Toilets for Disabled Person: Which type is Best?

The reasons to seek an accessible toilet can be many, so in short – one type of toilet will not work for everyone. The features that can make a toilet accessible for different people may include:

• higher-than-average toilet seat height
• compatibility with other toilet equipment/accessories
• small footprint (requires less floor space)
• bidet features

In order for you to determine which type of toilet is right for you, it’s helpful to first understand what your options are. Below you’ll find a quick overview of the different toilet types. Beside each we have identified some of the key elements that make each of them more (or less) easily accessible to aid you in determining which type will best match your own personal needs and the architectural features of your bathroom.

Two Piece Toilet (aka close coupled toilet)

2-Piece Toilet
What Is It?	A two-piece toilet is one of the most common types of toilets found in homes in the USA. It consists of a toilet bowl supported by a floor-mounted pedestal with a separate water tank bolted to the back.
Pro:	Compatible with most types of toilet equipment, such as bidet-style toilet seats, elevated toilet seats and toilet rails.
Con:	This type of toilet occupies a lot of floor space, which can make it more difficult for persons using a walker or wheelchair to move around inside of a small bathroom.




One Piece Toilet

1-Piece Toilet
What Is It?	One-piece toilets have a bowl, pedestal and tank that are all molded together to create one seamless unit.
Pro:	Less joints and crevices make it easier to clean than a 2-piece toilet.
Con:	This type of toilet occupies a lot of floor space, which can make it more difficult for persons using a walker or wheelchair to move around inside of a small bathroom.
Alert:	Use caution when selecting a one-piece toilet. Some (but not all) models have a curved, elevated ridge present between the toilet seat and the toilet tank (as shown in the picture above), which can make it impossible to attach equipment such as a bidet-toilet seat, raised toilet seat, or toilet rails in the future, if needed.




Comfort Height Toilet (aka Chair Height Toilet, ADA Toilet)

Comfort Height Toilet
What Is It?	A comfort-height toilet (aka ADA Height Toilet) is a toilet with a higher-than-average toilet seat height of 17-19 inches measured from the floor to the top of the seat. In contrast, most standard toilets have a seat height of 16″ or less.
Pros:	Easier for a tall person to sit down and stand up from the toilet. Easier for some (but not all) wheelchair users to slide sideways from the wheelchair seat to the toilet seat.
Con:	Persons who are shorter in stature tend to find these toilets to be uncomfortably high because they can cause their feet to dangle down, which in turn can cause their legs go numb while seated on the toilet.
Alert:	It is a common misconception to assume that an ADA height toilet is best for all persons with disabilities. It is not! If the toilet is being installed in someone’s private home, it is important to assess on a case-by-case basis whether a higher toilet seat height is truly appropriate or not. To learn more about picking the best toilet seat height, click here.

Comfort Height Toilets Amazon.com

Floor Standing Back-to-Wall Toilet

Floor Mounted Back-to-Wall Toilet
What Is It?	A back-to-wall toilet has a floor-mounted toilet bowl and has a water tank that is neatly concealed away inside the wall.
Pro:	Since the water tank is stored inside the wall, there is more clear floor space available in front of the toilet bowl, which can increase usable clear floor space in front of the toilet by as much as an additional 10-12 inches, making it easier for a person using a walker or wheelchair to move around inside the bathroom.
Con:	The bathroom wall will need to be opened up to install the water tank inside and then the wall will need to be refinished afterwards. If you plan to replace a standard, pedestal-style toilet with a back-to-wall toilet, the plumbing will need to be modified to get the pipes in the new toilet and the pipes in the floor to line up appropriately together.

Floor Standing Back to Wall Toilet Amazon.com

Wall Hung Toilet Bowl and Tank (aka Off-The-Floor Fixtures)

Wall Hung Toilet Bowl and Tank
What Is It?	This type of toilet does not require a pedestal to support the bowl. Both the water tank and the bowl are suspended from a carrier system that is attached to the bathroom wall.
Pros:	You have more control over selecting the toilet seat height that best meets your needs. The absolute min & max height range the toilet can be installed will vary depending on the toilet model and carrier system selected & the architectural features in the bathroom. The lack of a pedestal base will allow the footrests on most wheelchairs to pass underneath the bowl (if the wheelchair doesn’t have elevated leg rests), which can increase usable clear floor space by approximately 6 inches, making it easier for a wheelchair user to move and turn around inside the bathroom. It is easier to clean the floor under a wall-hung toilet, than under one with a pedestal base.
Con:	More expensive to install than a floor-mounted toilet because it requires purchasing more parts (I.e. toilet and carrier system) and requires more labor to install. If you are installing a wall-mounted toilet where a floor-mounted toilet formerly resided, it will be necessary to open up the bathroom wall to insert the carrier system inside, adjust the plumbing, refinish the bathroom wall and also refinish the floor where the former toilet resided.
Alert:	The toilet and carrier system are usually sold separately, so make sure you order both prior to starting your project..

