Can A Bedside Commode Be Used Over A Toilet ?

by | Beginners Info, Personal Hygiene, Safety

Roughly 18 months ago, my now 90 yr old mom had hip replacement surgery, and I had the job of finding the best type of raised toilet seat for her so she wouldn’t strain, or injure herself after the operation. After one or two false routes, I chose a portable bedside commode, which is still being used everyday, and turned out to be probably our most useful and versatile purchase to date.

Can a bedside commode be used over a toilet seat ? Yes, a portable bedside commode can be used over a toilet seat, either as a raised toilet seat, or as a safety frame around the toilet just for help with sitting, or standing.

What is a bedside commode ?

As I said, my mom has been using what is a portable bedside commode for over 18 months now, as a raised toilet seat in our bathroom.

Bedside commodes can be divided into a few various types –

Foldable bedside commodes which are very lightweight and can be folded away when not in use if the person has a small bedroom.

3-in-1, or All-in-1 bedside commodes which are portable bedside commodes which have a number of uses, other than just as a bedside commode.

These can be used –

  • a bedside commode
  • over the toilet as a raised toilet seat
  • as a toilet frame
  • as a shower seat if they are waterproof

The 3-in-1 bedside commodes usually fold as well, but they are structurally different from the simple folding commode, have more functions, and also hold a greater weight.

Drop arm bedside commode chair – this commode has drop armrests which can be moved out of the way if the user has to slide over to the side, to get on and off the commode. 

These can also be very practical if you need to help an elderly parent with cleaning themselves, as fixed armrest may get in your way.

Transfer or rolling bedside commodes – these are bedside commodes on wheels.

The commode can be used as –

  • a transport chair
  • a commode
  • placed over the toilet

As you can imagine, if you are caring for an elderly parent who has trouble walking, being able to wheel them on a commode to the bathroom if they are agreed, can greatly reduce odor control problems in their bedroom.

You need to be careful that you pick the correct height commode for your toilet, as some models are fixed height, and you have to be able wheel to it over the toilet bowl.

Shower chair transport commodes 

These are –

  • a shower chair
  • a transport chair
  • a commode
  • certain of these commodes will also fit over a toilet as a raised seat as well

For all these bedside commodes you need to check the weight limits. For heavier individuals the commodes will be called bariatric commodes, and you should be able to get these in all of the types of models mentioned above, except for the simple folding commode which takes less weight.

Some of the commodes also have models with higher raised seats for taller people. 

Bedside Commode or raised toilet seat ?

At the time of my mom’s surgery we had to decide whether or not my mom was best using some sort of frame with a seat over the toilet, or a type of riser or raised toilet seat which was attached to the toilet bowl.

And I am guessing that this is the same question that you are asking yourselves if you have elderly parents.

The first thing you will need to do, is to take a look at the types of risers and raised toilet seats that are available, if you are not sure you want to use a bedside commode. 

I have tried to break them down in a way that is simple to understand, and that is by how they are attached to the toilet, or if not, how they are elevated over the toilet bowl.

Bedside commode over toilet seat compared with the different types of raised toilet seat

We can immediately divide raised toilet seats into two groups –

  • those where you use your own toilet seat
  • and those where you remove your toilet seat altogether

Systems using your existing toilet seat  –

1/ Risers

  • these fit between the seat and the toilet
  • you remove your seat, place the riser on the bowl, put your seat on top of the riser and bolt everything down again
  • some risers come with a hinge in them just like seats do, so that you can lift and clean
  • risers can come with or without armrests
  • they come as standard and elongated
  • you can get risers in heights from 2 – 4 inches

Risers are very solid due to the fact that they are bolted to the toilet along with your seat and some models also come with armrests, which will make it much easier for elderly parents with balance and mobility issues, or visual impairments to sit down.

Compared with a bedside commode –

  • risers take more work to install than a bedside commode
  • you can’t change the height, as you can with the commode
  • the commodes give you around 5 height adjustments in increments of an inch at a time
  • some models do come with removable armrests
  • both risers and portable commodes are very solid

Two examples of these risers are –

  • Nova 3 1/2 inch toilet seat riser
  • Maddak 4 inch hinged seat riser

2/ Clip On combi seat/risers

  • clip onto your existing toilet seat
  • you squeeze them and place the inside rim in the opening of your seat
  • hold themselves in position through the tension
  • there are no clamps or locks to fasten them
  • do not have any form of armrest or handle to help with support

Some examples of this are –

  • Ability Supertstore 4 inch Clip On Raised Toilet Seat
  • Performance Health 4 inch Clip On Raised Toilet Seat

Personally, due to the fact that there is no real locking device, and there are no armrests, I wouldn’t like my elderly mom to be using one of these seats.

With elderly adults who aren’t too strong, they can sit back quite hard when they are tired, and I would want the the most solid of options for this, and armrests or handles for them to grab onto.

