Bidets

​Bidets offer significant benefits in occupational therapy by promoting hygiene, independence, and dignity in toileting for individuals with physical, cognitive, or sensory impairments. Clinically, bidets can reduce the need for upper limb mobility, grip strength, and fine motor coordination—making them particularly useful for clients with conditions such as arthritis, stroke, spinal cord injuries, or post-surgical limitations. They support aging-in-place goals by reducing reliance on caregivers for intimate care tasks, thereby enhancing autonomy and privacy. Occupational therapists may recommend bidets as part of a broader bathroom modification plan, aligning with assistive technology principles to improve daily living outcomes and reduce caregiver burden.

​Bidets in Occupational Therapy
Overview

• Definition of a bidet and its primary functions (e.g. personal cleansing, hygiene).
• Differentiation between standalone bidets, toilet seat attachments, and handheld options.
• Increasing relevance in OT practice due to ageing populations, disability support, and assistive tech innovation.

Clinical Applications

• Toileting Independence: How bidets support clients with:
  • Upper limb impairment (e.g., stroke, arthritis, MS)
  • Reduced reach or flexibility (e.g., post-hip replacement, spinal conditions)
  • Fatigue or endurance limitations (e.g., ME/CFS, long COVID)
• Dignity and Privacy: Enhancing autonomy in intimate care.
• Carer Burden Reduction: Minimising manual handling and hygiene-related support tasks.

Assessment and Prescription Considerations

• Client Factors:
  • Physical (reach, grip, balance)
  • Cognitive (ability to operate controls)
  • Sensory (tactile aversion, awareness)
• Environmental Factors:
  • Toilet type (e.g. back-to-wall, wall-hung)
  • Plumbing and electrical access
  • Grab rails and accessibility
• Care Context: Single or shared toilet, carer access needs, future commode use
• Hygiene and Maintenance: Cleaning routines, antimicrobial surfaces, user education

Funding and Schemes (Australia-Specific)

• NDIS: Assistive Technology under Core or Capital Support
• DVA: RAP Program non-schedule items
• CHSP & HCP: Home support and care packages for older adults
• State Health Systems: Limited support for inpatients and discharge planning
• Grants and charitable pathways

Product Types and Features

• Non-electric bidets: Affordable, no power required, basic controls
• Electric bidets: Heated seats, adjustable spray, drying functions, remote controls
• Integrated bidet toilets vs. add-on attachments
• Accessibility features: Large buttons, presets, voice controls (emerging)

Clinical Justification

• Aligning with OT outcome measures (e.g., FIM, COPM)
• Reporting hygiene outcomes, independence gains, and support reduction
• Documenting risk mitigation (e.g., skin breakdown, falls, infection control)

Training and Follow-Up

• Client and carer education
• Written instructions and troubleshooting
• Long-term monitoring of effectiveness and usage

Special Considerations

• Wheeled commode use: Limited compatibility
• Plumbing regulations: WA and national backflow prevention codes (AS/NZS 3500)
• Cultural sensitivity: Comfort with water-based cleansing
• Environmental impact: Reduced toilet paper use, sustainability bonus

​The Role of Occupational Therapists in Bidet Prescription and Toileting Independence
Occupational therapists play a vital role in assessing and recommending bidet solutions for clients experiencing toileting challenges. As an assistive technology, bidets can significantly improve personal hygiene, functional independence, and quality of life, while also supporting carers and reducing long-term care needs.

Why Bidet Solutions Matter in Occupational Therapy
1. Improved IndependenceBidets support individuals with disabilities or physical limitations to manage personal hygiene with less or no assistance, promoting greater autonomy in daily routines.
2. Enhanced HygieneA bidet offers superior cleansing compared to toilet paper alone. This is particularly beneficial for individuals with:

• Limited reach
• Skin sensitivity or wounds
• Incontinence-related hygiene needs

3. Reduced Caregiver BurdenBy enabling clients to self-manage toileting tasks, bidets help reduce the physical strain, time, and emotional load on carers, promoting sustainability of care at home.
4. Increased Self-Esteem and DignityMaintaining control over personal care can boost self-esteem and support psychological well-being, especially in clients adjusting to disability, ageing, or medical trauma.
5. Improved SafetyBidets eliminate the need for twisting, reaching, or standing while cleaning, which helps reduce the risk of:

• Falls
• Shoulder or wrist strain
• Poor skin integrity

How Occupational Therapists Use Bidet SolutionsAssessmentOTs assess:

• Functional toileting ability
• Hand and upper limb coordination
• Sitting balance and transfers
• Sensory preferences
• Environmental fit and safety

RecommendationFollowing assessment, the OT recommends the most suitable solution based on:

• Physical and cognitive capacity
• Toilet setup
• Funding options
• Short- and long-term goals

TrainingTherapists provide:

• Education and hands-on training to clients and carers
• Demonstrations and visual supports as needed
• Troubleshooting tips and safety considerations

Follow-UpThe OT reviews:

• Whether the bidet meets client needs
• Comfort and satisfaction
• Any evolving care or equipment requirements

Types of Bidet Solutions
​1. Bidet Attachments

• Installed beneath the existing toilet seat
• Simple, low-cost, and non-electric options available
• Often suitable for early intervention or short-term support

2. Bidet Toilet Seats

• Replace the original toilet seat with an electric or manual system
• Can include warm water, air drying, heated seats, remote controls, and self-cleaning nozzles
• Ideal for long-term use and greater comfort

3. Portable Bidets

• Handheld or battery-powered devices
• Useful for travel or where installation is not feasible
• May be a temporary or supplementary solution

Special Considerations

​​

• Wheeled Commode Use (Current or Future):
  Clients who use or may require a wheeled commode present significant limitations in bidet compatibility. Many bidet models are not compatible with commode frames due to seat design or plumbing restrictions, so it’s essential to assess current and future toileting needs early in the prescription process.
• Plumbing and Electrical Requirements:
  Electric bidets often require a nearby GPO (General Power Outlet) and suitable water access. Some homes, especially older or rental properties, may not support easy installation, so coordination with a plumber or electrician may be required. Non-electric options are available but may provide fewer features.
• Toilet Design and Compatibility:
  Not all bidets fit all toilet bowls—especially back-to-wall, wall-hung, or compact toilets. Measuring the pan, checking for cistern clearance, and reviewing seat dimensions is crucial to ensure a suitable fit.
• Cognitive and Sensory Considerations:
  Bidets with electronic controls, heated seats, or spray adjustments may be overwhelming for clients with cognitive impairments or sensory processing issues. Simpler models or those with manual dials might be more appropriate in such cases.
• Dexterity and Strength Requirements:
  Clients must be able to operate the bidet's controls unless a remote or automated model is used. Consider the user’s reach, grip, and ability to maintain balance during and after use.
• Carer Involvement and Manual Handling:
  For clients with high physical support needs, a bidet may reduce carer strain by eliminating the need for wiping. However, ensure bidet use doesn’t compromise the carer’s ability to assist safely or increase transfer complexity.
• Trial Opportunities and Client Acceptance:
  Bidet use is highly personal. When possible, providing trial opportunities or supporting access through an equipment library can improve acceptance and confidence. Cultural norms or discomfort around water cleansing should also be sensitively explored.
• Funding Pathways and Documentation:
  Ensure the clinical rationale aligns with relevant scheme requirements (e.g., NDIS, DVA RAP, or CHSP). Justification should focus on hygiene, independence, and manual handling benefits, not luxury.
• State-Specific Building and Plumbing Requirements:
  Each state or territory in Australia may have different plumbing and building codes that impact the installation of bidets—particularly those with backflow prevention requirements. Occupational therapists should consult with licensed plumbers familiar with local regulations and include these considerations in funding and installation planning.
• Environmental Benefits:
  Bidets significantly reduce toilet paper use, conserving water and reducing environmental waste. While toilet paper manufacturing consumes large volumes of water and trees, bidets use a small amount of water per use, making them an eco-friendly alternative.

