Technology-assisted toilets: Improving independence and hygiene in stroke rehabilitation

BACKGROUND AND PURPOSE: Dependence on assistance for toileting is a widespread problem for persons receiving healthcare. Technology-assisted toilets, which hygienically wash and dry the perineal region, are devices that could improve toileting independence in a variety of patients. The objective was to investigate whether technology-assisted toilets improve toileting independence, quality of life, and whether technology-assisted toilets can provide sufficient toileting hygiene in stroke rehabilitation. METHODS: This pilot study was carried out in a stroke rehabilitation unit. Thirty participants were recruited. Participants had a bowel movement and cleaned themselves using the technology-assisted toilet on one to three occasions. Participants rated their toileting before using the technology-assisted toilet and after each technology-assisted toilet use with the Psychosocial Impact of Assistive Devices Scale (PIADS). After each session, participants were rated for cleanliness. RESULTS: PIADS scores were analyzed from eight individual participants, five of whom completed the full protocol. PIADS scores were significantly higher with the technology-assisted toilet than with the participants’ regular toileting routine (p < 0.05). Technology-assisted toilets cleaned effectively in 73% of cases (16/22, p < 0.05). CONCLUSION: Technology-assisted toilets improved stroke patients’ psychosocial outcomes compared to standard toileting and completely cleaned participants in the majority of cases. A larger study should confirm technology-assisted toilet’s benefit in stroke rehabilitation through improved independence and hygiene.