Can Technology-Assisted Toilets Improve Hygiene and Independence in Geriatric Rehabilitation? A Cohort Study

Study Overview
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Brief Summary
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Toileting is a private activity of daily living. Geriatric rehabilitation patients are often unable to toilet themselves independently, leading to embarrassment and loss of self-esteem. Relationships with their caregivers may also become strained. Furthermore, improper toileting hygiene can lead to skin irritation, breakdown and infection. Technology-assisted toilets (TATs) clean and dry the anal and vaginal regions using a stream of water and a fan. They can therefore potentially eliminate the need for patients to be able to wipe themselves. TATs are operated using wall-mounted remote controls. This study will examine the potential benefits of TAT use in geriatric rehabilitation patients. Forty patients aged ≥65 years referred for treatment of physical impairments to the Geriatric Rehabilitation Unit (GRU) of the Elisabeth Bruyère Hospital (EBH) will be recruited for this study. Participants will have a bowel movement on two occasions, once using toilet paper and once using the TAT. The Psychosocial Impact of Assistive Devices Scale (PIADS), a validated questionnaire, will be used to analyze participants' toileting experience. Participants will be visually evaluated for cleanliness before and after each testing session. The investigators hypothesize that participants will report that, in comparison with use of a standard toilet, toileting using the TAT: 1) is easier to use, 2) improves psychological well-being and 3) is more effective at cleaning than regular wiping techniques.

Official Title
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Can Technology-Assisted Toilets Improve Hygiene and Independence in Geriatric Rehabilitation? A Cohort Study

Conditions
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Geriatric Rehabilitation

Intervention / Treatment
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* Device: Technology-Assisted Toileting


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: over the age of 65 inpatients at the EBH GRU can communicate effectively in English or French are able to remain balanced while sitting on a toilet are able to physically use the remote control are able to wipe themselves, but they do not need to be able to wipe themselves effectively Exclusion Criteria: are cognitively unable to provide informed consent are severely aphasic are undergoing treatment that interferes with toileting have any conditions that increase perineal sensitivity such as ulcers, wounds, or infections require two people to assist them in transferring to and from the toilet are under isolation precautions

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Standard Toileting First<br>This group will complete the standard toileting trial before the TAT toileting trial. | Device: Technology-Assisted Toileting<br> <br> * Other names: TOTO Washlet;|
| Experimental: TAT Toileting First<br>This group will complete the TAT toileting trial before the standard toileting trial. | Device: Technology-Assisted Toileting<br> <br> * Other names: TOTO Washlet;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychosocial Impact of Assistive Devices Scale (PIADS) | Scale used to assess participants' subjective feelings of adaptability, competence, and self-esteem | up to 12 weeks | 
| Cleanliness Scale | A new scale being piloted to measure cleanliness of the anal/genital regions | up to 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Toileting, Technology-Assisted Toilets, Rehabilitation, Assistive Devices, Activities of Daily Living