11.1 Normal Elimination and Toileting Assistance

Normal Elimination and Toileting Assistance

Assisting with elimination (urination and defecation) is one of the most common and important CNA tasks. Proper toileting assistance maintains dignity, promotes independence, and prevents complications like urinary tract infections, skin breakdown, and incontinence. Understanding normal elimination patterns helps you identify problems that need to be reported to the nurse.

Normal Urination (Voiding)

Abnormal Urination — Report to Nurse

Normal Bowel Elimination

Abnormal Bowel Findings — Report to Nurse

Assisting with Toileting

Using the Bathroom:

1. Answer call lights promptly — urgency increases incontinence risk
2. Assist the resident to the bathroom using appropriate mobility aids
3. Provide privacy — close the door, stay nearby but not in view if possible
4. Stay within hearing distance for safety
5. Provide toilet paper within reach
6. Assist with hygiene as needed (wipe front to back for females)
7. Assist with handwashing after toileting
8. Help the resident back to bed or chair
9. Observe and report any abnormal findings

Using a Bedpan:

1. Warm the bedpan under warm water (or place a cloth cover on it)
2. Apply gloves
3. Position the resident on the bedpan (roll them onto it or have them lift their hips)
4. Raise the head of the bed for comfort (if not contraindicated)
5. Provide toilet paper and privacy
6. When finished, assist with removal
7. Observe contents before disposing
8. Provide perineal care and handwashing
9. Measure output if on I&O

Using a Urinal (Male):

1. Position the urinal between the resident's legs or hand it to them
2. Provide privacy
3. Empty, clean, and measure contents if on I&O
4. Assist with handwashing

Promoting Regular Elimination