Wall Mounted Toilet Bowl With Tank Amazon.com

Wall Hung Toilet Bowl & Concealed Tank

Wall Hung Toilet Bowl
What Is It?	The toilet bowl and flush controls are attached to the front of the bathroom wall. A support structure (aka carrier system) is installed inside the wall to support the toilet bowl and house the water tank, which are neatly concealed away inside the wall.
Pros:	You have more control over selecting the toilet seat height that best meets your needs. The water tank is hidden inside the wall, which opens up more clear floor space in front of the toilet bowl (often as much as an additional 10-12 inches of space), making it easier for a person using a walker or wheelchair to turn around inside the bathroom. The lack of pedestal base will allow most wheelchair’s footrests to pass underneath the bowl (if the wheelchair user doesn’t have elevated leg rests), which can further increase usable clear floor space for many wheelchair users by an additonal 6 inches, making it easier to move and turn around inside the bathroom.
Con:	More expensive to install than floor-mounted toilets because there are more parts to purchase (I.e. toilet and carrier system) and more labor involved. The bathroom wall needs to be opened up in order to insert the carrier system and water tank inside and then the wall needs to be refinished afterwards.
Alert:	The min & max height range a wall-hung toilet can be installed will vary depending on the toilet model and carrier system selected & on the architectural features in the bathroom. If you are very short or very tall, confirm that the carrier system for the toilet model you select will allow you to install the toilet at the height range you require. Also confirm that the weight limit is suitable for your needs (and any anticipated visitors needs too!). Some carriers can support up to 1000 pounds.

Wall Mounted Toilets Amazon.com

Corner Toilet

Corner Toilet
What Is It?	Corner toilets have a triangular shaped water tank that is specially designed to fit into a corner of the bathroom.
Pro:	If you have a small or unusually shaped bathroom, placing the toilet at an angle may allow you to make better use of the available clear floor space present on either side of the toilet.
Con:	In most cases, a corner toilet will still extend out about the same distance into the room, so you will not necessarily gain more usable free clear floor space in front of the toilet bowl.

Corner Toilets Amazon.com

Toilet Bidet Combination

Toilet Bidet Combo
What Is It?	This type of toilet is enhanced with bidet functionality. With the push of a button, a wand emerges from inside the toilet and releases a steady stream of water, making it possible to cleanse after using the toilet, without needing to use toilet paper.
Pro:	More hygienic because it reduces and/or eliminates the need to use your hands to perform toilet hygiene. Using water to cleanse is a more pleasant means of performing toilet hygiene for persons who have sensitive skin due to hemorrhoids, skin tears, pressure sores etc. Reduces and/or eliminates the use of toilet paper.
Con:	Mechanical parts will require periodic replacement or repairs.

Bidet Toilet Combo Amazon.com

Motorized Adjustable Height Toilet

Motorized Adjustable Height Toilet (not available in all countries)
What Is It?	This type of toilet is a power-assisted, height-adjustable toilet. With the push of a button, the entire toilet can be adjusted up and down in height.
Pros:	Makes it easier for persons who have difficulty standing up independently. Good consideration for tall persons who require a toilet seat height of 19 inches or more. Some models can achieve a seat height of 32 inches. Good consideration if there is only one toilet and there are multiple people living in the household who vary significantly in height.
Cons:	Building permits are required to install an adjustable height toilet, because it requires special, flexible plumbing and electric lines. Mechanical components will require ongoing periodic maintenance. If the toilet has mechanical issues, it could make it impossible to use the toilet until the issue is fixed. This would be problematic if there is only one toilet present in the home.




Portable Toilet (aka Commode, Portable Potty)

Portable Toilet
What Is It?	A portable toilet consists of a chair-like frame with a toilet seat and a bucket attached underneath. It is often positioned beside a person’s bed.
Pros:	It is helpful for persons who have incontinence or have difficulty getting to the toilet in a timely manner. It is a good option if architectural barriers prevent access to the bathroom.
Con:	If you cannot access your bathroom to empty the bucket, you will have to rely on someone else to empty it.
Alert:	Most models have an institutional-looking appearance. A few models do exist that have been cleverly made to look like a regular piece of furniture, neatly hiding the bucket away out of site.

What should you keep in mind when choosing a new toilet?

