At the June 24-27, 2009 MOVE trainings, Linda Bidabe, founder and author of the MOVE Program and Curriculum, introduced her most recently completed resource─the MOVE Hygiene and Toileting Program for children AND adults. There is a guidebook, an accompanying instructional DVD to visually illustrate what the guidebook describes, five large wall posters to mount in toileting areas for easy reference, and a Hygiene and Toileting Profile to complete for each student or adult learner. These items are now available for purchase from MOVE International (see MOVE Program Products).

The Need

Did you know? . . .

• The “toileting” issue is a primary reason people are placed in care facilities such as nursing homes.
• People with “toileting” issues are more confined to homes/institutions with fewer opportunities to get out into their communities.
• Care providers who change diapers (briefs) experience more back injuries, stress, frustration and low morale.
• There is a lack of dignity, especially for large people, when using change tables or the floor to change their diapers (briefs).

The Rationale and Purposes

The rationale and purposes of the MOVE Hygiene and Toileting Program are:

1. To change diapers (briefs) in a vertical position (even for non-weight bearing persons) rather than in a horizontal position.
2. To allow persons with disabilities the option/opportunity of using a toilet(or adaptive toilet).
3. To provide instructions for care providers on how to use the program.
4. To provide learning experiences for persons with disabilities to become as independent as possible in using the toilet (or adaptive toilet) and to provide opportunities to increase motor skills in sitting, standing, pivoting and taking steps. Other related skills are also addressed such as hand and arm use and communication.
5. The person with disabilities feels more secure when placed in a forward- learning position rather than on his or her back.
6. More dignity is afforded when the person with disabilities is not treated like a baby and private areas are less exposed.
7. Health is improved.
8. Less injuries for care providers and for persons with disabilities because lifting and/or maneuvering is reduced or eliminated.
9. Care provider morale increases, absenteeism rates decline because “toileting is easier, less time consuming, more dignified, and the care provider sees improvement in toileting and motor skills.
10. Reduces diaper (briefs) use.

Levels of Success and Six Steps

The MOVE Hygiene and Toileting Program has four functional levels of success (from non-weight bearing to walking with one hand held).

The program is divided into six steps. The first three steps define the learner’s current skills, the support needed to implement the program and establishment of a basic toileting routine.

1. ASSESS the learner’s current skills.
2. ESTABLISH a team and SELECT a toileting routine.
3. PREPARE the toileting environment & finish assessment.

The last three steps delineate the most critical skills to address and the methods for improving and recording the skills.

4. TARGET critical skills.
5. DEVELOP PLANS for improving skills.
6. TEACH & GENERRALIZE the skills.

Some MOVE Hygiene and Toileting Stories

I have a client who is geriatric, and had a stroke and aneurysm. She left another center because they wanted to use a catheter because she was so difficult to toilet. At our facility we use the MOVE Hygiene and Toileting Program and she LOVES IT!!

If this center would have inserted the catheter, she would have been at increased risk of infection and would have had to deal with the bag and line. She probably would have lost all mobility as well (since the staff at the other program would not have continued to get her up).

─Physical Therapist, Adult Care Facility

Using the MOVE Hygiene and Toileting Program has benefited my staff, students and their families. The students are using their weight bearing skills to use the toilet. The MOVE Hygiene and Toileting Program is helping our students develop skills for toileting in more community settings outside of school and the home.

Because of the MOVE Hygiene and Toileting Program, my staff is happier and parents are thrilled. Physical stress and strain have been reduced and staff and parents are not so tired. My staff has more energy to interact with students during classroom instruction times.

─Principal

When you ask staff to select a toileting preference, everyone unanimously responds, the ‘MOVE way’ please!! The reasons are specific and emphatic: 1) Our learners keep their dignity, and 2) The process is simple, manageable and adaptive for both our learners and staff. Simply stated, ‘It’s easier.’

─Administrator, Adult Care Facility

MOVE Hygiene and Toileting Seminars Available

One-day MOVE Hygiene and Toileting seminars are available. For more information, see Trainings/Events and contact David Schreuder, executive director, at MOVE International 800-397-MOVE(6683).