Arrangements of wash toilets and ageing bodies–an exploratory study

Purpose: The purpose of this study is to study how a specific assistive technology, namely wash toilet systems, are used and which values they enact for their users. 

Materials and methods: The study is primarily based on ten semi-structured interviews conducted with older adults who were offered a wash toilet as an element in the welfare service of a large Danish municipality. 

Results: The study shows how, in various ways, specific aspects of wash toilet systems are associated with specific aspects of human physiology. Essential challenges to older adults that implicate the use of wash toilet systems either relate to ’arms that cannot reach behind’, or the leakage of urine and eventually faeces. Furthermore the study shows that values enacted by wash toilet systems differ in the various arrangements, e.g., enabling social relations, being a part of something, being self-reliant or independent, preserving intimacy limits, or just ‘be pleased with’. 

Conclusions: The wash toilet systems are woven into several different arrangements of the ageing body, wheelchairs, walkers, care personnel, spouses, diapers, etc. being situated in differently spaced bathrooms in different homes and different municipalities. We propose that the abandonment of focus on abstract policy values in favour of an emphasis on the actual arrangements of technology and the human body in old age will, in fact, be beneficial to our understanding of how welfare technology can contribute to enhanced citizenship.Implications for rehabilitation An implication of this study for rehabilitation is not to take for granted how a wash toilet system will interact in arrangements with older adults, but attend to the potentially various/many ways the system can create value for the user in the actual arrangement it is part of. Another implication of the study is that it is always an empirical question whether self-reliance–which is often an aim of implementing assistive technologies - is an effect of a specific arrangement of a wash toilet system and the human body in old age.