-infection is a risk. If you are at home and have sole use of the commode then you don’t have to worry about cross-infection.
The commode pan should be emptied as soon as convenient and the pan cleaned as you would a conventional toilet using your usual products and an anti bacterial spray. Wiping around the body of the commode is recommended to reduce the risk of unpleasant odour.
If you know that you need to open your bowels but have very little warning then a commode might be useful for you.
If you have bowel leakage with no warning you will need to use either pads or a faecal device.
Commodes generally take up the same amount of space as a chair. However, some are much bulkier than others, particularly those intended to resemble furniture.
Commodes can be relatively expensive. If your need for a commode is likely to be short-term it may be possible to borrow one from a disability organisation or through your health care professional.
The cost of commodes varies according to the design and which country you live in, so it is not possible to give an exact price range.
They can be purchased directly through the manufacturer, by phone or mail order and on the internet.
Click on Worldwide for information about obtaining commodes where you live.
The main disadvantage is that you have a temporary ‘toilet’ in your room. If there is a delay in emptying the pan, urine may start to smell which, for some people, makes commode use unacceptable 7 This can be avoided by emptying the pan as soon as you have used the commode. Alternatively you could consider other options such as a chemical toilet.
The appearance of commodes makes them unacceptable for some people. 27 If the look of the commode is important to you, choose a commode designed to look like furniture.
Commodes can be associated with a lack of privacy, especially if you require someone to help you on and off the commode.
Some commodes have been found to be unstable and likely to tip backwards, and also uncomfortable 12 and so you are recommended to try out a range of commodes before making a purchase.
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