Choosing a Mobile Shower Commode: OT Guide

For OTs, physios & support coordinators

Choosing a mobile shower commode comes down to how the person moves, what the bathroom allows, and how long the seat stays under load. This guide sets out the decisions, the measurements and the mistakes that cost a reissue.

The 5-step process

Step 1. Start with the person

• Sitting balance. Independent balance suits an upright frame. Poor trunk control points to a contoured back, laterals and often tilt.
• Skin history. Check breakdown at the ischial tuberosities, sacrum, coccyx and greater trochanters. Any history here changes the seat, not just a cushion.
• Time seated. A five minute shower and a twenty minute bowel routine are different prescriptions.
• Upper limb function. Strength and reach to push rims makes self propulsion worth trialling.
• Lower limb range. Sets leg support angle and whether feet clear the castors and toilet bowl.
• Transfer method. Standing, sliding board or hoist, each drives different armrest and footplate needs.
• Who assists. A chair a spouse cannot push over a hob will not be used.
• Continence routine. Over toilet, pan, or both. The biggest driver of frame geometry.

Step 2. Narrow the type

Self propelled or attendant propelled

Self propelled chairs carry two large rear wheels with hand rims. Attendant chairs run on four castors, turn tighter and fit over more toilets. Do not decide on upper limb strength alone: test it wet, with the person reaching the taps.

Tilt in space or fixed

Tilt moves seat and back together so hip and knee angles stay put. Prescribe it for a stated clinical reason, not as insurance.

Over toilet or pan

Over toilet use is usually preferred, but only if the chair fits, and that has to be measured rather than assumed. Many chairs take both, so check that swapping does not need two hands.

Step 3. Match the detail to the bathroom

Seat aperture and pressure risk

The aperture is where most prescriptions fail. Too wide and the ischial tuberosities drop into the gap, loading soft tissue at the edges. Too narrow and care access is poor. Queensland Health guidance suggests aperture width of IT width plus about 70mm, with average adult IT width near 135mm, so a common result sits near 210mm. An aperture set about 50mm from the back of the seat helps hold a neutral pelvis and keeps load off the coccyx. A good pressure seat carries weight through the thighs and greater trochanters and leaves the ITs unloaded. Extended or keyhole apertures improve access for male anatomy and bowel care.

Castors, turning and thresholds

Larger castors cross hobs, tile lips and thresholds and track better on wet tile. Smaller castors turn tighter and sit lower. Front swivel with rear locking castors is common, and every castor needs a brake if the chair is used for transfers. Measure the hob height, the narrowest point of the doorway and the clear turning space. If a hob stops the chair, put the threshold ramp, castor change or bathroom modification in the report.

Armrests and transfers

Armrests should support the forearms with elbows near 90 degrees and should not press into the trunk. Removable or swing away arms suit sliding board and lateral transfers. Fixed arms are more stable but block side transfers. For hoist transfers, check sling clearance at the backrest.

Materials and corrosion

A shower commode lives in hot water, soap and urine, so material decides working life. Stainless steel resists corrosion and carries load, but is heavier. Powder coated aluminium is lighter and holds up while the coating is intact, with chips at fixings the usual failure point. Check fasteners, footplate hardware and castor stems too: a stainless frame with plain steel bolts fails.

Safe working load

Standard mobile shower commodes commonly sit in the 110kg to 125kg range. Above that, move to a bariatric frame. Read the rating for the exact configuration: tilt mechanisms, folding frames and some accessories can rate lower than the base frame.

Paediatric considerations

Children need growth built in: adjustable seat width and depth, adjustable leg support length, and a backrest that extends. Postural supports are needed more often than in adults and must not block personal care. A smaller aperture reduces the risk of sliding into the gap. Review more often than an adult prescription.

