Toilet issues


2 Toilet and bedwetting issues

Please note: All tips in this section have been suggested by members of our community.

Easy does it!

Make it easier for the person you are caring for to go to the toilet independently by giving them clothes that are easy to pull up and down - avoid awkward fastenings. Use sanitising hand gel once outside so they don't need to deal with hand washing if they find this difficult and too confusing.

Box tight

My son is a nappy wearer. I have always – since he was about 4 years old – put boxer shorts on top of his nappy. It not only keeps the nappy in place, but if there is a leak, it often gets the boxers before the trousers, so so at least I don't have two things to change. It also helps if teaching children to use the toilet, because you can to still pull underwear down.

Spring time

If you can't go cold turkey on the nappies try pull ups, huggies pull up nights for older children (the girls' version seemed more absorbent than the boys) or Libero who do a version. Try and start the process in April so you are doing it through the warmer months, and be prepared for it to take years; the rewards will make it worth it.

Terry nappies

Pete who has Down Syndrome was toilet trained with Terry nappies (poppers).

Easy on - easy off

We use easy to remove clothing to make life simpler for us both.

Protect the car seat

Buy a Wetec seat protector (waterproof - washable mat).

Free nappies for over 4s

If your child is 4 they are entitled to free nappies if needed. It is best to contact the school as most of the organisations that are supposed to know don’t! I found this was the quickest way.

Going at your own pace

I left underpants in Harry’s drawer so that he could help himself to them (mostly to put on his head as hats at first, but he knew what they were as they were the same as his older brothers!) and also seeing his brother use the loo helped. With no pressure from me; just a few hints left lying around he was able to decide himself that he wanted to wear big boy pants and threw his nappies away himself! Not to say we have never had any accidents but so what - he was almost physically and definitely mentally ready and going at his pace was the way to go.

Who cares what they think

Toilet training seemed to be a long task but I found that once I relaxed and ignored the pressure I came under from peers and professionals (after all does it really matter when it takes a bit longer than usual?) it was so much easier.

Games in the toilet

At 5, we had tried almost everything to get Steve to use the toilet. We then put lots of fun activities in the toilet, bubbles, Velcro dart board, stickers etc and as he sat on the toilet we distracted him with lots of fun in the toilet, he realised he can actually do it, his constipation has eased and he uses the toilet now every time on his own.

Caravan toilet

Inspiration came. A caravan portable toilet! We picked up one for £20 and buy the chemicals to disinfect/neutralise the odours and it has been a Godsend! Low seat, stable base and easy to store behind the door out of visitors’ sight.

Step by step in colour

Because Joey was scared of toilets we used a portable potty/toilet. You can get them from the chemist. It is a potty shaped two piece plastic frame to which you attach disposable plastic bags which are lined to absorb liquids. From then on it went slowly to the child size toilet, or child toilet seat with a step.

Picture books are good

Potty training - Many autistic people are visual learners and the only way my daughter understood the idea was through a book. I used her princess obsession. I bought I Want My Potty by Tony Ross and it worked a miracle! The book is full of pictures and the phrase “I want my potty” is repeated continuously through the book. It also shows that accidents happen.

Footstool

Karen didn’t have enough stability and so was struggling to sit and “perform”. We gave her a footstool. It is so easy to forget that as an adult you have the floor for your feet to gain support.

Save the embarrassment!

When Betty uses the toilet she often misses and makes a mess on the floor. We leave moist tissues in the bathroom so she can clean it up herself and doesn't have the embarrassment of asking for help.

Non slip

Evie can’t sit up very well. We cut up some non-slip matting to fit the toilet seat which stops her bottom slipping down.

Sprinkler system

We use a plant sprayer to wash Jesse’s bottom (with warm water!)

Sticky tabs alert

Make sure the sticky tabs are tucked in so they don't stick to the skin.

Make it stick

Use steri tape for a really firm stick on incontinence nappies that have lost their stickiness.

Flush reward

Put a few drops of assorted food colouring in the cistern. Guessing what colour the flush will be is a fun reward for using the toilet appropriately.

Boys boys boys

When Colin was learning to use the toilet we put a table tennis ball in the toilet bowl for him to aim at - makes it all a bit of fun (you can roll up pellets of paper which works as well).

Creative solution

If having problems keeping hands out of nappies - put a ladies swimming costume on!