Available funding and processes

 National Disability Insurance Scheme (NDIS)

• Eligibility: People under 65 (or under 9 with early childhood approach) with a permanent and significant disability.
  
• How bidets are funded:
  
  • Usually under Assistive Technology (AT) categories (mid- or high-cost).
    
  • Requires OT assessment, justification, and sometimes a trial.
    
  • May require quotes and evidence of value-for-money.
    
• Relevant when: OT is supporting participants with toileting independence, carer reduction, or hygiene-related functional goals.
  

​OT Process for Prescribing a Bidet under the NDIS1. Initial Assessment

• Conduct a comprehensive functional assessment to understand the participant’s abilities, goals, and support needs in toileting tasks.
  
• Identify barriers to safe and effective toileting, including physical, cognitive, sensory, or psychosocial factors.
  
• Evaluate current supports, equipment, and carer input.
  

2. Determine Suitability

• Assess the appropriateness of a bidet as an assistive technology (AT) solution.
  
  • Does it promote increased independence or reduce carer burden?
    
  • Is the participant receptive to this type of support?
    
• Consider alternatives, including long-handled aids or carer assistance, and justify why a bidet is the most reasonable and necessary solution.
  

3. Home Environment Assessment

• Complete a toileting area assessment, noting:
  
  • Toilet type and dimensions.
    
  • Proximity to water supply and electrical outlet (for electric models).
    
  • Structural or plumbing limitations.
    
  • Future equipment needs (e.g. wheeled commode compatibility).
    
• Consider NDIS participant housing type (private, rental, SDA) and landlord permission if required.
  

4. Identify Appropriate Product

• Research and trial (if possible) suitable bidet models that:
  
  • Match the participant’s physical and cognitive capacity.
    
  • Are compatible with their toilet type and environment.
    
  • Meet NDIS criteria for "value for money," durability, and functionality.
    
• Record specific model, supplier, and installation requirements.
  

5. Consultation with Installer or Plumber

• Obtain a quote and written confirmation from a licensed plumber or supplier for installation, including:
  
  • Compliance with state-based plumbing codes (e.g. backflow prevention).
    
  • Any modifications needed to the toilet or bathroom environment.
    

6. Gather Supporting Evidence

• Prepare supporting documentation, including:
  
  • Functional assessment findings.
    
  • Clinical justification for the bidet as a necessary and reasonable support.
    
  • Quote from supplier and/or plumber.
    
  • Photographs or measurements of the toilet area (if relevant).
    
  • Trial outcomes or consumer feedback (if applicable).
    

7. Submit Assistive Technology Request

• If the bidet is low-cost AT (under $1,500 and low risk):
  
  • The participant can typically purchase it directly using their Core budget.
    
  • The OT should still provide written guidance and include the item on the participant’s AT Self-Management Plan if required.
    
• If the bidet is mid or high-cost AT (over $1,500 and/or higher risk):
  
  • Submit a complex AT request via a detailed Assistive Technology Assessment Report.
    
  • Include all supporting documents and quotes.
    
  • Use the correct NDIS template (e.g., the AT assessment form or home modification form if structural changes are required).
    

8. Follow-Up and Training

• Support the participant after installation:
  
  • Provide education on use, cleaning, and maintenance.
    
  • Monitor function and benefits during review.
    
  • Adjust recommendations as needed.
    

9. Documentation and Review

• Ensure thorough documentation in clinical notes.
  
• Flag the support for future plan reviews or if the participant’s needs change (e.g., transition to a commode, cognitive decline).
  

Department of Veterans’ Affairs (DVA) – Rehabilitation Appliances Program (RAP)

• Eligibility: Veterans with a Gold Card or relevant condition under a White Card.
  
• How bidets are funded:
  
  • Prescribed as hygiene-related aids under RAP (usually non-schedule).
    
  • Requires D929 form, OT report, and supplier quote.
    
• Relevant when: Veteran’s condition impacts toileting, independence, or carer safety.
  

​Prescribing a Bidet for a Veteran under DVA RAP: OT Process & Eligibility1. Confirm Eligibility

• The veteran must hold a Gold Card (covering all clinically necessary healthcare needs) or a White Card (covering specific accepted conditions).
  
• For White Card holders, the bidet must be directly related to the accepted condition.
  
• Check the RAP National Schedule of Equipment (NSO) for bidet eligibility and item codes. Bidets fall under the Hygiene and Toileting category and may be classified as non-stock items.
  

2. Clinical Assessment

• Conduct a functional assessment focusing on the veteran’s:
  
  • Physical capacity (e.g. mobility, strength, coordination).
    
  • Cognitive ability to safely operate bidet features.
    
  • Current toileting method and challenges.
    
• Determine whether the veteran requires assistance with wiping or hygiene, and whether a bidet will:
  
  • Improve independence,
    
  • Reduce carer/manual handling needs, or
    
  • Maintain dignity and safety.
    

3. Environmental Assessment

• Assess the veteran’s home bathroom environment, specifically:
  
  • Toilet type (e.g., standard vs. back-to-wall).
    
  • Access to power and water supply.
    
  • Need for licensed plumbing or electrical work.
    
• Consider whether the veteran rents or owns the home, and if landlord permission is needed for modifications.
  

4. Determine Equipment Appropriateness

• Confirm the clinical rationale for a bidet over simpler solutions (e.g. bottom wipers, handheld bidet hoses).
  
• Consider the veteran’s goals and preferences, and trial the equipment if possible.
  
• Identify compatible bidet models that suit the toilet design and user capacity (e.g. push-button vs. remote control, non-electric vs. electric).
  

5. Liaise with an Approved DVA Supplier

• Contact an approved RAP supplier for quotes and confirmation of suitability.
  
• If the bidet is not on the NSO list, it will be treated as a non-schedule item, requiring:
  
  • Clinical justification.
    
  • Detailed quote(s).
    
  • Possibly a prior approval request from DVA via the supplier or OT.
    

6. Complete the RAP Form

• Submit a D929 – RAP Appliance Request Form, including:
  
  • Veteran details and DVA file number.
    
  • Clinical justification and goals.
    
  • Specification of bidet make/model and quote.
    
  • Attach any photos or installation notes if needed.
    
• For non-schedule items, provide a comprehensive rationale addressing:
  
  • Functional limitations.
    
  • Risks if support is not provided.
    
  • Cost-effectiveness over time (e.g. reduction in carer hours or hygiene products).
    

7. Supplier Installation & Handover

• Upon DVA approval, the supplier will:
  
  • Deliver and install the bidet.
    
  • Organize licensed plumbing/electrical work if needed.
    
  • Provide user training and manuals.
    
• The OT should:
  
  • Review the installation.
    
  • Ensure the veteran and/or carer understands how to use and maintain the equipment.
    

8. Follow-Up & Review

• Reassess outcomes and satisfaction within a reasonable timeframe.
  