Compared with a bedside commode –

  • very quick to install, but nothing like as solid as a commode
  • they have very specific weight limits as they aren’t locked on, commodes can take far greater weight
  • no armrests for support like a bedside commode
  • difficult to hold onto when getting up and down – commodes are far easier
  • come in fixed heights – 2 – 4 inches
  • they cannot be height adjusted like bedside commodes
  • lack all of the versatility of a bedside commode

Some examples of this are –

  • Ability Supertstore 4 inch Clip On Raised Toilet Seat
  • Performance Health 4 inch Clip On Raised Toilet Seat

Systems where your existing seat is not used  –

3/ Seats with spacers

    • this is a seat with small legs or spacers on it’s underside
    • seats come in 2 inch or 3 inch high models
    • to install you remove your old seat and replace with the new one and bolt it on
    • comes with, or without, lids
    • comes with, or without, an opening at the front to facilitate wiping
    • comes in standard, or elongated models
    • does not come with armrests

    Due to the fact, like risers, that these seats are bolted to the toilet in the same way as your original toilet seat they are structurally good and solid.

    These seats have no armrests, or handles, for support, and this could make it very difficult for elderly parents with mobility, or balance, issues to get up and sit down. 

    For people who may have visual impairments, like my mom, it’s easier to have some kind of armrest to reach back and hold onto.

    You could, of course, argue that grab bars can be placed on the wall if the toilet is in the corner, or a safety frame, but this means you will need to purchase two, or three, pieces of equipment, instead of just the one.

    Compared with a bedside commode –

    • it is more complicated to install than a bedside commode
    • they are bolted to the toilet which makes them solid
    • no armrests for support like the commodes
    • they only come in 2 and 3 inch models, so are lower than a bedside commode in most cases
    • you cannot adjust the height once you have bought one, whereas a commode usually has 5 adjustments for seat height
    • you have to buy a specific model – elongated or standard – but commodes should go over any toilet
    • like bedside commodes you can get them with a lid to the seat

    An example of these seats is –

    • Centoco 3L440STS-001 raised toilet seat with lid

    Elevated or raised seats

      • 2 inch, 3 inch, 3 1/2 inch, 4 inch, 5 inch and 6 inch models are available
      • there is no one way to install these units
      • certain models have armrests, or handles, and others don’t
      • on some models the armrests, and handles, may be removable and adjustable
      • some models have side clamps
      • some models have front locking
      • some have a form of locking and a rim at the back which slides under the rim of the inside of the bowl to reduce any wobbling of the seat
      • it’s important to check if the seat fits all of toilet sizes or not
      • depending on the way the raised seat is attached to bowl the weight limits will vary

       

      I’ll be distinguishing between the various types, by the method that they use to attach to the toilet, and the ways they do, or don’t, lock onto the bowl.

      4/ Bubble seats –

      • slot onto the rim of the toilet bowl
      • often have “sticky grip pads”
      • have no clamps, bolts or locks
      • have a lip around their inside edge which goes a few inches into the bowl to help reduce movement
      • sometimes have a lip at the back of the seat slotting under the bowls inside rim to increase stability
      • have models for standard toilet bowls
      • have models for elongated toilet bowls
      • do not have armrests

      Due to the fact that these seats are not attached by any locking, or clamping systems, I wouldn’t want my elderly mother using one.

      They also don’t have armrests, or handles, for the person to hold onto as they sit down on, or stand up from, the seat, which again is not helpful to elderly individuals with either mobility, balance or vision related problems.

      Even with a grab bar, I don’t think they are suitable as a longterm solution for the elderly.

      Compared to a bedside commode –

      • they are almost as easy as a bedside commode to install
      • they are nothing like as a stable, or solid as a bedside commode
      • you cannot adjust the height as you can on a bedside commode
      • there are no armrests, or handles, as on a commode
      • only some models fit all toilets, unlike a bedside commodes which fit over all toilets
      • I have not seen any with a seat lid, as on a bedside commode

      Examples of this type of seat is –

      • The NRS Comfort Raised Toilet Seat
      • AquaSense Portable 4 inch Raised Toilet Seat – standard toilets
      • HealthSmart  Portable 4 3/4 inch Raised Toilet Seat – universal

      5/ Seats which have side clamps and front “bracket” –

      • this type of seat has two fixings, one on each side of the seat towards the rear
      • to fix it to the toilet bowl side clamps are to grip on to the bowl
      • a small lip at the front called a “front bracket” is also used to fix the seat at the front
      • are available in heights form 2 to 6 inches
      • are available with or without lids
      • are not adjustable in height
      • have no armrests or handles
      • some are for all toilets sizes
      • some are for elongated toilets
      • some are for standard toilets
      • have different weight capacities 

      This type of seat does at least have elements which are gripping the the toilet bowl by applying some kid of pressure.