Step 4. Measure

1. Seated hip width, including clothing and supports.
2. Ischial tuberosity width, to size the aperture.
3. Thigh length, back of buttock to popliteal crease, for seat depth.
4. Lower leg length, popliteal crease to heel, for footplate height.
5. Seat height. Aim for feet flat, with the seat about 50mm above the popliteal crease where no footplate is used.
6. Client weight against the safe working load of that configuration.
7. Seated elbow height, for armrest and push handle heights.
8. Toilet pan height, and distance from the front of the cistern to the back of the bowl.
9. Doorway clear width at its narrowest point, including door leaf and hardware.
10. Shower recess entry width, hob or threshold height, and internal floor space.
11. Clear turning space between toilet, basin, shower and grab rails.
12. Storage and transport dimensions, folded if relevant.

Step 5. Document it for funding

Under the NDIS, mobile shower commodes usually fall into mid cost or high cost assistive technology. Mid cost sits between $1,500 and $15,000 and needs written evidence from a suitably qualified advisor. Above $15,000, a formal assistive technology assessment is required. Either way the report carries the same load: what the item is, why it is the best option, how it links to plan goals, what else was trialled and ruled out, the risks and how they are managed, training needs, and a supplier quote.

For older Australians, the Support at Home Assistive Technology and Home Modifications scheme funds equipment in tiers, and prescribed items need an occupational therapist or physiotherapist. Mobile shower commodes generally sit in that category. The scheme works on a loan before buy principle, so check loan pool availability before quoting a purchase.

Write the measurements into the report. A prescription recording IT width, aperture size, seat height, doorway width and hob height is harder to query than one naming a model number. The relevant product standard is ISO 17966, assistive products for personal hygiene that support users.

Book a trial with Thrive Lifecare

Thrive Lifecare is Tasmanian owned, with showrooms at 4 Broadland Drive, Launceston and 4/11-13 Abernant Way, Cambridge, working Tasmania-wide. To measure a client against real chairs, or run a wet trial before committing to a prescription, book a trial with our team. Email team@thrivelifecare.com.au. Launceston is open 8am to 4pm Monday to Friday, Cambridge by appointment. We hold trial stock across the mobile shower commode range, including Etac, K Care, ShowerBuddy, Broda and Raz. A commode trial runs during the appointment, and it is best done in the home so we can check the toilet, the shower recess and the clearances the chair has to work in.

Common questions

How do I size the seat aperture on a shower commode?

Measure ischial tuberosity width and add about 70mm. Average adult IT width is near 135mm, which gives an aperture around 210mm. Position it close to the back of the seat, roughly 50mm back, so the pelvis sits neutral and the coccyx stays clear. Too wide an aperture drops the ITs into the gap and loads soft tissue at the edges.

When is tilt in space worth prescribing on a shower commode?

When there is a stated pressure, postural or blood pressure reason: unstable trunk control, a history of skin breakdown, long sitting times for bowel care, or postural hypotension. Tilt adds weight, length and cost, and it makes over toilet access harder, so it should answer a specific clinical need rather than act as insurance.

Will a shower commode fit over the client’s toilet?

Only if you measure it. Take the pan height and the distance from the front of the cistern to the back of the bowl, then check those against the chair’s rear frame clearance and castor positions. Close coupled and back to wall pans are the usual problem. If it will not fit, prescribe a pan or bucket carrier instead.

What safe working load should I be checking?

Standard mobile shower commodes commonly rate between 110kg and 125kg. Above that, move to a bariatric frame. Check the figure for the exact configuration you are prescribing, because tilt mechanisms, folding frames and some accessories can carry a lower rating than the base frame.

Stainless steel or powder coated aluminium?

Stainless steel resists corrosion well and handles higher loads, but it is heavier for a carer to push and lift over a hob. Powder coated aluminium is lighter and holds up while the coating is intact, with chips at fixings being the usual point of failure. Check that bolts, footplate hardware and castor stems are corrosion resistant too.

What should a paediatric shower commode include?

Growth adjustment above all: adjustable seat width and depth, adjustable leg support length and a backrest that extends. Postural supports such as laterals, a pelvic belt or a chest harness are common and must not block personal care access. A smaller aperture reduces the risk of the child sliding into the gap. Review more often than an adult prescription.