• Document functional improvement and any ongoing concerns.
  
• Plan for re-prescription or changes if the veteran’s condition deteriorates.
  

Additional Considerations

• DVA won’t fund luxury or non-essential features—ensure the prescribed bidet is clinically justified.
  
• If the home layout restricts installation or access, consider alternative toileting strategies or refer for home modifications assessment.
  

WA Health Equipment Funding

• Eligibility: Inpatients or outpatients in public health services, subject to hospital policy.
  
• How bidets are funded:
  
  • May be short-term via hospital AT pools or social work discretionary funds.
    
  • Rarely long-term—usually redirected to external schemes.
    
• Relevant when: Discharge planning or inpatient rehab requires interim toileting support.
  

​Prescribing a Bidet through the WA Public Health System: OT Process & Eligibility1. Confirm Eligibility for Public Health Support

• The client must be eligible for publicly funded occupational therapy services—typically through:
  
  • Hospital inpatients (e.g., rehab wards, surgical recovery).
    
  • Outpatients or community clients (e.g., aged care, neurological conditions, disability services).
    
• The bidet must be clinically justified as necessary for functional independence, hygiene, or to support discharge planning.
  
• Public funding for assistive technology (AT) in WA is generally:
  
  • Short-term loan through hospital-based AT pools (if available).
    
  • One-off funding via internal hospital equipment budgets (limited).
    
  • External schemes, e.g., CHSP, NDIS, DVA, or charitable organisations, for ongoing/community needs.
    

2. Functional Assessment

• Complete a full functional toileting assessment, including:
  
  • Physical capacity (e.g. trunk control, hand function).
    
  • Cognitive ability (can they operate controls?).
    
  • Risk of skin breakdown, incontinence, infection.
    
• Identify whether the bidet addresses discharge barriers, reduces carer/manual handling, or promotes long-term independence.
  

3. Environmental Assessment

• Assess the client’s home toilet environment, including:
  
  • Toilet type (back-to-wall, standard, etc.).
    
  • Access to power and water supply.
    
  • Room for carer support if required.
    
• Determine whether structural changes are needed and if landlord permission is required (for renters).
  

4. Determine Funding Source

• OTs in WA public health generally cannot purchase bidets directly for long-term use.
  
• Depending on the client’s age, funding status, and setting, you may:
  
  • Refer to NDIS, DVA, or CHSP (if the client is eligible).
    
  • Apply for hospital-based short-term AT loan (often for inpatient rehab).
    
  • Provide documentation to support a social work or grants application (e.g., Lotterywest).
    
  • Refer to external services (e.g., Silver Chain, WAPHA, or community OT teams) for ongoing AT support.
    

5. Trial and Product Selection

• Arrange a trial if possible, especially for cognitive or sensory concerns.
  
• Identify a specific model that:
  
  • Meets the client’s needs.
    
  • Fits their toilet.
    
  • Can be installed safely.
    
• Confirm with supplier or installer regarding electrical/plumbing requirements and WA-specific regulations (e.g. backflow prevention under AS/NZS 3500).
  

6. Clinical Justification and Reporting

• Document a clear clinical rationale, including:
  
  • Functional limitations and goals.
    
  • Justification for bidet vs. alternatives.
    
  • Quotes and installation details.
    
• If the device is being referred for external funding (e.g. CHSP or NDIS), prepare formal documentation to support this (assessment report, AT forms, etc.).
  

7. Installation and Handover

• Installation may be arranged:
  
  • Privately by the client/family.
    
  • Via the external funding source (e.g., NDIS, DVA).
    
• Ensure:
  
  • The bidet is fitted correctly by a licensed plumber.
    
  • The client/carer receives education and a user manual.
    
  • Written maintenance instructions are provided if needed.
    

8. Follow-Up

• Schedule or recommend follow-up (if service capacity allows), especially for:
  
  • Review of functional outcomes.
    
  • Monitoring equipment use and satisfaction.
    
  • Re-prescription if the client’s condition or needs change.
    

Additional Considerations

• WA Health Services often work in multidisciplinary teams—liaise with:
  
  • Social Work (for funding pathways).
    
  • Allied Health Assistants (for trials and reviews).
    
  • Home Visiting Teams (for environment checks).
    
• Always check your hospital/health service’s specific equipment funding policy, as some sites have restricted AT purchase policies.
  

Home Care Packages (HCP)

• Eligibility: Older adults assessed by ACAT and approved for a Level 1–4 Home Care Package.
  
• How bidets are funded:
  
  • Funded directly from the client's package funds.
    
  • OT provides clinical justification and liaises with the provider.
    
• Relevant when: Bidets support ageing-in-place and reduce care needs.
  

Commonwealth Home Support Programme (CHSP)

• Eligibility: People aged 65+ (50+ for Aboriginal and Torres Strait Islander people) with functional limitations but not yet eligible for a Home Care Package.
  
• How bidets are funded:
  
  • Funded as entry-level support under home modifications or AT.
    
  • Requires assessment by a My Aged Care-registered OT provider.
    
• Relevant when: Supporting older adults to maintain independence and dignity at home.
  

Insurance Commission of WA (ICWA)

• Eligibility: Clients with injuries resulting from motor vehicle accidents in WA.
  
• How bidets are funded:
  
  • As part of rehabilitation or home modifications.
    
  • Requires OT report and clear link to the compensable injury.
    
• Relevant when: OT is involved post-MVA in functional restoration or discharge planning.
  

Lotterywest and Community Grants (via Social Work)

• Eligibility: WA residents facing hardship or ineligible for other schemes.
  
• How bidets are funded:
  
  • Social work teams may apply for one-off grants for necessary equipment.
    
  • OT provides supporting assessment and quotes.
    
• Relevant when: Client has no formal funding or falls between schemes.
  

State-based Aboriginal Health Services or Community Health Programs

• Eligibility: Aboriginal clients receiving support through Aboriginal Community Controlled Health Services or regional health programs.
  
• How bidets are funded:
  
  • Funding is often flexible and used based on clinical priority.
    
  • OT collaborates with case manager or Aboriginal health worker.
    
• Relevant when: Providing culturally appropriate care and supporting hygiene needs in the community.
  

Personal or Self-Funded (Private)

• Eligibility: Any client choosing to self-fund.
  
• How bidets are accessed:
  
  • OT provides guidance on product selection and supplier referral.
    
  • May assist with planning low-cost options or staged modifications.
    
• Relevant when: Other schemes are not available or clients prefer immediate access.
  

WorkCover WA / Workers' Compensation Insurers

• Eligibility: People with workplace injuries under approved workers' compensation claims.
  
• How bidets are funded:
  
  • Requires OT report linking toileting limitations to workplace injury.
    
  • Processed through insurer approval and rehabilitation provider.
    
• Relevant when: Supporting return to independence or transition from hospital to home.
  

Can CAEP Fund a Bidet?Possibly, but it’s not guaranteed. CAEP does not have a specific item category for bidets, so they are typically considered a non-standard or non-listed item, which means:

• A strong clinical justification is essential.
  
• The item must support essential activities of daily living (ADLs)—in this case, toileting and personal hygiene.
  
• The funding must demonstrate that a bidet is the most appropriate and cost-effective solution, compared to alternatives (e.g., bottom wipers, carer support).
  

Eligibility Criteria for CAEPTo be eligible, the person must:

• Be a permanent resident of WA.
  
• Be over 16 years of age.
  