      Again, though, if you are buying one for an elderly, or frail, parent there are no armrests, so you will have to buy, and install grab bars, or a safety frame, to give your parent the extra support they will require.

      Along time ago I bought a seat of this type for my mom, but when we tried it we found that it still moved all over the place.

      It was also with this purchase that I became aware of how hard it would be for an elderly person to sit back onto a seat without handles or armrests.

      Compared to a bedside commode –

      • these raised seats are almost as easy to install as a bedside commode
      • they are nothing like as strong, or as solid, as a bedside commode
      • they do not come with adjustable heights like a bedside commode
      • you can get them with lids like a commode
      • none of these seats come with armrests, or handles, as do the bedside commodes
      • only some of these seats will fit most toilets, whereas a bedside commode will fit over any normal toilet bowl

      Examples of raised seats using this system are –

      • Aquasense 4 inch Raised Toilet Seat with lid
      • Vaunn Medical Clamp-on 4inch Raised Toilet Seat
      • Carex Universal 4 1/2 inch Raised Toilet Seat with Safe Lock
      • PCP 4″ Raised Toilet Seat
      • Drive Medical 6 inch Raised Toilet Seat with Lock

      6/ Front Locking raised toilet seats –

      • have a type of clamp located at the front of the seat to fix it to the toilet bowl
      • have a small lip at the back of the seat, which sticks out and slots under the rim of the bowl of your toilet to give extra stability
      • heights of the seats will vary from 4 – 5 inches but are not adjustable
      • most have armrests or handles, some are adjustable and others are also removable
      • are compatible with most toilet shapes, as they clamp to the front edge only
      • have different weight capacities depending on the model, but these are designed to be stronger than the previous types
      • do not have lids

      The front locking seats are more expensive than the other seats that I have listed so far, and are a lot more solid.

      The fact that they have handles, or armrests, makes them a lot easier to sit down on, but I wouldn’t really suggest one for an elderly parent with balance, mobility or sight issues unless there was either a couple of grab bars or a safety frame around the toilet. I still prefer either an elevated seat in a frame, or a bedside commode for weaker elderly adults.

      Compared to a bedside commode –

      • almost as fast to install if you don’t have to remove your toilet seat and lid
      • not as strong as a bedside commode
      • most of the raised seats with front locking do come with armrests, or handles
      • you can’t adjust the height of the seats as you can with the bedside commode
      • they don’t have a lid as does the seat on a bedside commode
      • like bedside commodes, front locking seats are generally compatible with most toilet bowl sizes

      Some examples of this type –

      • Carex E-Z Lock 5 inch Raised Toilet Seat with Arms
      • Medokare 4.5 inch Raised Toilet Seat with Arms
      • Vive 5 inch Raised Toilet Seat with Padded Handles

      7/ Raised toilet seats with legs

      • this is a raised toilet seat very similar to the previous front locking seats, except they have 4 legs
      • legs adjust to the height of the bowl
      • the seats add around 4 1/2 inches in height
      • they have armrests
      • the seat either sits on the bowl with an inner rim which slots inside the bowl, or another design features a front locking system
      • can take greater weight than seats without legs

      These seats certainly are more solid than the seats without legs, and the armrests would make it a lot easier for an elderly person to use.

      Compared to a bedside commode –

      • these seats only take a minute or so longer to install than a bedside commode
      • some models will adjust the height above the bowl by adjusting the leg height, some attach to the bowl and give one raised height only
      • like bedside commodes they are compatible with most toilet bowl sizes
      • they do not come with a lid

      Some examples of these seats with legs –

      • Maddak Tall-Ette Elevated Toilet Seat With Legs
      • Mobb Raised Toilet Seat With Legs

      8/ Safety frames with elevated seats

      • safety frames with a raised seat are placed over the toilet
      • to install you just put your lid and seat in the upright position and place the frame over the toilet
      • some frames go as high as 26 inches from the floor
      • the seat is attached to the safety frame so that the frame takes all the weight of the body
      • there is no lid to the seat
      • all the frames with seats have adjustable height – the legs are height adjustable
      • the frames also have armrests 
      • the will go over all toilets
      • there are different weight capacities – including bariatric for heavier individuals

      There really is not a lot of difference between these and commodes in terms of structural integrity and support.

      The seats distribute the weight over the four legs, and there is no wobbling, as is often the case with raised seats which actually attach to the toilet bowl. For elderly parents these are a very good choice.

