Toilets, continence and medicines across a long wedding day

The ceremony needs thought, because the guest cannot easily get up and leave. So does the gap before the meal, which can be three or four hours of drinks and photographs with little to eat, and the end of the night, when they are tired and may face a long drive home.

Ask the couple for the order of the day as early as you can. Then sit down with your relative, or the person who looks after them day to day, and write their routine beside it: when they eat, when each tablet is due and how often they need the toilet. Where the two do not fit, you have something to sort out before the day rather than at the venue.

If you are still choosing a venue, the toilet is one of the first things to check. The accessible wedding venue checklist covers the toilets alongside step-free access, parking and a quiet room. The wider picture of who helps with what through the day is in looking after an elderly relative at a wedding, and everything about this guest can go on one page with the wedding day care plan template.

1. 1

   Write down every medicine and when it is due

   A month before

   Each tablet, inhaler, patch or injection, its time, and whether it needs food. Work from the boxes or the repeat prescription list.
2. 2

   Put the times against the order of the day

   A month before

   Mark any dose that falls during the ceremony or speeches, and any that needs food when there will be none.
3. 3

   Ask the pharmacist about the awkward ones

   Two or three weeks before

   Ask their usual pharmacy whether each awkward dose can move, by how much, and whether it is safe with alcohol. A GP or specialist nurse can help with anything the pharmacist is unsure of.
4. 4

   Pack the doses for the day in labelled pouches

   The night before

   One pouch or organiser compartment for each dose, labelled with the time, plus a spare day of everything. Keep the boxes and leaflets in the bag too.
5. 5

   Set alarms and give one person the job

   On the day

   An alarm on a phone for each dose, and one named person responsible. If the helper changes, hand over the pouch and the job in person.

Most medicines have some leeway. Guidance from the NHS Specialist Pharmacy Service says that for most medicines it is acceptable to take a dose up to two hours late, and that a double dose should never be taken to make up for a forgotten one unless a prescriber has said so. The same guidance points to the patient information leaflet in each box as the first place to look. That leeway is why a 1pm tablet can often move to 2pm, after the ceremony, but confirm it with the pharmacist for each medicine before the day.

Food is the other half of it. If a tablet must be taken with food and the meal is at four, bring something plain to eat with it: a sandwich, crackers or a banana. If your relative needs to eat at a particular time, tell the couple or the caterer in advance and ask whether a plate can be brought out early for them. If they have diabetes, ask their diabetes nurse about the gap before the meal.

Some medicines need to be taken at exact times. The guidance gives specific advice for insulin, medicines for Parkinson's and medicines for epilepsy, where a missed or late dose can cause harm. For Parkinson's medicines it warns that even a delay of 30 minutes could be serious, so do not move those doses without the specialist nurse or pharmacist agreeing. Our guide to Parkinson's medication on time, every time explains why the timing matters and how families keep to it on busy days.

If a carer usually prompts or gives their medicines, whether a carer can give medication explains the difference between reminding and administering.

Changing Places toilets are larger rooms for people who cannot use an ordinary accessible toilet. Councils describe them as having a centrally placed toilet with room either side for carers, a washing and changing area with enough space for the disabled person and up to two carers, a hoist and an adult changing bench. The official Changing Places toilet finder is a map of the registered ones across the UK. You can search near the venue and see the facilities at each.

On a venue visit, walk from the guest's likely seat to the toilet at their pace, and open the door. An accessible toilet that is locked, full of stacked chairs or up a step is no use on the day. Ask the coordinator to keep it unlocked and clear until the end of the night, and to tell the evening staff. Then ask the couple to seat your relative near it. Where grandparents should sit at a wedding covers the seating in more detail.

Some accessible toilets in public places are locked to stop misuse and open with a RADAR key from the National Key Scheme run by Disability Rights UK. If your relative has one, put it in the day bag for the journey. If they have a bladder or bowel condition, the Bladder and Bowel Community's Just Can't Wait card is a card they can show to explain that they need a toilet urgently.

If they will need a commode or toilet frame at a hotel, hiring a wheelchair, scooter or commode for a wedding day covers where to get one.

The NHS advice on bladder leaks is to drink 6 to 8 glasses of fluid a day unless a doctor has said otherwise, because cutting back on fluids makes the bladder hold less and can lead to constipation, which puts more pressure on the bladder. The same page says caffeine irritates the bladder and that alcohol makes you pass urine more often. On a wedding day, encourage steady drinks of water, squash or decaffeinated tea, and go easier on coffee, cola and fizz before the ceremony and speeches. The NHS lists dark, strong-smelling pee, dizziness and tiredness among the signs of dehydration, and notes that older people are more at risk.

A plan for the toilet helps far more than drinking less. Offer a trip before each part of the day: before the ceremony, before the photographs, before the meal and before the journey home, and roughly every two hours in between. Offer it in a low voice and as routine, rather than asking whether they need to go, so it does not feel like a fuss. If your relative has dementia, they may not recognise that they need the toilet or remember where it is. The NHS suggests looking for signs such as fidgeting, standing up or sitting down, and a sign on the toilet door can help them find it again. Taking a parent or grandparent with dementia to a wedding has more on a calm day for someone with dementia.

Use a bag that looks like any other, not a medical bag. Decide who carries it, and make sure it moves with the guest when helpers change. If the guest's clothes make the toilet harder, look at what an older guest can wear to a wedding, which covers elastic waists, easy fastenings and clothes that work with a stoma or catheter.

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If leaks are new, or their usual products will not last a long day, sort this out before the wedding. The NHS says you may be able to get incontinence products on the NHS through your local continence service, usually after an assessment, and that the GP can tell you about the local service. Pharmacies and supermarkets sell them too, and the Continence Product Advisor helps you compare types. Try any new product at home for a few days first. Managing incontinence has more on products and skin care at home, and if your relative has a catheter or stoma, catheter and stoma care at home covers the basics of emptying and changing bags.

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Talk with your relative, in private, about who they would like to help them in the toilet if they need it. Some are happy for a son or daughter to help, while others would rather it was someone outside the family. Some relatives are not comfortable doing it either, and that is fair too. If nobody they are happy with is free on the day, a paid carer can do it, and on PrimeCarers that means a wedding carer who stays with them all day, with time and privacy for agreed personal care and medication reminders.

The NHS lists people aged 65 and over, and people taking several medicines, among those most at risk in a heatwave. Its advice is to keep out of the heat where you can, have cold food and regular cold drinks, and avoid alcohol, caffeine and hot drinks. A suit jacket traps heat, so tell your relative before the day that it is fine to take it off or sit inside. Our guide to hot weather and heatwaves has more on keeping an older person cool.

If someone becomes unwell in the heat, the NHS advice on heat exhaustion and heatstroke is to move them to a cool place, remove unnecessary clothing, give them plenty of water and cool their skin with water and a fan. Call 999 if they have signs of heatstroke, such as a very high temperature with hot skin that is not sweating, a fast heartbeat or breathing, confusion, a fit or losing consciousness.

Cold is easy to miss in a guest who will not complain. Marquees can get cold in the evening, even in summer, and churches can be cold at any time of year. The NHS advice on keeping warm says the cold can lead to serious problems such as heart attacks, strokes and pneumonia, and lists older people among those most at risk, so pack a warm layer for any wedding outside high summer. If the guest is likely to need the toilet in the night after a long day, plan a warm, well-lit route at the hotel too; a wedding far from home with an older relative covers the overnight stay.