The short answer
- Ask permission at every stepNot just once at the start of the visit. Tell them what is about to happen and wait until they are ready before you do it.
- Support what they can still doMost clients can manage part of this alone. Your job is filling the gap safely, not taking the whole task over.
- Never take their full weight by handIf they cannot bear any weight, that calls for equipment or a second person, whether they are moving to a commode or being positioned on a bedpan.
- A sudden change is worth a callNew difficulty reaching the toilet in time, or a continence change that appears overnight, is for the GP or district nurse, not something to manage alone.
Checked against CQC's guidance on dignity and respect, NHS and Marie Curie guidance on personal care, and the Care Act 2014, in September 2026.
Dignity and consent
Why dignity comes before technique
Helping someone use the toilet is one of the most private tasks a client will ever ask of you, and it can be a difficult or embarrassing moment for them however many times you have done it. How you handle it matters as much as getting them there safely.
Talk to them and reassure them as you go, and ask permission before each step rather than assuming the first yes covers everything that follows. Give them as much privacy as the task allows: close the curtains or pull the door to, and step back or turn away once they no longer need your hands. Ask them to call you when they are ready for help again rather than hovering.
What protects their dignity
- Asking before each step, not just once at the start of the visit
- Closing the curtains or door, and stepping back or turning away once you are not needed
- Reminding a client to use the toilet the same way you would remind them to take medication, especially useful with dementia
- Letting them do what they can themselves, even if it takes longer than doing it for them
- Talking normally rather than working in silence, so the moment feels less clinical
What takes it away
- Rushing them because the visit is running behind
- Standing over them or watching when you do not need to
- Assuming they cannot manage a step because they could not last time
- Discussing what happened with anyone who does not need to know
- Treating a request for help with this differently from any other part of the visit
CQC's own standard on dignity and respect says a person's privacy must be maintained at all times, including when they lack capacity, and that every service user must be treated in a caring and compassionate way. PrimeCarers is an introductory service rather than a care provider, so it is not the one enforcing that standard on your visits, but it is the standard families and clients expect and the one worth working to regardless. CQC's guidance on dignity and respect sets it out in full. If a client has dementia and struggles to tell you what they want in the moment, mental capacity: MCA and DoLS covers how to act in their best interests when they cannot say yes or no clearly. If a family member you work alongside is doing some of this for their relative themselves, bathing and toileting elderly parents covers the same ground from their side.
Helping someone use the toilet
Getting them there, and giving them privacy once they are
Most clients can still use a toilet or a commode with some support to get there, sit and stand. How much help they need decides which of these fits, and it is worth checking again at each visit rather than assuming yesterday's answer still holds.
- 1
Independent, with a prompt
They can manage the whole task alone once they get there. Your part is reminding them regularly, in the same way you would remind them to take a tablet, which matters most for a client with dementia who may not notice or act on the urge themselves.
- 2
Needs help to walk, sit or stand
They can use the toilet itself, but getting there and up again needs your support. Check what they can still do before you help with the rest, and use a support rail or your arm rather than lifting under theirs.
- 3
Commode, raised seat or rails, near the bed or chair
Walking to the bathroom has become too far or too risky, but they can still transfer onto a seat with support. A raised seat, handrails or a commode brought close by removes the distance rather than the task.
- 4
Bedbound: bedpan or urinal in bed
They cannot get out of bed at all. This is the point to talk to their district nurse or GP about the arrangement before you settle into it, rather than after something has gone wrong.
- 5
Contact the district nurse or GP
If a client cannot stand, sit or transfer safely even with equipment and support, or the equipment they have is not enough, that is a job for a professional assessment, not a stronger grip.
If a client needs help with buttons or removing clothing before they sit down, make sure they have something to hold on to, such as a support rail, rather than relying on you alone to keep them steady. If they are using a commode, check the brakes are on before they sit or stand, since a commode that rolls is one of the more common causes of a fall in this part of the visit. None of the walking, sitting or standing support here should ever tip into taking a client's full weight by hand; moving and handling for private clients covers the technique and the law behind it in full.
Once they are on the toilet or commode, give them as much privacy as the room allows: step back, or turn away if you need to stay in the room, which is what Marie Curie's guidance on helping someone use the toilet recommends too. Ask them to call out when they are finished rather than checking on them yourself.
Some clients can clean themselves with a little help, such as passing the toilet paper; others need you to do it directly, which cleaning up safely below covers. Once they are finished, help them back to the chair or bed, and if a commode was used, clean and dry it before it is needed again.
If a client is bedridden or cannot stand at all, that is not something to solve with a stronger lift. Contact their district nurse or GP to talk through a bedpan, a urinal, or another arrangement that suits how they are now.
Making it easier and safer
Setting up the room and the route so it takes less help, not more
A few changes to the room and the way there make some clients able to manage more of this themselves, and make it safer for you both when they cannot.
