Mobile shower commodes

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Clinical rationale

A mobile shower commode may be used:

  • for showering and toileting, and can facilitate independence in intimate hygiene tasks such menstrual management
  • to reduce the risk of a shoulder overuse injury associated with multiple transfers each day – by using a mobile shower commode rather than transferring on and off the toilet and on and off a shower chair each day a person can reduce the number of transfers that they do from seven to three
  • to promote carer workplace health and safety when assisting a person who is dependent in self-care.

Individual characteristics

  • Method of transferring
  • Length of time taken with toileting and showering
  • Level of independence with toileting routine
  • Pressure relieving method
  • Propulsion method
  • Skin integrity
  • Travel requirements
  • Posture – whether they require support
  • Medical history e.g. postural hypotension.

Features to consider

Commode seats

  • Important to maintain good pressure care
  • Seat is designed to distribute as much pressure through the greater trochanters and thighs as possible whilst the ischial tuberosities 'float' in the aperture and therefore remain free from pressure
  • Note: Accommodation will need to be made if there is a history of greater trochanters pressure injuries
  • Double foam-layered seat with foam wrapped around the inside edge of the aperture is also recommended for enhanced pressure care
  • Consultation assessment with the supplier is recommended for custom commode seats, with the involvement of an experienced occupational therapist
  • If a custom commode seat does not provide adequate pressure care, cushions can be added to the seat, such as an air-filled commode cushion or a padded gel cushion.

Other features

  • Folding frame for ease of transport
  • Fixed frame for greater stability
  • Self-propulsion (two large rear wheels) for independent mobility; large rear wheels can also assist a carer to push the commode
  • Attendant propulsion (four small castors) when a person is unable to propel themselves, or for use in small space if assistance is available to move the commode
  • Tilt-in-space to help manage postural hypotension, for pressure management or to stabilise posture. This is usually required by people with a high-level injury
  • Custom-made pressure reducing foam seat with vinyl hand-made cover to help maintain skin integrity; the seams are underneath the seat, reducing the risk of damage to the skin
  • Smaller aperture (distance from IT to IT + 50mm) located towards the rear of the seat (50mm from the back of the seat) recommended to promote neutral position of pelvis, to help prevent pelvic rotation and to reduce pressure around the coccyx area
  • Extended aperture to accommodate male genitalia
  • Additional padding around aperture to help maintain skin integrity
  • Cut-outs (full at front or rear, or partial at sides) for ease of access for bowel care and showering
  • Seat-to-back support angle (usually 3°) can be increased to 5° or 7° to enhance posture or to accommodate spasm; can be ordered with angle adjustment
  • Padded backrest may be required for greater comfort or pressure management
  • Higher back rest or removable backrest extension (one and two strap extensions available) for people with higher level injuries
  • Head supports for those with little or no head control
  • Arm supports (e.g. troughs) for upper limb positioning and protection
  • Push handles at the rear of the backrest may assist a person to maintain balance by hooking an elbow over the handle
  • Foot plate angle and orientation can be adjusted to accommodate musculature changes and lower limb position
  • Elevating leg supports with calf support for management of oedema
  • Padded leg supports for improved pressure management of lower limbs
  • Shortened leg supports for those with short limbs
  • Anti-tip bars to enhance safety
  • Pan and pan carrier if person unable to access the toilet or travels.

Further information

Clinical practice tools

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