Houdini pyjama suits

At night we put Jim’s pad on back to front with a popper style vest (larger sizes available via Fledglings) under his pyjamas which makes it harder to get to.

Back to front

Ali likes to take off her pad to get to the contents, so we put the nappy on back to front as it is much harder to take it off but not that much harder to fit on that way.

Happy Pee

The Happy Pee, available from some mail order catalogues and Amazon online, has worked wonders for my son’s potty training. It’s a unisex canister (with a froggy lid designed to appeal to kids) and we keep it discreetly tucked away under the stairs. 

Maia dry wipes

I buy Maia soft and absorbent dry wipes for bottom wiping. They are dry but I moisten them with warm water and use a bit of handwash or shower gel. You can get them from www.care-house.co.uk. They are cheaper than buying packets of wipes.

Waterproof-lined swimwear

If your son/daughter sometimes has accidents in public swimming pools, Fledglings do really good waterproof lined swimming trunks and swimsuits.

Toddler wipes

In trying to encourage our son to become totally independent using the toilet, I taught him to use the toddler wipes (he is now 17) which come in a container and pull out one at a time. These sit next to the toilet and are used by the whole family.

Urine bottle

When we carry out intermittent catheterisation for someone, we use an old 1.5 litre pop bottle to collect the urine in. You can see how much, note the colour, smell. A narrower opening is less likely to spill. Keep clean by soaking in regularly-changed Milton water and change of bottle.

Superundies

We use Superundies Toilet training pants (pull-ups) for our 6 year old son for everyday wear at school and when out and about. They look like proper pants, but are far more absorbent than most trainer-style pants. We got them from BabyKind. They sell lots of reusable nappies too.

Disposing pads

If you receive free pads/ pull-ups from the Incontinence Service try contacting Waste Services at your local council to dispose of them. Our council collects ours as clinical waste. Not only are you saving room in your household waste bin but you know they aren't going to landfill.

Clos-o-mat

Ask your OT about the Clos-o-mat total hygiene shower toilet. It is great for people with physical disabilities and also those who struggle to manage hygiene issues independently. It has meant our son can go to the toilet all by himself - marvellous!

Ready Set Potty

We've had real toilet training success using the book Ready, Set, Potty by Brenda Batts. Written by a mother of an autistic child, it outlines various techniques and strategies including decorating your bathroom, footsteps on the floor, keeping a log of elimination times and special pants. We are now 4 weeks in, and he's signing to us he needs to go the toilet. Result!

Refusing to poo

Our son refused to poo in the toilet. Although he was dry he would only poo in his pad. We were advised to meet him halfway - we would give him a pad but only to be used in the toilet. Gradually we got him to sit on the toilet wearing his pad until finally he was able to go without the pad altogether.

Help with toilet training

The Autism Helpline have an information sheet on toilet training and children with autism. It includes advice, resources, legal information, and organisations who can help. 

A gentle approach

Remember to keep positive and offer praise. Even if that's not your gut reaction. Our son used to poo behind the sofa. Realising this meant he was not using his nappy and choosing somewhere private was actually a step in the right direction.

Scared of the hole

Being scared of going to the toilet due to fear of the hole is common. We've had countless of people say that using a portable bidet (placed over the toilet hole) has helped the person they care for use the loo again.

Bowl under

If you care for somebody with a catheter, it’s worth putting a washing up bowl under the night bag. It saves a lot of cleaning up if the tap gets left open or the bag leaks.

Feel wet

When toilet training my son, I put a pad over regular underpants so that he could feel the wetness but wouldn't be so messy. Also when he could still fit into regular nappies I bought really cheap basic pull ups that weren't so absorbent for the same purpose. He was being very lazy with it all so feeling uncomfortable / wet did motivate him to use the toilet.

Sitting comfortably

My son always sits down to have a wee. It is far less messy and stressful than standing at the urinal / toilet. As he's got older we've reassured him that it’s fine to do this.

Pad recommendation

I'm caring for someone who is doubly incontinent, and I find Tena comfort Maxi pads the most absorbent.

Big nappy bags

My son is 8 years old and in nappies. I found nappy bags just weren't big enough, so now I use pedal bin liners. Supermarkets' own brand are really cheap and just the right size.

Protein isolate drink

John has had chronic runny bowels since birth. He has recently been found to have low plasma protein amino acids. A friend recommended a protein isolate drink, and we tried pea protein isolate. John's bowel motion was normal after one drink a day. I am one happy mum!

