Bariatric Palma
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Catalog excerpts

Bariatric Palma - 1

Considerations in toileting provision for bariatrics. Guidance for occupational therapists. A Closomat White Paper

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In the UK today, over a quarter of adults are classed as obese based on a Body Mass Index (BMI) of 30+. The number of obese adults has nearly doubled since 1993 (Baker, 2021). Guidance and considerations in toileting provision for bariatrics

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Bariatric toileting Toilet lifts Shower chair Wash and dry (shower) toilet Bariatric toilet seating Douche spray Our products are customisable and flexible We’re a UK-based manufacturer, and on hand to help Weight load and body mass Guidance and considerations in toileting provision for bariatrics

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Bariatrics refers to a branch of medicine that focuses on causes, prevention and treatment of obesity, defined by weight. Many of the functional challenges faced are caused by a plus sized person’s body shape who may or may not be bariatric in weight. Much of the content in this paper is appropriate for bariatric services or individuals considered plus sized. Increased body mass has an impact on a person’s ability to participate in daily life, even before associated health issues are taken into account. Everyone goes to the toilet on average eight times a day. Adaptations to ensure safe and...

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If difficulties with using the toilet are identified following an assessment, a thorough understanding of the barriers to independent toileting should be established. A person’s weight, and corresponding size, can influence mobility and agility. If people need support to lower or raise themselves when transferring on and off the toilet, the basin is often used as a support and the provision of a grab rail may be fitted as an alternative. Because of the person’s weight, consideration should be given to the load placed upon the grabrail and whether this method of supporting safe transfers is...

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Toilet lifts Toilet lifts. If the person can weight bear and mobilise and is having difficulty with toilet transfers, a toilet lift should be considered following a thorough assessment, as it may provide appropriate support. A toilet lift is fitted over the toilet and replicates the natural movement of standing and sitting. They assist people with limited mobility transfer on and off the toilet with minimal or no carer assistance. There are two types available: the tilting toilet lift which assists with sit to stand in a more normal ‘tilting’ motion; and the vertical lift, useful for people...

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Shower chair Shower chair. A shower/toileting chair should have an appropriately positioned opening in the padded seat to enable access to the toilet pan and douche/drying mechanism without the person having to transfer on to the toilet from the chair. The width and weight limit of the shower chair should be reviewed for suitability for people with a bariatric weight/size. Guidance and considerations in toileting provision for bariatrics

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Hoist. If a person cannot weight bear and transfer, even with assistance, a hoist may be required – taking into account manual handling guidance and weight limits of equipment. Variants include mobile hoists and ceiling track hoists. Choice should be based on a risk assessment, and whether it is for: • single or multi-person environment A • or use in one room or beyond F Single-track system • he layout of the room i.e. whether ceilings and walls T are robust enough to bear the necessary load, and the positioning, and style/protuberance of fixtures and fittings. • he number of carers...

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Weight loading and body mass If a person is having difficulty with intimate cleansing after using the toilet, the provision of a wash and dry toilet will often be an appropriate solution to achieving effective cleanliness, independence and reduction in reliance upon carers for assistance. There are two main influencing factors when working with a person of bariatric weight or indeed plus sized: weight loading and body mass. Weight loading: The toilet itself needs to have an appropriate weight limit for the person/people using it. The seat and brackets used also need to have a suitable...

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Wash and dry (shower) toilets Wash and Dry Toilets were invented by Closomat over 60 years ago to provide solutions for people having difficulties with toileting and, in particular, with cleaning themselves afterwards. Cleaning with toilet tissue requires manual, mental and physical dexterity, flexibility, and balance. It requires intimate hand: body contact, either by the person or their carer. As the wash and dry toilet effectively washes the anal area, it eliminates the potential for faecal smearing and/or cross-contamination under fingernails etc. Cleaning with the function of a wash...

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Bariatric toilet seating The Big John seat. The size of the seat may need to be larger, to accommodate increased body mass. A bariatric seat tends to be deeper – (60mm/2.5ins) and wider – 486mm/19ins compared to 410mm/16ins. Toilet seats are available which will safely bear up to 363kg/57st. For larger-bodied people, a bariatric bench may be more comfortable. This is a padded full toilet seat or horse-shoe seat mounted on a steel frame with the bench positioned over the top of the toilet. Flat-topped versions and armrests are available. A bench will usually hold up to 349kg/55st as...

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Douche spray Douche spray. The positioning of the douche can be set in most cases to personal requirements, to achieve the fundamental aim of cleaning the genital/anal area. Once set, it is not likely to be adjusted unless the person’s needs change. The positioning, and angle, of the douche within the pan is set at point-of-manufacture and varies between models of wash and dry toilets. Expert advice from one of Closomat’s product specialists will facilitate an individualised recommendation. Ensure there is adequate clearance between the douche and the bottom of the seat for effective...

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Operation. It is important that the person is able to operate the controls for the wash and dry toilet independently, if possible. The cognitive function of the person should be fully evaluated to ensure that the most appropriate method of operation is chosen. Some units have complex controls positioned on a handset which can be located to the side of the unit and wall mounted. A flush which incorporates a wash and dry function is located on the cistern of the Closomat which can be operated whilst seated. There are also other options such as a pressure sensitive switch which can be operated...

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