The world of raised toilet seats is perhaps not the most fascinating one, but it certainly can be a bit confusing. There are enough different types, names and ways of locking onto the toilet, that for my mom we had to try a number of different types until we were happy. Mixed in with raised, or elevated, toilet seats there is also the safety frame, and the safety frame with a raised, or elevated, seat. So, I am hoping to shed a little light on the subject.

What is the difference between a raised toilet seat and a safety frame ? A safety frame is a support which is placed over the toilet to help with sitting and standing. A safety frame with a raised toilet seat is a frame with an integrated seat which is placed over the toilet and not attached to it. All other types of raised toilet seat are attached to the toilet bowl itself.

So what are the main differences ?

•  All of the risers and raised toilet seats, without legs, are fixed to the toilet seat, or to the toilet bowl.
• Two-legged safety frames bolt to the toilet and are there just as a support rail to hold onto when sitting and standing.
• Four-legged safety frames which act just as a support frame, to help with sitting and standing, are not attached to the toilet at all, and are simply stood over it. The safety frame without seat, just to confuse things even further is often referred to as a toilet rail.
• Safety frames with an integrated raised seat have four legs and do not attach to the toilet at all. The frame is stood over the toilet in such a way as the seat is suspended above the bowl in the best possible position.
• These frames with seats are normally called safety frames with raised, or elevated seats.
• All types of safety frame, with or without a seat, have adjustable height – usually 18 – 23 inches. The seats which attach to the seat or bowl almost exclusively come in ranges of different models with fixed heights from 2 – 6 inches.
• What sets the frames with seats apart is their stability and the support they give to people who may be elderly, and lacking in strength and coordination. The large armrests make it ver easy to reach back to them, and the fact that they don’t wobble is very much a confidence booster to someone who is already having a terrible time trying to go backwards and sit down with pain or other discomfort.
• Risers with armrests are the only raised seat which can compete for stability as it is bolted to the toilet but the size of the armrests doesn’t really match that of the safety frames.
• It is of course possible to use a safety frame in combination with a raised toilet seat, to give greater support with sitting down and standing up.

What are the differences between the raised toilet seats and the safety frame with an integrated raised toilet seat ?

The raised toilet seats which attach to the toilet break down into two groups – 

• those which use the seat
• those which use the bowl

Raised toilet seats which attach to the seat

Risers

The riser actually is sandwiched between the seat and the bowl, so I had to cheat a bit there.

• strongest of the devices which attach to the toilet as they are bolted
• the installation is not too difficult
• can come with armrests
• have different models for different toilet shapes
• come in heights of 2 – 4 inches

Risers with armrests are very solid and if combined with a grab bar on the wall I think they are reasonably safe for the elderly.

Some examples –

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

Compared to a safety frame with an elevated seat –

• longer to install
• the frame can go over any size toilet
• the frame has a range of at least 5 inches, of 1 inch increments, in height adjustments and some have 8 inches
• the frames have larger armrests for the elderly to grab ahold of

Clip – on combi seats/risers

• clip onto the seat and hold on through tension
• no fixings or bolts to fasten them on
• no armrests on any models
• come in a range of heights from 2 – 4 inches
• the different seats vary in weight capacity

Some examples of this are –

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

Compared to a safety frame with an elevated seat –

• very quick to install as well
• can’t take anything like the weight that a safety frame can
• are not a long term solution like a safety frame with an elevated seat
• can’t give the support that armrests on a frame do
• don’t have the advantage of adjustable height
• they fit with most toilet seats, as do the safety frames

Raised toilet seats which attach to the bowl

Tall seats, or seats with spacers

• replace your existing seat
• bolt to the toilet
• seats with small wedges or legs on the underside – 3 2n 3 inches tall
• come in fixed height only
• can be bought with or without lids
• do not come with armrests or handles
• can be bought with an opening at the front to help with wiping
• one model of each for elongated, and one of each for standard toilet
• the different brands have different weight capacities

An example of these seats is –

• Centoco 3L440STS-001 raised toilet seat with lid

Compared to a safety frame with an elevated seat –

• the seats are only in fixed heights, so not adjustable – 2 and 3 inches only
• tall seats are lower than safety frames with elevated seats
• tall seats require bolting etc so take longer to install
• because they are bolted down tall seats are solid
• none of the models have armrests as do the safety frames
• like a safety frame seat they don’t wobble
• you can get them with a lid for the seat which safety frame seats don’t have
• tall seats won’t fit on all toilets – you must by an elongated or a standard model

As these seats are solid but without armrests I think they would be fine for an elderly adult, either combined with a safety frame around the toilet, or with some grab bars on either side.

Bubble seats

• slots over the rim of the bowl – most have what are called grip pads
• there are no actual clamps, or bolts, to attach it with
• have an inside lip which extends down several inches into the bowl for stability
• have plastic rims which catch under the inside rim of the toilet bowl and reduce wobbling of the seat
• these are either for elongated, or standard toilets
• there are no models with handles, or armrests
• the seats come in 2, 3, 3 1/2, 4, 4 1/2, 5 and 6 inch sizes – not adjustable
• all the seats have different weight capacities

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

Compared to a safety frame with an elevated seat –

• very quick and easy to install like the safety frames
• not at all as stable as a frame with a seat
• with no armrests or handles they are hard to hold on to as you sit down
• you cannot adjust the height of the seat – only come in fixed heights
• only a few models fit most seats, and the rest are for either standard, or elongated toilets
• these cannot take as much weight as the elevated seat on a safety frame

The lack of fixings doesn’t really inspire me at all, and combined with the lack of any form of armrest, I personally would not want my elderly parent using a seat of this type.