1. Floor Space
   If your you use a walker or wheelchair and your bathroom is small, the smaller the toilet you select, the easier it will be for you to move around inside the bathroom. Wall mounted toilets and back-to-wall toilets with the tank installed inside the wall are both great options for maximizing usable floor space. The shape of the bowl selected can also a play a role in enhancing usable floor space. A toilet with a compact-sized toilet bowl (round or square) will typically occupy less floor space (often 2″ less) than models with elongated bowls. In small bathrooms, every inch counts!
2. Weight Capacity
   If there are persons living in your household who have bariatric needs or you anticipate there will be guests visiting your home with bariatric needs, we recommend to confirm with the manufacture what the maximum weight limit is for the model selected prior to purchasing. The representatives we spoke to at American Standard and Kohler, reported that most of their floor mounted pedestal-style toilets can accomodate 1000 pounds of static, vertical force. The representative we spoke to at Toto reported that most of their floor mounted toilet models can accomodate somewhere between 400 lbs to 500 lbs of vertical force. In general, most wall-mounted toilet models, when installed correctly, will accomodate a weight capacity that falls in the realms of 350-500 lbs. A few wall-mounted toilet carrier system are specially designed to accomodate up to 1,000 pounds.
3. Toilet Height
   When selecting an accessible toilet, many people immediately think “the higher the seat height the better”. This is not always true. The taller toilets, known as Comfort-Height Toilets, can be uncomfortably high for shorter adults, children, and some wheelchair users. Ideally, select a toilet model with a seat height that is high enough that you can easily transition on and off the toilet, yet low enough that you can comfortably rest your feet flat on the floor when you are seated on the toilet. To learn more about how to choose the best toilet height, click here.
4. Location & Type of Flush Controls
   The toilet flusher comes permanently fixed to a specific part of the toilet, so it is important to take this feature into consideration prior to selecting a toilet model. Toilet flushers come in four different types, which include: a lever-style handle that is permanently fixed on the right or left front-side of the toilet tank; a button that is located on the top center of the toilet tank or wall behind the toilet; a pedal located at the base of the toilet that can be operated using a foot, or an automatic touch-less flusher operated via sensors that can be added to the toilet.

   Toilets & Touch-less Flusher Amazon.com

5. Installation
   Floor-mounted toilets are easiest to install. Any licensed plumber should be able to install a floor-mounted toilet correctly. If you have a wall-mounted toilet installed, select a professional who is experienced with installing this type of toilet to ensure the support structure is installed inside the wall correctly.
6. Ease of Cleaning
   If you have difficulty bending and reaching low surfaces or hate the task of cleaning behind and around a standard floor-mounted toilet, a wall-mounted toilet is a good consideration. The lack of pedestal base makes it much easier to pass a mop underneath the bowl to clean the floor around the toilet.
7. Water Efficient
   Selecting a watersense-labelled toilet (a toilet that meets certifications for using less water per flush) and/or a dual-flush toilet (one that allows you to select the amount of water used based on whether the toilet contents are solid or liquid) can help you to conserve water and save on monthly water bills.

Average Cost to Install Floor & Wall Mounted Toilets

Standard, floor-mounted toilets will usually cost on average $200-$500 to purchase and have installed. A wall-hung toilet can cost on average $1,500-$2,000 to purchase and have installed. Wall-hung toilets cost more, because there are more parts to purchase and it takes more time to install the support frame inside the wall and/or to reinforce the existing walls.

A floor-mounted back-to-wall toilet with the tank concealed inside the wall is usually less expensive to install than the wall-mounted toilets because it does not require the same support structure. The back-to-wall toilets will be more expensive to install, however, than a standard toilet because the plumbing will need to be modified so the pipe in the floor lines up with the pipe located inside the toilet.

Prices will be lower than those shown here if you can install it yourself and may vary from those listed here, depending on the brand selected and your geographic region.

The Homeability Advice™

If you are designing a bathroom, with the intent being that it should be user-friendly for everyone who enters (immediate family, grandparents, friends who visit), one of the most important features to include is ample free, clear floor space. If space is at a premium inside the bathroom, the wall-hung style toilets with a concealed water tank are a great consideration. Since the tank resides inside the wall, an extra 9″-12″ or more of clear floor space becomes available in the bathroom, making it easier to move and turn around with a walker or wheelchair. The lack of pedestal base also makes it much easier to clean the bathroom floor around the toilet. (Yeah!)

Bidet-toilets and bidet-toilet seats are a great consideration for everyone! It does the washing – no wiping required. A toilet that’s enhanced with bidet features can be a particularly helpful addition for persons suffering from incontinence because it makes it much easier to stay fresh and clean. It can also be a great relief for persons with hemorrhoids. Some models (ones with a more powerful water stream) can be helpful for persons who suffer from constipation as well. If you are on a tight budget, replacing your existing toilet seat with a “bidet-style toilet seat” is a much more budget-friendly option than installing an entirely new toilet with bidet features integrated into the design.

Once you have determined the general type of toilet you feel will work best for you, then it will be necessary to narrow it down further to which manufacturer, make and model you like within the given categories. In future articles we will be exploring each of these categories in more detail, including the specific models and manufacturers. To stay up to date as new articles are added, sign up for the Homeability Newsletter.

More Topics You May Be Interested In

1. “I can’t wipe myself!”: 6 Solutions to Make Toilet Hygiene Easier
2. “I Can’t Get Up From the Toilet!” 10 Remedies
3. Bidets: An Overview of the Basics
4. Best Type of Toilet for a Wheelchair User
5. Falls – Equipment to Help You Get Up Again