Worth checking in a client's home
0 of 6 ticked
For dementia or poor eyesight
For safety
Managing clients with dementia and managing visual impairment and blindness go further into adapting a home for each of those, beyond what this checklist covers for toileting specifically.
Helping with a bedpan
Using a bedpan safely when someone cannot get out of bed
If a client cannot get out of bed, a bedpan or urinal may be the arrangement their district nurse or GP has agreed. It is worth doing carefully, both for their dignity and for your own back.
- 1
Ask, and get them upright
Before you startTalk them through what is about to happen and ask permission before you proceed, every time. Help them sit up if they can, supported by pillows so their back stays upright, or raise the head and back of an adjustable bed. - 2
Slide the bedpan into place
Lift or rollSlide a waterproof pad underneath them first. If they can lift their back and bottom off the bed, known as making a bridge, support their lower back with one hand and place the bedpan under them with the other. If they cannot lift, roll them gently onto their side, position the pad and pan, then roll them back onto it. - 3
Cover them, and give them a moment
While they use itLay a towel over them to maintain their dignity, and step back or leave the room if they can manage alone from here. Ask them to call you when they are ready. - 4
Remove it the same way you placed it
AfterwardsAsk them to raise their buttocks again while you support their lower back and slide the pan out, or roll them off it gently if they cannot lift. Cover the bedpan with a paper towel and set it aside while you clean them.
Never try to take a client's full weight by hand at any point in this process, whether that is lifting them upright or catching them if they slip while positioned. If a bedpan is becoming a regular part of the visit and it feels difficult or unsafe to manage alone, that is worth raising with their district nurse rather than persisting with a technique that is not working. Moving and handling for private clients covers the wider legal position on lifting a client as a self-employed carer, including what to do if something goes wrong.
Cleaning up safely
Cleaning someone properly, and protecting them from infection
The cleaning that follows matters as much as the positioning. Done badly, it risks soreness or a urine infection, on top of the embarrassment a client may already feel about needing the help.
Front to back, every time
Gloves on, then hands washed after
Wipes and pads go in the bin, not the toilet
Wash and dry equipment between uses
Clean with toilet paper first, then wet wipes or a wash with clean water if the client wants one, drying gently afterwards. Help them back into their clothing and to the chair or bed, and cover them again if they were exposed. If soreness or broken skin becomes a regular finding, mention it to the GP rather than treating it as routine; managing a client's continence covers ongoing skin care and products in more depth than this page needs to.
When to call for help
When a change means it is time to call the GP or district nurse
Toileting needs usually change slowly, and you will often notice before the family does because you see your client several times a week. Some changes are worth raising straightaway rather than waiting to see if they settle.
- 1
Notice a sudden change
Compare it with their normalNew difficulty getting to the toilet in time, new pain, blood, or being unable to stand or transfer where they managed it last week. A sudden change is more likely to have a treatable cause than something that has crept up gradually. - 2
Tell the GP the same week
GPInfections and constipation are common, treatable causes of a sudden change, so it is worth raising it rather than assuming nothing can be done or putting it down to age. - 3
Ask about a needs assessment
District nurse or occupational therapistIf walking, standing or transferring safely has become the problem, ask the family to request a needs assessment. An occupational therapist can recommend equipment such as a raised seat, rails or a hoist, and in England, community equipment and minor adaptations costing £1,000 or less must be provided free under the Care Act 2014, whatever the client's savings. Apply for a needs assessment on GOV.UK.
Questions
Questions carers ask about helping with toileting
Respect it, unless leaving them to manage alone puts them at real risk. Step back and offer again in a few minutes rather than insisting. If refusal becomes a pattern, mention it to the family, since it may point to embarrassment worth addressing gently or a capability that has changed.
Yes, personal care of this kind is a normal part of caring for a client day to day. PrimeCarers is an introductory service, not a care provider, so it does not issue clinical policies or supervise visits; the standards on this page come from CQC, NHS and Marie Curie guidance. Carer resources has the rest of the guides on day-to-day care.
Watch how steady they are over the distance, not just whether they can do it once. If they are tiring, unsteady, or the walk is taking noticeably longer than it used to, a commode or a raised seat closer by removes the risky part without taking the task away from them.
No, that request has to come from the family through a needs assessment and an occupational therapy assessment. Apply for a needs assessment on GOV.UK. In England, equipment costing £1,000 or less is provided free once assessed, whatever the client's savings.
Only if they can bear a meaningful amount of their own weight, such as standing with support or bridging their hips on a bedpan. If they cannot bear weight at all, it needs equipment or a second person. Moving and handling for private clients covers the full legal position for a self-employed carer.
Wiping back to front can carry bacteria from the bowel towards the urethra, which is one of the most common causes of a urine infection. Marie Curie's guidance on helping someone use the toilet treats this as a basic step rather than an optional one, and it matters for every female client, not just those who have had infections before.
Mention it to the GP rather than covering it with more pads. A sudden change is more likely to have a treatable cause, such as an infection, than a permanent one. Managing a client's continence covers the four types of incontinence and what helps day to day once the cause is known.