• Have a long-term disability or condition (6 months+) that impacts their independence or safety.
  
• Not be eligible for another major funding scheme (e.g., NDIS, DVA, HCP, or CHSP).
  

Steps an OT Should Take When Requesting a Bidet through CAEP

1. Conduct a functional toileting assessment identifying clear hygiene and safety needs.
   
2. Trial lower-cost or simpler alternatives first, if appropriate.
   
3. Get a quote from a supplier or installer.
   
4. Submit a detailed application via the CAEP portal or to the Equipment and Technology Team (ETT), including:
   
   • Client information and eligibility.
     
   • Clinical justification linking the bidet to functional gains.
     
   • Evidence that other options are not suitable or effective.
     
5. Wait for approval—applications for non-listed items may be escalated for review and can take longer than standard requests.
   

Important Considerations

• CAEP will not fund luxury features—only basic models necessary for function.
  
• Bidets that require electrical or plumbing modifications may not be covered unless deemed essential and safe.
  
• Home ownership or rental permissions may impact installation.
  

Department of Communities – Housing) does not fund bidets directly.
However, they may permit or facilitate modifications related to toileting--but only when another funding body (like NDIS or DVA) is covering the cost of the equipment and installation.

Brett's Top 3 tips -

Bidets Are an Eco-Friendly Assistive Tech
​A typical household can use up to 40 rolls of toilet paper per person per year—bidets drastically reduce this, saving water, trees, and packaging. For clients who are environmentally conscious, this is a great talking point that also supports sustainable living—something that aligns well with OT’s holistic, values-based practice.

Not All Bidets Are Created Equal
​OTs prescribing bidets must think beyond hygiene--toilet bowl shape, client cognition, future commode use, and carer access all impact the best choice. For example, clients needing wheeled commodes will have limited compatibility with standard bidet seats. This makes bidets a surprisingly complex piece of assistive tech—and one where an OT’s problem-solving and environmental modification skills really shine.

Suggestions for Managing Client Expectations When Prescribing a Bidet1. Be Clear About What a Bidet Can—and Can’t—Do

• Explain that a bidet assists with cleaning, but:
  
  • May not fully eliminate the need for carer support, especially for transfers or clothing management.
    
  • May not suit everyone—some clients dislike the sensation or have difficulty using controls.
    

Tip: Use plain language:
“The bidet helps clean after toileting, but it won’t dry you completely unless you choose a model with a dryer. You may still need a small amount of drying or repositioning depending on your mobility.”

2. Discuss the Trial and Adjustment Period

• Let clients know that using a bidet often takes practice.
  
• There may be:
  
  • Initial discomfort or uncertainty.
    
  • The need to adjust settings (water pressure, nozzle position, temperature).
    
  • A learning curve with remote controls or side panels.
    

Tip:
“It’s normal to take a week or two to get used to it. We’ll trial a few settings to find what works best for you.”

3. Be Honest About Installation Requirements

• Clarify that not all toilets are compatible, and some electrical or plumbing modifications may be needed.
  
• Managing expectations around:
  
  • Timeframes for delivery and installation
    
  • Landlord or housing approval processes
    
  • Delays in funding approval (NDIS, DVA, etc.)
    

Tip:
“Because it’s a medical device, we need to follow the correct process to ensure it’s safe, installed properly, and funded appropriately.”

4. Talk Through Maintenance and Cleaning

• Let clients and carers know:
  
  • Who is responsible for cleaning the unit.
    
  • How often filters or nozzles may need servicing.
    
  • The lifespan of the bidet (typically 5–7 years).
    

Tip:
“We’ll go through how to clean the bidet safely—it’s fairly simple, but it’s important to keep it hygienic.”

​

5. Address Cost and Funding Realistically

• Be transparent about:
  
  • Whether the client is eligible for funding (NDIS, DVA, CHSP, etc.)
    
  • What additional costs may arise (e.g. plumbing, electrician, removal at end of lease)
    
  • Funding approval timelines (can range from 2–12+ weeks for mid/high-cost AT)
    

Tip:
“We’re applying for funding, but it may take some time to process. I’ll keep you updated and let you know as soon as we get an outcome.”

Bonus Suggestions:6. Set Follow-Up Expectations

• Let the client know you’ll:
  
  • Check in after installation
    
  • Provide education or troubleshooting support
    
  • Adjust the approach if needed
    

Tip:
“If anything feels uncomfortable or not quite right after install, just let me know—we can adjust settings or talk through other options.”

7. Use Goal-Oriented Language

• Keep the focus on what they want to achieve (e.g. privacy, dignity, less carer reliance), and how the bidet supports that.
  
• Reinforce that assistive tech is part of a broader independence strategy.
  

Client Groups or Diagnoses Where a Bidet May Not Be Appropriate1. Moderate to Severe Cognitive Impairment (Without Supervision)

• E.g. Advanced dementia, brain injury with disinhibition, or severe intellectual disability
  
• Clients may:
  
  • Not understand how to operate or use the bidet
    
  • Activate it unsafely (e.g. while standing)
    
  • Become distressed or confused by the sensation
    

Why avoid:
High risk of misuse, distress, or injury without direct supervision or a simplified alternative.

2. Clients with Severe Behavioural Dysregulation

• E.g. Psychosis with disorganisation, impulse control disorders, trauma-based dysregulation
  
• Risk of:
  
  • Aggression toward the device
    
  • Overuse or deliberate damage
    
  • Reactivation of past trauma during toileting routines
    

Why avoid:
Bidets may become a focus of agitation or be used inappropriately, compromising safety and hygiene.

3. Individuals With Significant Sensory Aversion

• E.g. Autism spectrum disorder, sensory processing disorder, or PTSD where bidet sensations are triggering
  
• Symptoms may include:
  
  • Intolerance to water spray, noise, warmth
    
  • Fight-or-flight responses in the bathroom
    
  • Shutdown or refusal to toilet
    

Why avoid or modify:
If trial attempts cause distress, consider alternative supports (e.g. bottom wipers, tailored sensory preparation).

4. Complex Skin Breakdown or Perianal Wounds

• E.g. Pressure injuries, fistulas, radiation burns, or chronic skin infections
  
• Water spray (even on low pressure) can worsen:
  
  • Tissue fragility
    
  • Healing delays
    
  • Pain during cleansing
    

Why avoid:
Bidets may aggravate wounds or delay healing. Seek continence nurse or wound specialist input first.

5. Incompatible Transfer Methods

• E.g. clients who rely on a wheeled commode, hoist transfers, or bedside toileting
  
• Bidets typically require:
  
  • Sitting directly on the toilet
    
  • Standard toilet height and seat access
    

Why avoid:
Bidets are generally not compatible with wheeled commodes or over-toilet frames with seat cutouts. Consider other hygiene solutions.

6. Clients in High-Risk Rental or Group Accommodation (Without Support)

• E.g. Unsupervised SDA, boarding homes, or rental housing without landlord approval
  
• Risks include:
  
  • Electrical or plumbing misuse
    
  • Lack of maintenance
    
  • Safety non-compliance
    

Why avoid or delay:
If there’s no guarantee of safe installation, maintenance, or use, a bidet may not be sustainable.

Clinical Tip:If unsure, trial the bidet with supervision in a controlled environment (e.g. Solutions Centre) and collaborate with carers or allied health colleagues to assess suitability.

