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The Gerontologist 45:694-699 (2005)
© 2005 The Gerontological Society of America

The Potential of Wash-and-Dry Toilets to Improve the Toileting Experience for Nursing Home Residents

Jiska Cohen-Mansfield, PhD1,2 and James R. Biddison, BA1

Correspondence: Address correspondence to Jiska Cohen-Mansfield, PhD, ABPP, Director, Research Institute on Aging, Hebrew Home of Greater Washington, 6121 Montrose Road, Rockville, MD 20852. E-mail: cohen-mansfield{at}hebrew-home.org

Purpose: We investigated the feasibility of using a "wash-and-dry" toilet in the nursing home. Design and Methods: We used a controlled comparison baseline-versus-treatment design with 22 female nursing home residents aged 75 and older living in a 562-bed, not-for-profit nursing home facility in Maryland. The Luscence Luxury Lavage wash-and-dry toilet–bidet system was installed in the bathrooms of the experimental group. Measurements included staff and resident toilet experiences and toilet reaction questionnaires, utilization logs, Minimum Data Set information, Mini-Mental State Examination scores, and urine cultures. Results: About half of the residents and staff members reported the toilet to have a positive effect on toileting. We saw a positive trend in resident affect for the experimental group that was not apparent for the comparison group. Nursing staff reported that the toilet functions did clean the residents, but that cleaning was not complete. Bacterial content of urine decreased in the experimental group and increased in the comparison group during the trial. Toilet installation was more complex than anticipated. Implications: These results show that a wash-and-dry toilet shows promise for improved resident comfort in toileting and cleanliness, although further research is needed to verify the findings. Improved toilet design, design of nursing homes, and design of care activities would all improve the utility of these toilets in the nursing home population.

Key Words: Toileting care • Incontinence • Technology






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