A bedside commode usually comes flat or in several parts, with a seat, a frame, a pail and a bag of small hardware. Nobody should sit on it until it has been built, leveled, adjusted and locked in the order below. Most of the work takes about the length of one television program, but it is easy to skip the checks, and the checks are the part that keeps it from moving under someone.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Before the delivery
Ask the hospice who is supplying the commode, whether it is covered under the hospice benefit, and who will pick it up when it is no longer needed. Some hospice programs use a contracted equipment company, and the company that delivers may not be the one you call when a part breaks. Get the name and the phone number written down next to the bed, not in a phone you may not be carrying at 2am.
Measure the path from the bed to the bathroom, and measure the narrowest doorway on that path. Compare those numbers to the width of the assembled seat and the frame, not to the box, because the box often shows the folded size. Clear the floor where the commode will sit. Note whether the floor is carpet, tile or a threshold, because wheels and feet behave differently on each.
Unpacking and counting
Open the box on a clear floor. Lay out every part on a towel so that bolts and pins do not roll under furniture. Keep the manual, the packing list and the hardware bag together. Count the parts against the list before you start. If a piece is missing, call the supplier before you improvise a replacement, because a substitute bolt that is almost the right size can strip under load.
Do not throw away the cardboard or the foam until the commode is assembled, tested and accepted. If it is damaged in transit or the wrong model arrived, the supplier will ask you to keep it as delivered.
Assembly and leveling
Build the frame first, and tighten each bolt by hand before you turn any of them with a tool. Snug all of them, then go around the frame once more to tighten them evenly. Crossed or uneven tightening is the usual reason a frame wobbles.
Seat the leg extension pins all the way in, and check that each locking clip has snapped over the pin. Set the seat in place and make sure it sits flush with the frame. Put the commode on the floor where it will stay, then push on each corner in turn. If one corner rocks, check whether the leg height matches the others. If the floor is uneven, ask the supplier which adjustment the manufacturer allows. Do not stack improvised shims under one leg unless the supplier has said that is acceptable for this model.
Setting the height
Adjust the seat height using the pin holes the manufacturer marks, and set both sides to the same hole. Check the height with the person who will use it present, if they are able to be there, because the height that suits a sitting person is not the same as the height printed on the box. Lock the height pin and try it once with the seat empty to confirm that it stays put.
The armrests, if the model has them, should lock in the upright position. The backrest, if there is one, should not slide when pressed. Any adjustment that moves under gentle pressure should be fixed before use, not after.
The pail, the lid and the brakes
Slide the pail in and out of the frame several times. It should go in without catching on the seat opening and come out without dragging. Check that the lid closes and seats firmly. Check that the splash guard, if present, is in place and that it does not bind against the pail.
If the model has wheels, lock each brake and test it on the actual floor. Lock the brakes, then push the commode gently in each direction. A wheel that rolls with the brake on needs to be checked by the supplier before the commode is used. The weight of the person sitting on it is not something to test by guessing. Use the rated capacity printed on the frame, and do not allow anyone to lean on it or use it as a support for standing until the setup has been confirmed.
The weekly check and who owns it
Decide in writing who checks the commode each week. The check takes a few minutes and covers the leg pins and clips, the bolts, the brake action, the rubber feet or wheel tips, the seat and the lid, and the pail seal. A cracked seal or a loose pin is easy to miss when the commode is used every day, so name a person for the job rather than leaving it to whoever notices first.
Emptying and cleaning the pail is a household task. Decide whether the family does it or whether a hired caregiver does it under the agency's rules, and write that down too. Do not hand this to the agency by assumption.
When it is taken away
When the commode is no longer needed, call the supplier to arrange pickup. Do not take it apart for the pickup unless the supplier asks you to. Leave the pins and hardware in their bag, tape the bag to the frame, and keep the manual with the paperwork. The supplier will need the serial number on the tag, so write that down before anything leaves the house.
Where the rules that govern equipment and hospice supply come from, the Sources page lists them. For the wider set of questions about who answers for the equipment, the local help page is a place to start.