      Compared with bedside commodes – 

      • it is just as quick to install as a bedside commode over the toilet
      • they both are supported by a metal frame
      • each has adjustable legs
      • both safety frames with raised seats and bedside commodes have armrests offering lots of support
      • they just lack the versatility of the bedside commodes functions as a chair, or commode away from the toilet

      Some examples of frames are –

      PCP raised toilet seat and safety frame 2-in-1

      Aidapt President raised toilet seat and frame 

      Aidapt Bariatric Solo Skandia raised toilet seat and frame

      Lattice commode toilet seat and frame 

      For the elderly, or for anyone else for that matter, these safety frames with raised seats, or portable bedside commodes, are really the only options which afford total support and safety, except for special toilet lifts which are far more expensive and come with electrical, pneumatic, or hydraulic assistance systems, to raise and lower the most frail of people.

      What to consider when choosing the type of raised toilet seat for an elderly parent ?

      You need to consider what is the appropriate type of seat for the your elderly parent or loved one, and to do that you need to be asking yourself a range of questions –

      • what is the reason for using the seat
      • what is the age of the user
      • if it is a post-operative need, what is the user like physically in the rest of their body
      • how strong are they
      • is the user frail
      • is the user overweight – will you need a bariatric seat
      • does the user need an extra wide seat
      • how is their sense of balance – do they lurch a lot
      • how confident is the person moving backwards
      • how good is their eyesight
      • will the person need handles
      • do you think they have the strength to sit back slowly without jolting the seat
      • what is around the toilet
      • how much room is there for maneuvering
      • will they be using a walker to back up into position

      If you decide to get a  bedside commode –

      The following is just some tips about how to –

      • set up the commode
      • how to clean the commode
      • general maintenance of the commode

      How to set up a bedside commode over a toilet

      To set the commode up over a toilet –

      • remove the pale from under the seat of the commode
      • if you have a small toilet you may wish to remove the backrest from your commode – just push the buttons on the two ends of the back rest bar and slide the bar out
      • lift the lid and seat of your toilet into their upright position
      • place the bedside commode next to the toilet to see if your need to adjust the height the legs of your commode to place it over the toilet
      • to adjust the length of the commode legs you just push in the metal buttons and adjust the length of the commode leg
      • always have the legs all the same length for stability and safety
      • don’t adjust the height of the legs, so that when seated the user’s feet don’t touch the floor – this can cause people to fall when they stand up – most of the foot should be on the floor when the user is seated
      • place the commode over the toilet once you have the right seat height
      • lift the seat and lid of the commode and insert the commode splash guard, and put the commode seat and lid down again – you don’t have to use the splash guard if you don’t want to, especially if the seat is only an inch or so above the bowl

      How to clean a bedside commode

      To clean a frame or commode

      • clean and then disinfect
      • start by removing the armrests, the seat, the seat lid and  the splashguard and cleaning them one by one with a non-abrasive household bathroom surface cleaner and wipe them off
      • next you need to disinfect them with a household disinfectant
      • make sure to pay particular attention to the armrests and seat as this is where the skin has the most contact
      • the underside of the seat, the metal bracket holding the splashguard and the splash guard are the areas which can get soiled, so they have to be throughly cleaned and disinfected as well
      • rinse and wipe off with a dry cloth
      • then clean the frame, disinfect, and wipe and dry it off
      • check that the seat is not cracking anywhere

      Maintenance

      As you clean the bedside commode check –

      • that the joints aren’t rusting on the frame if it’s a steel frame
      • that there are no cracks in the plastic seating, as this could break and cause an painful accident
      •  that the rubber tips on the legs are working – if you need to replace them they are called “ferrules” and can be found easily online
      • make sure that the metal buttons/ pegs, if spring loaded, are securely engaged on the legs, and are are sticking out properly and can’t move and cause the leg to change it’s height
      • make sure that any parts which click together are properly fastened, especially as you will need to remove bits to clean them properly

       

      Summing up…

      Bedside commodes are very easy to use as raised toilet seat, they install in seconds over the toilet and provide a secure very stable seat.

      Along with safety frames with elevated seats, I personally feel that bedside commodes (3-in-1) give the most amount of comfort, and security, to an elderly parent, or loved one, who needs a raised toilet seat.

      If the person using the seat is very frail, it is very useful to also have a walker for them to back up to the toilet with, as they can transfer their weight from one piece of equipment to the other, as they sit and as they stand up.

      As I have said, my mom has been using one now for around 20 months and loves it – she actually find the commode seat more comfortable than our actual toilet seat, which I feel may be taking it a bit far !

      I hope this helps, and good luck !

      I’m Gareth and I’m the owner of Looking After Mom and Dad.com

      I have been a caregiver for over 10 yrs and share all my tips here.

      Gareth Williams

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      Article Name
      Can a bedside commode be used over a toilet ?
      Description
      Yes a portable bedside commode can be used over a toilet, either as a raised toilet seat, or as a simple safety frame to help the user with sitting and standing. How does it compare to other raised toilet seats, and how to choose ?
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      Lookingaftermomandad.com