Prescription Process

Bidet prescription - good practice

Department of Communities – Housing) does not fund bidets directly.
However, they may permit or facilitate modifications related to toileting--but only when another funding body (like NDIS or DVA) is covering the cost of the equipment and installation.

​Here’s What You Need to Know as an OT:1. Client Lives in a HomesWest Property

• You must seek written permission from the Department before any modification or installation can occur (including plumbing or electrical work for a bidet).
  
• The OT (or service provider) usually completes a "Request for Property Modification" form with supporting clinical justification.
  
• The modification must be reversible (i.e., the bidet can be removed if the tenant moves out).
  

2. HomesWest’s Role

• Provides approval for modifications on their properties.
  
• May cover minor modifications (e.g., grab rails, hand-held bidet hoses) in some cases where no other funding is available, but this is rare and limited.
  
• More commonly, HomesWest expects the NDIS, DVA, or CHSP/HCP to fund the equipment and installation.
  

3. OT Tips for Working with HomesWest Properties

• Always clarify whether the client owns, rents privately, or is in public housing.
  
• If in public housing:
  
  • Apply for funding separately through NDIS, DVA, or CAEP.
    
  • Engage with a licensed installer familiar with HomesWest processes.
    
  • Emphasize that the modification is medically necessary and supported by formal assessment.
    

Summary

• HomesWest does not fund bidets.
  
• They can approve modifications to allow installation—once another funder has approved the bidet.
  
• OTs play a key role in:
  
  • Writing clinical justification
    
  • Coordinating permission and paperwork
    
  • Ensuring compliance with tenancy agreements
    

Prescribing a Bidet in a Leased (Rental) Property: OT Considerations & Requirements

1. Landlord Permission Is Mandatory

• Any modification that involves plumbing, electrical work, or fixture changes must receive written approval from the landlord or property manager.
  
• Even minor installations (e.g., replacing a toilet seat with a bidet seat) should be disclosed.
  
• The OT or equipment provider should help the tenant request permission in writing, explaining:
  
  • That the modification is medically necessary.
    
  • That the change is reversible upon tenancy end, if applicable.
    

2. Type of Bidet Matters

• Non-invasive or removable models (e.g., bidet toilet seat attachments that don’t alter plumbing) are more likely to be approved in rental settings.
  
• Avoid prescribing bidets that:
  
  • Require permanent wall-mounted controls,
    
  • Alter structural plumbing,
    
  • Require significant electrical work without landlord consent.
    

3. Responsibility for Restoration

• The landlord may approve the bidet on the condition that:
  
  • The property is returned to its original condition at the end of the lease.
    
  • This cost may fall to the tenant, service provider, or funding scheme (e.g., NDIS or DVA may fund removal as part of the life of the equipment).
    

4. Installation Must Be by Licensed Professionals

• Plumbing and electrical work must comply with local building codes (e.g., AS/NZS 3500 for backflow prevention).
  
• OT should recommend installation only by licensed and insured professionals.
  
• A quote and installation plan may need to be shared with the landlord.
  

5. Ensure Reversibility

• Prefer removable or portable options when:
  
  • The lease is short-term.
    
  • There’s a risk of moving soon.
    
• Document how the bidet can be uninstalled and the area restored.
  

6. Funding Scheme Requirements

• If the bidet is funded by NDIS, CHSP, or DVA, the OT must:
  
  • Clearly state the property is a rental.
    
  • Demonstrate that permission has been obtained or is pending.
    
  • Justify why the equipment is the least restrictive, most cost-effective solution.
    
  • Confirm the installation is safe and will not void tenancy agreements.
    

7. Tenant’s Rights & Responsibilities

• In Australia, tenants with a disability have the right to request reasonable modifications under tenancy law (varies by state).
  
• The landlord cannot unreasonably refuse a request that is:
  
  • Clinically necessary,
    
  • Reversible,
    
  • Properly installed by professionals,
    
  • Funded at no cost to the landlord.
    

Optional OT Actions:

• Support the tenant with advocacy letters or reports explaining clinical need.
  
• Coordinate with support coordinators or housing advocates to liaise with real estate agents or housing departments.
  
• Provide a risk management plan to address concerns like leaks, misuse, or cleaning.
  

Recommended Replacement Period for a Bidet in Clinical Use: 5–7 Years

Why 5–7 Years?1. Hygiene and Infection Control

• In clinical or high-use community settings (e.g., aged care, supported disability housing), bidets are exposed to frequent moisture, organic material, and cleaning products, which over time can:
  
  • Degrade seals and nozzles.
    
  • Lead to biofilm buildup in internal components.
    
  • Reduce reliability of self-cleaning features.
    
• Regular use of disinfectants can also wear down plastic surfaces and controls, increasing risk of hygiene breaches.
  

2. Mechanical and Electrical Wear

• Most electric bidets have pumps, heating elements, sensors, and electronics that naturally degrade with regular use.
  
• As with any assistive tech with moving parts, there's a point where:
  
  • Maintenance becomes cost-inefficient.
    
  • Replacement is more reliable than ongoing repair.
    
• Mid- to high-end bidets typically have a warranty of 1–3 years, but performance tends to decline after 5–7 years in high-usage settings.
  

3. Manufacturer and Supplier Guidelines

• Reputable suppliers often suggest replacement at 5–7 years to ensure:
  
  • Ongoing safety compliance (especially electrical).
    
  • Compatibility with updated technology and accessories.
    
• Some providers offer preventative replacement as part of asset management plans.
  

4. Client Needs May Change

• Functional decline (e.g., cognitive impairment, commode transition, mobility change) may make the original bidet incompatible or unsafe.
  
• Replacement offers a chance to reassess suitability, environment, and upgrade features if necessary (e.g. larger buttons, remote control, auto-wash/dry cycles).
  

Clinical Practice Tip:For OTs prescribing bidets under schemes like NDIS, DVA, or CHSP, it’s good practice to:

• Include the expected life of the equipment (5–7 years) in your report.
  
• Recommend scheduled review at 3–5 years to assess continued appropriateness and function.
  
• Ensure documentation supports re-prescription or upgrade at the end of life if clinically justified.
  

WA-Specific Regulatory Requirements

• Plumbing compliance: Backflow prevention requirements (must be installed by a licensed plumber in WA)
  
• Electrical compliance: Any bidet requiring a power source must be installed with access to a safe GPO
  
• Health Department Guidelines: Infection control standards in hospitals, residential care, and rehab units
  

Review and Re-prescription Guidelines

​

• Include a recommendation to review bidet use every 3–5 years or if:
  
  • The client’s condition changes significantly
    
  • The client moves house
    
  • Funding becomes available for a model upgrade
    
• Re-prescription checklists for long-term outcomes (e.g., reduced carer input, improved continence management, skin integrity)
  

Standardised Assessment

there are currently no standardized assessment tools developed specifically for bidet prescription in occupational therapy practice. However, there are several standardized functional assessments that are commonly used in clinical practice to support and justify the need for assistive technology such as a bidet, especially when demonstrating impact on toileting performance, independence, carer burden, and hygiene.
Below is a list of relevant standardized assessments that can be used as part of the bidet prescription process, along with their references:

1. Functional Independence Measure (FIM)

• Purpose: Assesses independence in ADLs, including toileting, grooming, and hygiene.
  
• Application to bidets: Helps quantify level of assistance required for toileting and personal hygiene, and supports justification for assistive technology to increase independence or reduce care hours.
  
