Wash v Wipe
My clients have every intention of Aging in Place and if needed will bring help in for assistance with ADLs (Activities of Daily Living). He is 90 and she is 82. They both have mobility issues and use walkers. They already have an accessible shower, but their 1926 Grant Park house, while having been remodeled once still did not provide much room for maneuvering around the toilet once they had installed temporary grab bars. This presented an issue with wiping the bum thoroughly and left an unhygienic condition. Face it, we all need help now and then wiping our bums, but I knew we could do something that would make it easier in the long run.
STEP 1: CHOOSE A SEAT
I recommended a personal bidet seat that could install directly onto their toilet. We discussed features they needed and started down the research path.
Here was the Design Criteria:
Easy to install (no plumber required)
Could be taken with them if they moved
Had a dryer feature
Easy to operate. Since we had very little room side-to-side it needed a remote control not side controls. FYI side controls, although lower the price, are impossible to see while sitting on the toilet so I ruled seats that only had side controls out of the running.
Customizable for each user (programmable)
Heated water. Heated seat a bonus.
Easy on the planet for energy and water consumption
According to my Kitchen and Bath instructor the Toto Washlet sets the standard for bidet seats, however they can only be installed on a Toto toilet and my clients have a discontinued Kohler Wellworth elongated toilet. I had seen a bidet seat at Costco (of all places) and started there. Costco was offering the BioBidet DIB Luxury Class Bidet Seat for $589 (Amazon Prime). It had all the features we were looking for and after calling them I determined that it would fit on their Kohler Wellworth toilet.
Wanting to bring my client two options, I found the Brondell Swash S1000-EW Advanced Bidet Elongated Toilet Seat for $574 (Amazon Prime).
All things being equal the two seats had most of the features we were looking for except for the feature that saves programming preferences for different users. It turns out to get this feature you must jump to the Brondell 1400 (which was not available at the time having just been introduced) $649. It also has a nightlight which I like.
I presented the two seats to my client and really the deciding criteria came down to the understandability of the remote control. I remembered they told me about the security system keypad that is right by the door. It has all white keys and small black lettering—not good for aging eyes—and they indicated they could not use it because they could not see it clearly in time to deactivate the alarm. Instead they walk clear across the room to deactivate the alarm on a different panel! So the Brondell Swash S1000 won out in the end. I was able to order it Amazon Prime and it came directly to their home. And even nicer touch was the delivery person walked the box all the way into the house instead of just leaving it on the doorstep.
It came down to which remote control seemed easier to use as the deciding factor.
STEP 2: GRAB BARS
The next issue to solve was new grab bars since the ones they were using mounted to the toilet in the same place the bidet seat would. I wanted something that would fit in the space they had, be cost effective and readily available. I had looked at the suite of accessories at Home Depot a while back so I turned to their website which lead me to the Moen line. The center of the toilet is a mere 15 inches from the wall (which is code) but is not very generous. I did not want to take up precious real estate with a traditional grab bar. I went with a Toilet Paper Holder Grab Bar ($32.25) which holds the paper for those who want to wipe vs. wash. Now on the other side the distance was just too great to mount anything on the cabinet (plus I did not want to mar the cabinet). The Moen 30-Inch Flip-Up Bathroom Grab Bar ($81.72) fit the need perfectly.
STEP 3: INSTALLATION & TRAINING
My clients are members of NE Village PDX so we put in a service request for a Simple Installation. I drew a sketch of how I wanted the installation and hand picked a volunteer who has a contracting background. It took him about 4 hours for the whole installation including touch-up paint. Instead of putting blocking that matched the picture rail they already had in the bathroom, he went with a series of heavy duty bolts.
Once everything was installed I excused myself to the bathroom and tested the equipment while reading the user manuals. I was able to train my client (which I will now divulge as being my cousins) and she trained her husband.
THINGS TO CONSIDER
If you are thinking of making this type of investment to join the “Wash Not Wipe” movement you will need to consider:
You will need a GFCI within 3-feet of the toilet. Most of our older homes do not have GFCI outlets near our toilets. I got lucky in that my client had one, but it was just a few inches off the 3-foot mark, so I purchased a wet-area approved extension cord. In new construction, project managers should just go ahead and put a GFCI near the base of the toilet for future use.
Mounting the bidet seat is pretty simple, but you will need to drain the toilet and install a “T” valve for the water supply. You don’t really need a plumber to do this, but a handy relative would be nice.
If installing grab bars be sure to provide the necessary blocking. The toilet paper holder grab bar installed with SecureMount anchors (click the link to watch a video) which did not need to hit studs, but the pull down bar ideally should be anchored into blocking.
If you do not spend the money for a programmable bidet seat, you will have to set the water temperature and adjust the positioning of the nozzles each time you wash. I wish the 1400 had been available at the time as I think this is really a needed feature, not a “nice to have”.
Intelligent Toilets for an Integrated Solution
- if you want to start from scratch
It turns out you can spend a tremendous amount of money on an “intelligent toilet” like the Toto Neorest for a whopping $10,200 or the Kohler Veil for only (?) $4,500! Here are links to videos for these just if you want to see how the other half lives! These toilets don’t fit my client's first THREE criteria so were off the table, but these have some amazing features.