New Jersey Certified Homemaker-Home Health Aide (CHHA) · Master Personal Care Skills
Toileting and Continence Care
On this page 6 sections
In 30 seconds
The body gets rid of solid waste through the lower gastrointestinal system and urine through the urinary system, and both change with age and illness. Many clients need help getting to the toilet or staying clean afterward, and some have incontinence, which means they cannot fully control when urine or stool comes out. The CHHA helps calmly, privately, and without any hint of blame, because nothing feels more personal to a client. Skin that stays wet breaks down quickly, so keeping the client clean and dry is a health task as well as a comfort task. Any change in how often, how much, or what the waste looks like gets reported to the nurse.
Why this matters
Respectful, careful help with elimination protects skin, dignity, and health, and reveals changes worth reporting.
The college version
In normal terms
- The bowel handles solid waste and the bladder handles urine, and both need to work regularly for a person to feel well.
- Incontinence is common and is nobody's fault, so the CHHA helps the client stay clean and dry without embarrassing them.
- Toileting help follows the plan of care, protects privacy, and keeps the client safe from falls.
- Changes in frequency, color, amount, pain, or accidents are reported to the nurse, not judged by the CHHA.
Concepts in this outline
- Lower gastrointestinal system. — The last part of the digestive tract, which handles solid waste and moves it out of the body.
- Bowel elimination. — A bowel movement, meaning the body emptying solid waste, and the regular pattern each client normally has.
- Urinary system. — The kidneys, bladder, and connecting parts that make, store, and release urine.
- Incontinence. — Not being able to control when urine or stool comes out, which is common, never the client's fault, and calls for kind, private help.
- Gastrointestinal and urinary changes to report to a nurse. — Changes in how often, how much, color, pain, blood, or new accidents, all written down and reported to the nurse.
- Client-care procedures related to elimination. — Helping with the toilet, commode, bedpan, or urinal and with cleanup afterward, following the plan of care and protecting privacy and skin.
Eli explains
The same idea, in plain words
Explain it like I’m 10
Think about the trash and recycling pickup at your house. Every week the trucks come, the bins get emptied, and the house stays clean. The body has its own pickup system for waste. The lower gastrointestinal system is the last part of the food tube. It handles the solid waste. Bowel elimination is the name for a bowel movement, which is the body emptying that solid waste. The urinary system is the set of parts that make and store urine. It includes the kidneys and the bladder, which fills up like a little balloon and then empties.
For a lot of people, this pickup system runs on its own. For many clients, it does not run as smoothly. Illness, age, certain foods, and not drinking enough can change the schedule. Some clients cannot get to the bathroom on their own. Others cannot feel when their body needs to go. When a person cannot control when urine or stool comes out, that is called incontinence. It is very common, and it is never the client's fault. It can feel embarrassing, so the CHHA's attitude matters a lot. A calm face and a kind voice tell the client that this is normal and okay.
Helping with the bathroom is one of the most personal things a CHHA does. Client-care procedures related to elimination are the ways a CHHA helps, always following the plan of care. That is the nurse's written list of what the CHHA does for this client. Help can mean walking the client to the toilet. It can mean setting up a commode, which is a toilet chair that sits next to the bed. It can mean helping with a bedpan or urinal, the pans used in bed. It also means cleaning the skin afterward and changing wet clothes or pads. The CHHA gives the client privacy and stays close enough to help. The path to the bathroom stays clear. Skin that sits in wetness gets sore and can break open.
The CHHA is also the one who notices when the pickup schedule changes. Going much more often or much less often is worth writing down. So are pain, blood, a very dark color, or new accidents. These are the gastrointestinal and urinary changes to report to a nurse. The CHHA does not figure out what the change means. The CHHA reports it to the nurse, who decides what to do next.
Worked example
Beatriz arrives at Mr. Dubois's home each morning and helps him walk to the bathroom with his cane, then steps outside the door and waits where he can call her. When he is done, she helps him clean up, wash his hands, and get back to his chair along a path she has cleared.
One morning Mr. Dubois says quietly that he had an accident during the night. Beatriz tells him it happens to lots of people and helps him wash and change without any fuss. She notices he has needed the bathroom much more often over the past few days, so she writes it down and reports it to the nurse before she leaves.
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