I think you need to be stronger and more agile in at least your arms and one leg to use these seats.

Seats with side fixings and a front bracket

• usually have two plastic clamps on each side of the seat towards the rear, and a central front “bracket”
• comes in models of 2, 3, 4, 4 1/2, 5 and 6 inches in height
• you can get models with lids
• these do not have armrests or handles
• there are some universal seats, some just for standard toilets sizes and some for elongated
• different models have different weight capacities

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

Compared with safety frames with an elevated seat –

• almost as fast as the safety frames with seats to install
• cannot take nearly as much weight as safety frames
• lack armrests and handles
• not that many universal toilet models – safety frames go over all toilets
• they do not have adjustable heights like the safety frames
• they have lids which safety frame seats do not

This was the first type of toilet seat that my mom had and rejected.

The model we had wobbled badly, and there was just now way an elderly woman like my mom, with leg problems, could sit down on a seat without armrests to hold on to.

The wobbling also did not make my mom at all confident about using the seat.

You need to be warned that if a seat has no armrests, the user will tend to put their hand on the seat in front of them in between their legs and push up to stand. This can cause some seats to tip forwards, especially if the user is heavy.

Front locking seats

• have a front locking clamp which grips the toilet bowl
• there is also a rear lip which wedges under the inside rim of the toilet bowl
• models come in 4 and 5 inch sizes
• these do not come with lids
• most of these seats fit most toilet sizes
• there are many models which come with armrests, or handles
• different models have different weight capacities

Compared to safety frames with an elevated seat –

•  relatively fast to install
• can wobble depending on how it the fit to the toilet – unlike safety frames and seats 
• not as strong a safety frame and seat
• like the safety frames a lot of theses seats come with armrests, although they are smaller
• the seats come in fixed heights and can’t be adjusted like a safety frame
• front locking seats are supposed to be compatible with most toilets, safety frames can go over all toilets
• neither type of seat comes with a lid

Front locking seats are definitely more solid that the clip-on, bubble and side fastening seats, and come with armrests, or handles, in most cases, but they can wobble if they don’t fit the toilet bowl snuggly.

A few examples of safety frames with and without seats

Two-legged Toilet Frames 

Here are some examples of two-legged models –

Lumex Versaframe Safety Rail

Heathcare Direct 101BSA Toilt safety Rails

Pivit Bathroom Safety Frame

Homecraft Toilet Safety Frame

Four-legged Safety Frames

Some examples of four-legged models –

Stand Alone Toilet Safety Rail

RMS Toilet Safety Frame

Carex Toilet Safety Rails

OasisSpace Stand Alone Toilet Safety Rail

Vaunn Deluxe bathroom Safety Rail

Healthex Portable Healthcare Foldeasy Safe Support

Examples of a second four leg design but wit horizontal bars on the floor –

Kinbelle Bathroom Toilet Safety Rail

Drive Medical Stand Alone Toilet Safety Rail

Elderly Assis Toilet Safety Frame

Safety Frames with a raised or elevated toilet seat

Some examples of safety frames with elevated seats –

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

MOBB elevated toilet seat and frame

Aidapt President raised toilet seat and frame 

Lattice commode toilet seat and frame 

Maddak Tall-Ette elevated toilet seat with legs

Safety Frames with raised toilet seats with lift mechanisms

There are also safety frames with raised toilet seats which incorporate a lift mechanism, but they can really be compared with the toilet seats which attach to the bowl as they are for people who are very weak in the legs and who have very debilitating mobility issues.

The lift mechanisms vary in terms the technology used. They can be pneumatic, hydraulic, or electric.

Examples of safety frame toilet lifts –

The Uplift Commode

Easy Access Tilt Toilet lift ( this model is secured to the toilet without legs)

The Liftseat Powered Toilet Lift

The Drive Solo Lift with Arms

How to choose which type of raised toilet seat ?

To choose whether you want a simple raised toilet seat which attaches to the bowl of the toilet, or you want a safety frame with an elevated toilet seat, you have to look at the physical condition of the user, and decide just what they are actually capable of using, and also look at the environment in which they will be using the seat.

For me, and more importantly for my mom, the best solution was the bedside commode over the toilet which is almost identical to a safety frame with a raised toilet seat.

My mom has problems with vision, with hip replacement surgery and doesn’t have particularly strong wrists and hands due to arthritis, and so we wanted a seat which had large armrests, like a safety frame, that wouldn’t wobble and that could take a jolt if she sat back a bit hard.

We felt that the other types of seat weren’t able to support what we needed.

A portable commode can also be used by the bed with a commode pale if your loved one can’t leave their bedroom, otherwise it is remarkably similar to a safety frame with an elevated seat.

I hope that this has helped. Good luck.

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