• Reference: Uniform Data System for Medical Rehabilitation. (1997). Guide for the Uniform Data Set for Medical Rehabilitation (including the FIM instrument). Buffalo, NY: UDSMR.
  

2. Canadian Occupational Performance Measure (COPM)

• Purpose: Client-centred tool assessing perceived performance and satisfaction in self-care, productivity, and leisure.
  
• Application to bidets: Identifies toileting or hygiene as a client-centred goal and tracks perceived improvement post-intervention.
  
• Reference: Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2014). Canadian Occupational Performance Measure (5th ed.). CAOT Publications ACE.
  

3. Toileting Performance Measure (TPM)

• Purpose: Measures performance in toileting tasks with step-by-step analysis.
  
• Application to bidets: Provides task-specific data on where independence breaks down (e.g., reaching to wipe, maintaining balance).
  
• Reference: As documented in literature on stroke and spinal cord injury rehab, e.g., Radomski, M. V., & Latham, C. A. T. (2014). Occupational Therapy for Physical Dysfunction (7th ed.). Lippincott Williams & Wilkins.
  

4. Caregiver Burden Scale / Zarit Burden Interview

• Purpose: Measures strain and burden on caregivers.
  
• Application to bidets: Use to demonstrate how reducing dependence for toileting reduces carer time and physical burden.
  
• Reference: Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649–655.
  

5. ADL Assessments (e.g., Barthel Index, AMPS, Modified Rankin Scale)

• Purpose: General measures of performance in activities of daily living.
  
• Application to bidets: Highlights impairment in toileting hygiene as part of overall ADL support needs.
  
• References:
  
  • Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65.
    
  • Fisher, A. G., & Bray Jones, K. (2010). Assessment of Motor and Process Skills (AMPS) Manual.
    

Note on Gaps in LiteratureThere is currently no validated tool that directly evaluates the functional benefit or use of a bidet, nor a tool that standardizes its prescription process. This presents an opportunity for research and development within occupational therapy—particularly in the context of ageing, disability, and environmental modifications.

Prescription form

bidet_prescription_form_ot.docx
File Size:	27 kb
File Type:	docx

Download File

---

Australian Standards & Regulations for Bidet Prescription in WA1. AS/NZS 3500 – Plumbing and Drainage StandardsKey Section:

• 1. AS/NZS 3500.1:2021 – Water Services
  This standard includes requirements for backflow prevention, which is critical when prescribing and installing bidets.

OT Relevance:

• Bidets must not contaminate the potable water supply.
• Bidets with a spray nozzle require appropriate backflow prevention devices, such as:
  • RPZ (Reduced Pressure Zone) valves
  • Air gaps
  • Double check valves (in lower-risk situations)

In WA:

• Only a licensed plumber can assess and install these systems.
• Plumbers must ensure compliance with the Water Corporation's regulations and report installations if needed.
• 2. AS/NZS 3000 – Electrical Installations (Wiring Rules)Key Section:
  
• AS/NZS 3000:2018 – Electrical Installations (Wiring Rules)
  This standard outlines electrical safety requirements, especially in wet areas like bathrooms.
  
• OT Relevance:
  
• Electric bidets require access to a GPO (General Power Outlet).
  
• The outlet must be:
  
  • Installed by a licensed electrician
    
  • Positioned at least 400 mm from the floor and away from direct water contact
    
  • Protected by a Residual Current Device (RCD)
    
• Extension cords or power boards are not permitted for permanent bidet use.
  
• 
  3. WA-Specific RegulationsWater Corporation (WA)
• Bidet installations must meet local plumbing laws, including appropriate backflow prevention.
  
• Plumbers may be required to submit a Plumbing Notification Form for non-standard fixtures.
  
• Department of Mines, Industry Regulation and Safety (WA)
• Enforces compliance with electrical work and installations under the Electricity (Licensing) Regulations 1991.
  
• All electrical modifications must be certified by a licensed electrician.
  
• Department of Communities – Housing (formerly HomesWest)
• If the client lives in public housing, landlord approval is mandatory before installation.
  
• Any modifications must be:
  
  • Clinically justified
    
  • Installed by licensed tradespeople
    
  • Reversible upon tenancy end
    
• 
  4. Infection Control and Hygiene
• In hospital or clinical settings, bidets must support infection prevention protocols.
  
• Use bidets with:
  
  • Self-cleaning nozzles
    
  • Antimicrobial surfaces
    
  • Closed design to prevent splash and contamination
    
• Disinfection and cleaning procedures should follow facility standards (e.g. Australian Guidelines for the Prevention and Control of Infection in Healthcare).
  
• 
  5. Assistive Technology Practice Guidelines (OT-Relevant)
• While not enforceable by law, OT practice should align with:
  
  • NDIS AT Practice Standards
    
  • Occupational Therapy Australia Clinical Guidelines
    
  • ATSA (Assistive Technology Suppliers Australia) recommendations
    
  • ISO 9999 AT Classification, for documentation and equipment codes
    
• 
  OT Recommendations for Compliance
• Always recommend licensed installation (plumber and/or electrician)
  
• Include relevant compliance requirements in your OT report or prescription form
  
• Identify whether client is in public housing, rental, or private property
  
• Document client consent and long-term suitability
  

​Optional Bidet Features to Consider in OT Prescription1. Washing & Water Features

• Rear wash (standard posterior cleansing)
  
• Front/feminine wash (gentler anterior wash)
  
• Adjustable water pressure (important for sensitive skin or sensory needs)
  
• Adjustable nozzle position (for precision and comfort)
  
• Adjustable water temperature (comfort and thermal safety)
  
• Pulsating or oscillating spray mode (for improved hygiene or sensory preference)
  
• Self-cleaning nozzles (automatically rinses after use)
  

2. Drying Features

• Warm air dryer (replaces need for wiping)
  
• Adjustable drying temperature and strength
  
• Timed drying cycles
  
• Auto-dry after wash (fully hands-free toileting)
  

3. Seat Features

• Heated seat (temperature adjustable)
  
• Soft-close lid and seat
  
• Deodoriser (automatic odour-neutralising fan)
  
• Seat occupancy sensor (activates functions only when user is seated)
  

4. User Interface and Controls

• Side control panel (fixed to seat, with buttons or dials)
  
• Wireless remote control (can be mounted or handheld)
  
• Large button or high-contrast options (vision or dexterity support)
  
• Voice-activated control (emerging feature, smart home compatible)
  
• Preset user profiles (e.g., "User 1", "User 2" with saved settings)
  
• Lockout/safety mode (useful in shared households or with cognitive impairment)
  

5. Accessibility and Safety Features

• Night light/LED lighting
  
• Anti-slip seat surface
  
• Child lock function
  
• Auto shut-off or timed power saving
  
• Backflow prevention compliance (plumbing safety)
  

6. Compatibility and Mounting

• Compatible with over-toilet frames or grab rails
  
• Slimline or compact models (for space-limited bathrooms)
  
• Quick-release seat design (for easy cleaning or removal)
  
• Removable remote holder/mounting bracket
  

7. Environmental and Power Features

• Eco mode / energy saver function
  
• Low water consumption
  
• Battery backup (in some models)
  

OT Considerations When Choosing Features:

• Client’s physical capacity: (reach, grip, strength)
  
• Cognitive and sensory needs
  
• Toilet design and bathroom environment
  
• Carer involvement (or reduction thereof)
  
• User comfort and personal hygiene preference
  
• Risk management (burns, overuse, misuse, confusion)
  

​Considerations for Other Toilet Users in Bidet Prescription

1. Shared Toilet Use

• If the toilet is used by multiple household members, consider:
  
  • Ease of switching settings (e.g., pressure, nozzle position).
    