Essentials bag

Pack a bag with all the essentials to deal with accidents like spare clothes, towel, talcum powder, pads, wet wipes etc. It will come in handy when you’re out and about or even at home so you don’t have to search for things when accidents happen.

Incontinence nurse

Ask your GP/consultant for an appointment with the incontinence nurse. Every area has one and they are life savers. They offer us everything from free nappies/pads etc (delivered to our door) to advice and support. Ours is very positive and tells us that even though Casey is incontinent she can be 'trained' using brain rather than bladder techniques.

Free pads

I might be stating the obvious here. But some people aren't aware that if their child is incontinent they can request help from an incontinence nurse and receive free pads, bed protection sheets etc. Different areas have various rules, but a good place to start is with a health visitor or GP.

Extra padding

Suki is incontinent during the night - as she gets bigger and drinks more her pads often leak causing a wet bed. We took the simple step of using booster pads which we bought from Boots and this provides additional absorption and keeps the bed dry. You can always cut them in half if they are too big.

Seeing red

Artificial food dyes are related to bed wetting, especially red dyes. If you've got a bed-wetter try eliminating red dye from their diet.

Conveen

Use a Conveen (if person is male). These have totally solved the wet bed problem. Works like a sheath, attached to a tube so the urine flows into a bag. Available on NHS from a doctor's scrip. Coloplast organise home deliveries superbly efficiently.

Bed protectors

Find cheap bed protectors on ebay. I have saved £££s that way.

Telecare

Telecare may be able to help with bed-wetting. If the person you are supporting is able to toilet themselves in the night, but needs a prompt to get up, you can get a device similar to a speaking clock, linked to a vibrating bed alert.

Rent an alarm

You can get a bed alarm for bed wetting, which can be rented from the enuresis clinic (you would need to get referred to your local one from GP or consultant), worked fantastically for us. You can also buy cheap ones in the shops – be careful though, you don’t want the alarm to go off for every dribble!

Avoid cocoa at night

Don't give hot cocoa before bedtime. Caffeine causes excessive urination. The combination of caffeine and sugar is not good for sensitive bladders.

Snow angel exercise

Bed-wetting can sometimes be a symptom of a retained spinal galant reflex. It's worth trying the Angels in the Snow exercise. It took about 6 months, but it worked for my son!

Just add water

My 10-year-old has regressed many times with his toileting skills. Contrary to the usual advice, our incontinence nurse told us to increase our son's fluid intake. Apparently if the bladder is not stretched it will lead to more accidents.

PVC-covered beds

You can get very strong, robust furniture, including PVC-covered beds, mattresses and pillows designed for use by people with special needs and incontinence problems.

No clothes, no wet bed

I've found that if my son goes to bed naked, he is less likely to wet the bed. Respite have found the same. Presume the sensation of control is better.

Understanding why

My son has autism and goes through phases of bed-wetting – usually when he is ill or losing a tooth etc. Other sensory issues seem to distract him from recognising the urge to go to the toilet. Always be aware there may be reasons behind bed-wetting.

Two duvets are as good as one

I can't get a thick winter duvet into my washing machine, which is a problem when it gets soiled. But I've found that if I put two thin duvets together they're as warm as a thick one, and I can wash them separately.

Bicarbonate of Soda

Sprinkle bicarbonate of soda (you can usually find it near the flour in the baking section of supermarket) on a wet mattress and it will not only absorb the smell it will soak up the wet. Leave it on the wet patch for as long as you can and then vacuum off.

Puppy pads

Disposable bed pads are really expensive, puppy training pads from the pound shop work just as well.

Pelvic floor

Alignment and breathing have a huge impact on the pelvic floor muscles and therefore on continence (and constipation). Children with movement challenges can benefit from activation of the deep core muscles, thus activating the pelvic floor muscles for improved continence.

Underlying constipation issues

Many children/adults who are bedwetters often have underlying constipation issues that are not being treated. Treat the constipation and the sensation and awareness often improve.

Two sheets

I put two waterproof sheets on, so when he wets, I can gently peel the sheet away without making him get up - so he goes back to sleep more easily!

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Using these tips

These tips have been contributed by members of our online community. We hope they will give you some ideas to try, but if you need further help why not post a question to the community or talk to one of our community advisors. If you have any concerns about your health or the wellbeing of someone you are caring for, please consult a doctor or qualified professional.