ADP daily living component activity 5 – managing toilet needs or incontinence

This chapter provides information on activity 5 of the daily living component of Adult Disability Payment (ADP).

This chapter should be read and applied in line with the overview of decision making and the daily living component introduction. 

What it considers

Daily living component activity 5 considers:

• an individual’s ability to get on and off the unadapted toilet,
• to manage evacuation of the bladder and/or bowel and incontinence, and
• to clean afterwards

What daily living component activity 5 does not consider

Daily living component activity 5 does not consider the ability to:

• manage clothing,
• climb stairs or
• move to the toilet

Daily living component activity 5 does not consider the following:

• loosening or removal of any clothing as daily living component activity 5, as far as toilet needs, is assumed to start at the toilet with clothing removed as required
• any movement or steps required to get to the toilet
• the use of a commode where the principal impact on an individual is related to mobility and not management of bladder and/or bowel

Daily living component activity 5 descriptors

The daily living component activity 5 descriptors describe 6 levels of functional ability to complete the activity:

1. Can manage toilet needs or incontinence unaided
2. Needs to use an aid or appliance to be able to manage toilet needs or incontinence
3. Needs supervision or prompting to be able to manage toilet needs
4. Needs assistance to be able to manage toilet needs
5. Needs assistance to be able to manage incontinence of either bladder or bowel
6. Needs assistance to be able to manage incontinence of both bladder and bowel.ADP regs, Schedule 1 Part 2 - Daily Living Activities, Activity (5)).

Managing incontinence meaning

Managing incontinence means the ability to manage involuntary evacuation of the bladder and/or bowel, including the use of a collecting device or self-catheterisation, and cleaning oneself afterwards.

Consider aids and appliances

An individual may use an aid or appliance to assist them in completing this activity and this may mean that they satisfy daily living component activity 5 descriptor B, which is covered later.

You should consider both aids and appliances that an individual uses, and aids and appliances that they could reasonably be expected to wear or use.

Consider prompting, supervision or assistance from another person

You’ll also consider if the individual needs prompting, supervision or assistance from another person to complete the activity.

Meaning of terms

’Prompting’ means reminding, encouraging or explaining by another person. This does not have to be in the physical presence of the individual.

’Supervision’ means the continuous presence of another person for the purpose of ensuring an individual’s safety.  The supervision can be in relation to any risk to the individual’s safety, whether or not the risk directly results from carrying out the activity in question.

‘Assistance’ means physical intervention by another person and does not include speech.

Individuals with a catheter

An individual with a catheter either permanent (indwelling) or long-term use of an external sheath catheter, or stoma, should be considered incontinent for the purposes of this activity.

If the urinary tract has normal function

If the urinary tract has normal function, there is likely to be little risk of incontinence, no matter how long it takes an individual to move to the toilet.

If an individual has a bladder condition and will be incontinent

If an individual has a bladder condition and will be incontinent before they reach the toilet, then a commode could be considered as an aid for the bladder condition (toilet needs) and not for moving to the toilet (mobility needs).

Conditions that cause an urgency to evacuate the bladder and/or bowel will be relevant in this context.

You should note however, that this activity is not limited to conditions that impair the voluntary control over the bowel or bladder.

If an individual tolerates incontinence without seeking help

An individual may tolerate incontinence without seeking help.

They may have accepted this, as part of having children or the ageing process, and purchase their own incontinence pads, in which case, daily living component activity 5 descriptor B may be appropriate.

The volume of incontinence may vary between individuals and each individual may tolerate different volumes of loss before feeling the need to purchase or obtain incontinence pads, including where use is on a precautionary basis.

There is no requirement for an individual to have a formal diagnosis, but you’ll need enough evidence to determine which descriptor applies to the individual.

Managing toilet needs meaning

Managing toilet needs describes the following process:

• getting on and off an unadapted toilet
• evacuating the bladder and bowel
• cleaning oneself afterwards

Help is needed with managing toileting if an individual needs prompting, supervision or assistance with 1 or more of these 3 actions.