  • Whether other users are comfortable or familiar with using a bidet.
    
  • Potential confusion or misuse if users aren’t trained.
    
  • Need for child safety features or lockout functions, especially with electric models.
    

2. Respecting Cultural Preferences

• Some household members may be unfamiliar or uncomfortable with water-based toileting.
  
• Cultural or generational norms may influence acceptance of bidet use—especially in multi-generational homes.
  
• OTs should involve household members in the discussion where appropriate, while prioritizing client privacy and independence.
  

3. Accessibility and Safety

• Ensure the bidet does not interfere with other users' safety or comfort, particularly:
  
  • Children or people with disabilities
    
  • Carers or family assisting other individuals in the same bathroom
    
• Consider how carer access might be affected if space becomes restricted (e.g., by the bidet seat or controls).
  

4. Cleaning and Maintenance Responsibilities

• Clarify who is responsible for maintaining the bidet:
  
  • Some models require manual cleaning, filter changes, or nozzle maintenance.
    
  • Make sure the solution is manageable for the household—especially in shared rental, group, or SDA housing.
    

5. Compatibility With Other Aids

• If another user requires:
  
  • A wheeled commode (future or current),
    
  • An over-toilet frame, or
    
  • Grab rails or hoist transfers, …ensure the bidet does not interfere with existing supports used by others.
    

6. Privacy and User Settings

• Consider bidets with:
  
  • Multiple user presets (some electric models can store settings).
    
  • Manual or automatic nozzle cleaning between uses.
    
  • Remote control storage to prevent accidental activation by others.
    

7. Water and Electrical Safety

• In multi-user homes, accidental misuse is more likely:
  
  • Ensure child lock features are engaged when needed.
    
  • Make sure power cords or hoses are secured and not a trip hazard.
    

Clinical Tip:In the OT’s clinical reasoning or justification, consider adding a line like:
"The bidet prescribed is appropriate for shared household use, with features that support hygiene, ease of use, and safe integration into a multi-user bathroom environment."

​Contraindications for Bidet Prescription
​1. Cognitive Impairment Without Supervision or Safety Controls

• Clients with moderate to severe cognitive impairment (e.g., dementia) who are unable to understand or follow instructions may:
  • Misuse controls (e.g., activate spray when not seated)
  • Be distressed by unexpected sensations (water or air spray)
  • Leave the unit on, posing burn or electrical risks

Precaution: Consider simple models, lockable features, carer-operated remotes, or avoid prescription if risk outweighs benefit.

2. Current or Planned Wheeled Commode Use

• Most bidets are not compatible with wheeled commodes or over-toilet frames with integrated seats.
• Using a commode over a bidet seat may damage the bidet and interfere with hygiene or safety.

Precaution: If commode use is likely in the near future, re-evaluate whether a bidet is suitable or delay prescription.

3. Significant Pressure Injury or Open Wounds

• Bidet use may irritate or exacerbate skin damage, especially around the perineum or buttocks.

Precaution: Consult wound care or continence nurse before prescribing. Delay use until wounds have healed.

4. High Sensory Sensitivity or Aversive Response

• Individuals with autism, sensory processing disorder, or trauma histories may find water spray:
  • Invasive or distressing
  • Triggering of emotional or behavioural responses

Precaution: Trial with desensitisation or support gradual exposure. Avoid if it causes distress or refusal to use the toilet.

5. Inadequate Bathroom Environment

• Lack of access to:
  • Safe plumbing or electrical installation
  • Sufficient space for safe transfers
  • Support rails or stable toilet

…can make bidet installation unsafe or non-compliant with AS/NZS regulations.
Precaution: Address environmental barriers first or explore alternative supports.

6. Inability to Sit Upright or Maintain Seated Position

• Clients with severe postural instability or risk of sliding/falling during toileting may be unsafe using a bidet independently.

Precaution: Trial with supervision or consider adaptations such as:

• Lateral supports
• Seating systems
• Alternative toileting methods

7. History of Electrical Device Misuse or Fire Risk

• In clients with unsafe behaviours, poor impulse control, or prior misuse of appliances, electric bidets may pose:
  • Fire hazard
  • Damage to property
  • Electrical injury risk

Precaution: Consider non-electric bidet models or omit prescription entirely.

Final Note:OTs should always complete a risk-benefit analysis in their clinical reasoning and document any contraindications, trial outcomes, and safety plans. The decision to prescribe (or not prescribe) a bidet should always be made in collaboration with the client, carers, and relevant health professionals.

Alternate Considerations for Bidet Prescription in a Clinical Setting
1. Infection Control and Hygiene Protocols

• Clinical environments require strict adherence to infection prevention guidelines.
  
• Bidets may be considered high-risk fixtures due to potential splash, backflow, and surface contamination.
  
• Must comply with:
  
  • Australian Guidelines for the Prevention and Control of Infection in Healthcare (NHMRC)
    
  • Local infection control policies
    
  • Backflow prevention (AS/NZS 3500) and cleaning protocols
    

Tip: Always consult the facility’s infection control team before recommending or trialling a bidet.

2. Shared Use and Communal Bathrooms

• In many clinical settings, toilets are shared between clients or residents.
  
• Bidets may:
  
  • Not be appropriate for shared use (hygiene risk)
    
  • Cause distress or confusion for other users
    
  • Increase maintenance needs
    

Alternatives:

• Personal hygiene wipes (if appropriate)
  
• Handheld bidet sprayers with lockout valves
  
• Allocated private bathroom where possible
  

3. Short-Term or Transitional Use

• Bidet installation may not be justifiable for short-stay or temporary patients.
  
• Consider loan options, non-permanent solutions, or trial devices.
  

Tip: Focus on whether the client is likely to benefit from a bidet post-discharge, and begin planning accordingly.

4. Carer or Staff Support Needs

• Ensure staff are trained and aware of:
  
  • How the bidet operates
    
  • Safety features (e.g. seat sensors)
    
  • Maintenance/cleaning responsibilities
    
• Consider whether the bidet reduces or complicates support tasks.
  

Tip: Trial periods and clear protocols help improve acceptance and appropriate use.

5. Environmental and Infrastructure Limitations

• Many hospital bathrooms lack:
  
  • Power outlets near the toilet
    
  • Accessible plumbing for T-valves
    
  • Permission to install semi-permanent fixtures
    

Workaround:

• Use portable or battery-operated non-electric bidets
  
• Recommend bidet only for post-discharge home use
  

6. Organisational Policies and Funding

• Some facilities have specific policies around equipment installation or permanent fixture modifications.
  
• Equipment in clinical settings is typically funded via:
  
  • Hospital AT pool (short-term use)
    
  • Ward/department discretionary budgets
    
  • External funding (e.g. NDIS, DVA) if supporting transition home
    

7. Documentation and Clinical Reasoning

• Justify the need for a bidet as part of:
  
  • A broader toileting or continence management plan
    
  • Pressure injury prevention
    
  • Functional rehab outcomes (e.g. FIM scores)
    
• Highlight relevance to discharge planning, reduced care needs, or dignity in care.
  

8. Equipment Trials and Supplier Access

• Bidet trials may be limited in clinical settings.
  
