Commode Chair Hygiene: Cleaning, Odour and Infection Control

Why hygiene matters

Urine and stool carry bacteria and viruses. A commode that is not cleaned properly can spread them to the user's skin, to the carer's hands and to the room. For an older adult, whose immune system and skin may be fragile, this can mean urinary tract infections, skin breakdown, stomach infections and wound infections. Good hygiene also protects family members, particularly children and other older people in a shared home.

It also affects willingness. A person who finds the commode dirty or smelly may delay using it, hold urine too long or try to walk to the bathroom alone, with greater risk of a fall. The guide to commode chairs explains how to choose and set one up; this guide is about keeping it in good order.

What you need

Set up a small cleaning kit, kept in a basket or box near the commode but out of sight:

• Disposable gloves, in the right size for the carer.
• A disposable apron, if cleaning a messy accident.
• Paper towels or disposable wipes.
• A spare pot liner or absorbent pad, if used.
• A bucket or jug for rinsing.
• A brush used only for the pot.
• A hand-washing area, with soap and a clean towel.
• A suitable household disinfectant.
• A pump bottle of hand sanitiser for quick use.
• Plastic bags for soiled waste.
• A spare cover or washable cushion.

After every use

1. Put on gloves. 2. Wipe or wash the person as needed, with water or a wipe; see wipes and perineal hygiene. 3. Carry the pot by the handle, with the lid on, to the toilet. 4. Empty carefully into the toilet bowl, close to the water, to avoid splashing. Flush. 5. Rinse with water, using the brush, and flush again. 6. Wash with warm water and detergent, then rinse. 7. Dry and return the pot to the commode, with a little water or a liner if you use one. 8. Wipe the seat, rim and handles with a damp cloth or a disinfectant wipe. 9. Remove gloves and wash your hands with soap and water for at least 20 seconds, even if you wore gloves.

If you cannot empty it at once, put the lid on and place the pot in a corner away from food areas, then empty as soon as possible. Do not leave a full pot overnight if you can avoid it.

Daily cleaning

Once a day, preferably in the morning:

• Wash the pot, lid and seat with hot water and detergent. A mild solution of household cleaner is fine for regular use.
• Disinfect high-touch points such as handles, arms, lid edges and the seat. Allow the disinfectant to sit for the time stated on the label, then rinse and dry if the label says to.
• Wipe the floor under and around the commode, where drips fall.
• Wash the seat cover if it is soiled.
• Open the window or run the fan for a few minutes.

Weekly deep clean

Once a week, or after an episode of diarrhoea or vomiting:

• Empty and take apart the commode as far as the design allows.
• Scrub all surfaces, including undersides, leg joints and the rim of the seat opening where urine collects.
• Disinfect with a suitable product, following the instructions on the label, including contact time. Do not mix cleaning products, particularly bleach with other cleaners or acids; fumes can be dangerous in a small room.
• Check for damage. Look at the pot for cracks and stains that cannot be cleaned, the seat for wear, the frame for rust and the feet for wear.
• Let it dry in the air before reassembling, preferably in sunlight or a breezy spot.
• Wash covers and cushions according to the care label, at the hottest temperature they tolerate.

Choose disinfectants suited to the material. Strong bleach can corrode metal, fade plastic and stain padded surfaces. Check the commode maker's guidance. Never use harsh abrasives that scratch plastic, because scratches trap germs.

Odour control

Smell in the bedroom is distressing for both the person and the family. Many odours are the result of not enough cleaning, and masking them with strong fragrance does not help.

• Empty and rinse promptly after each use.
• Keep the lid closed when the commode is not in use.
• Use a small amount of water in the pot after emptying, to stop residue drying on the surface.
• Ventilate. Open a window or use a fan if one is available. A fan placed so the air flows out and away from the person helps.
• Absorbent pot liners or powders are available and can reduce smell and splashing, though they add costs and should be disposed of as instructed.
• Look for the cause. A strong smell of urine, or a change in smell, may be a sign of dehydration or a urinary infection; mention it to a doctor. See urinary tract infections in older adults.
• Wash soiled clothes and linen quickly; see disposal, laundry and odour control.
• Dry the floor and mattress or chair covers after any spill. Use a washable underpad or a disposable pad beneath the commode in case of spills.
• Avoid strong air fresheners and sprays around people with asthma or breathing difficulties.

In the humid months, damp and mould can also cause smell, so check the walls and floor near the commode; see pest, damp and mould at home.

Protecting the user's skin

A wet or soiled commode seat, or sitting for long, can irritate skin. Wash and dry the skin after toileting, and check for redness, rashes or sores. Apply a thin layer of barrier cream if a nurse or doctor recommends it, particularly in people with incontinence. Replace seat covers that are damp. Avoid very long sitting; limit commode time to what is needed, and make sure the person is not left on the commode for a long period. See incontinence-associated dermatitis for signs to watch for.

Protecting the carer

• Gloves for contact with urine, stool or soiled items, and an apron for messy accidents.
• Hand washing after every task, before eating and after removing gloves.
• No sharing of cleaning cloths between the commode and kitchen items.
• Cover cuts on your hands with a waterproof dressing.
• Lift correctly when helping with a transfer; see how to lift and transfer safely.
• Do not eat or drink while cleaning the commode.
• Keep cleaning supplies away from children and from a parent with dementia, who may mistake a cleaner for a drink. Store them high or in a locked box.

The wider guide on infection control for home caregivers has more details.

When there is diarrhoea, vomiting or infection

If your parent has diarrhoea or a stomach infection, or a known infection such as C. difficile or a resistant bacterial infection, the commode needs extra care:

• Use separate cleaning items and clean after each use.
• Use a disinfectant that is effective against the germ in question; ask a nurse or doctor which to use, because some cleaners do not kill all germs.
• Clean the whole chair, including the arms and legs.
• Wash hands with soap and water; sanitiser alone does not work against some germs.
• Wash soiled clothes and linen separately at the hottest temperature they allow.
• Do not share the commode with others until the person is well and the commode is thoroughly cleaned.

Diarrhoea in older adults can cause dehydration quickly. See diarrhoea and dehydration in seniors and call a doctor if your parent is unwell.

Keeping the commode in good order

• Replace the pot if it is cracked, rough or permanently stained.
• Replace worn rubber feet and loose bolts.
• Check the lid hinge and the seat for cracks.
• Store a spare pot if you can, to allow one to dry while the other is in use.
• Keep the commode away from direct heat, and out of the bathroom where soap and water may rust it.

When to ask a professional

Ask a nurse or doctor to advise if your parent has recurring urinary infections, diarrhoea that lasts more than a day or two, blood in urine or stool, skin redness or sores around the buttocks or thighs, a catheter, or a weakened immune system. A nurse can also train carers in hand hygiene and safe handling. An occupational therapist can advise on a commode that is easy to clean and fits the room. If a carer develops stomach symptoms or skin problems, they should see a doctor too.