• Consider:
  
  • Demonstration models via suppliers or solutions centres (e.g. your Bentley location)
    
  • Involving family/supports to trial at home if not feasible in the facility
    

Complementary Assistive Technology & Equipment to Consider with Bidet Prescription
1. Transfer and Mobility Equipment

• Over-toilet frame:
  For clients needing upper limb support when lowering to or rising from the toilet.
• Shower commode chair (mobile or static):
  Especially useful for clients with poor sitting balance or who cannot safely transfer to a standard toilet.
• Wheeled commode with pan or over-to-toilet use:
  Important to note: Many bidets are not compatible with wheeled commodes.
• Grab rails:
  Wall-mounted or suction rails to support safe transfers, especially for clients with unilateral weakness (e.g. post-stroke).
• Transfer boards or slide sheets:
  For lateral transfers in clients using wheelchairs or with limited mobility.

2. Seating and Support Aids

• Toilet seat riser:
  Raises height of the toilet to reduce effort in sit-to-stand. Not always compatible with bidets, so assess carefully.
• Lateral or trunk supports:
  For clients with poor sitting balance or risk of falling sideways during toileting.
• Anti-slip cushions or pads:
  To prevent forward sliding and support posture during toileting.

3. Hygiene and Continence Aids

• Long-handled bottom wipers:
  An alternative or complementary tool when bidet is not appropriate or accessible.
• Incontinence pads and disposable hygiene products:
  Particularly in shared toilet environments or for clients with unpredictable continence.
• Skin integrity supports:
  Barrier creams, no-rinse cleansers, or protective wipes to accompany or replace bidet use in sensitive skin cases.

4. Environmental Aids

• Toilet surrounds or freestanding frames:
  An alternative for clients not ready for fixed grab rails.
• Privacy screens or toilet alarms:
  For clients who require privacy but also need supervision or quick staff response.
• Smart tech/environmental controls:
  Voice-activated or remote-controlled systems to control bidets, lighting, or alarms (especially for clients with high-level SCI or neurological conditions).

5. Visual or Cognitive Support Tools

• Visual instructions (picture-based sequences):
  For clients with cognitive impairment or neurodivergence (e.g., ABI, dementia).
• Contrast tape or high-contrast stickers:
  To increase visibility of bidet controls or toilet features for clients with low vision.
• Auditory or tactile cues:
  For clients with sensory processing challenges or visual impairments.

6. Pressure Care and Skin Management Aids

• Pressure-relieving toilet seat cushions:
  For clients at risk of pressure injuries due to prolonged time seated or reduced mobility.
• Moisture-wicking or breathable clothing adaptations:
  Supporting comfort and reducing hygiene-related skin risks.

Clinical Tip:
​When prescribing a bidet, think beyond the device itself—a holistic approach considers:

• Transfers
• Balance
• Cognition
• Carer supports
• Toileting routines
• Skin care and dignity

​The Aerolet toilet lift system is an electrically powered, height-adjustable toilet lift designed to assist people with:

• Reduced lower limb strength
  
• Postural instability
  
• Difficulty with sit-to-stand transfers
  

It raises and lowers the user smoothly over the toilet, mimicking a natural standing movement. Some models are compatible with bidet seats, making it a powerful combined solution.

Why Would an OT Consider the Aerolet?Indications:

• Clients with progressive conditions (e.g., MND, MS, Parkinson’s)
  
• Individuals recovering from hip or knee surgery
  
• Those with bilateral upper or lower limb weakness
  
• Situations where a bidet is appropriate, but the client can’t safely access or rise from the toilet
  
• Where a hoist or commode is not yet required, but conventional aids (e.g., rails, toilet seat raisers) are insufficient
  

Aerolet Key Features

• Electric sit-to-stand support
  
• Side or vertical lifting options
  
• Compatible with many toilets and some bidets
  
• Stable, wall-mounted or floor-mounted models
  
• Handheld control or button operation
  
• Gentle motion mimicking natural body movement
  

OT-Specific Considerations

• Environmental Assessment:
  
  • Requires structurally sound wall or floor (some models bolt into the floor)
    
  • Adequate space around toilet for equipment and user
    
  • Access to power outlet near the toilet
    
• Funding Pathways:
  
  • NDIS: High-cost Assistive Technology—requires formal assessment and quotes
    
  • DVA RAP: May be considered if clinically justified and no safer alternative
    
  • Private/self-funding for home installations
    
• Installation must be completed by a qualified technician
  
• Trial availability: Often available through AT suppliers or demo centres (e.g., your Bentley Solutions Centre could host one)
  

When to Choose Aerolet Over Other SupportsSituationConsider Aerolet If...Bidet + poor sit-to-standClient needs help transferring, but wants to remain continent and independent
OT frame or rails ineffectiveClient still cannot push up or maintain control
Wheeled commode not suitableClient doesn’t want to transfer to a mobile toilet or lacks space
Hoist feels excessive or intrusiveAerolet supports a dignified and user-led alternative

Report templates - 

- Landlord request letter (for rentals)

- OT clinical justification template

- Funding application support letter

- Client education handout (on using and maintaining a bidet)
​
- Installation scope template (to give to plumbers/electricians)

Recommended Hours for Billing – Bidet Prescription (Clinical Setting)
Below is a breakdown of typical time required for OTs involved in prescribing a bidet, based on clinical best practice and NDIS reporting standards. These estimates may vary depending on client complexity, funding scheme requirements, and environmental constraints.
1. Initial Functional Assessment Duration: 1.0 – 1.5 hours Includes: Discussion of toileting needs, physical and cognitive screening, and environmental setup.
2. Home Visit / Environmental Assessment Duration: 1.0 – 1.5 hours Includes: On-site measurement, access to power and water, commode compatibility, and landlord approvals if required.
3. Product Research and Supplier Liaison Duration: 0.5 – 1.0 hours Includes: Identifying suitable bidet models, verifying compatibility, and sourcing quotes.
4. Client and/or Carer Education or Trial Duration: 0.5 – 1.0 hours Includes: Trial at home or a demo site (e.g., Bentley Solutions Centre), explanation of functions and troubleshooting.
5. Report Writing and Funding Justification Duration: 1.0 – 1.5 hours Includes: Completion of NDIS AT assessment template or equivalent report, justification aligned with client goals.
6. Quote Collation and Application Submission Duration: 0.25 – 0.5 hours Includes: Uploading reports, attaching quotes, liaising with support coordinator or plan manager.
7. Post-Installation Review (Optional but Recommended) Duration: 0.5 hours Includes: Confirm correct setup, review client satisfaction, and provide further training if required.

✅ Total Recommended Time: Approximately 4.5 – 6.5 hours

(Time should be adjusted based on client complexity and funding requirements)
​
NDIS Reporting Tip: In your AT Assessment Form, clearly break down each of the above activities under: Assessment and Trials Report Preparation Coordination and Follow-Up

Useful references:

More information?

​Need Help with Bidet Prescription or Trial?
You can access support from an experienced occupational therapist or someone with lived experience through our Solutions Centre located in Bentley.
Demo bidet models are available on-site for hands-on trial and education. Contact:
OT Services Group – Solutions Centre
Bentley, WA
Phone: [Insert number]
Email: [Insert email or booking link]
Website: [Insert website]

Glossary of terms

What's not included?

- Research
- Supplier
​- CPD resources
- Case studies​
- clinical groups or diagnoese
- trauma informed and neuro affirming approach​