How to use Rifton HTS hygiene toileting system

The Rifton HTS is an easy to use durable and high quality system which redefines toileting for people with disabilities. Along with a broad range of supportive accessories, Rifton HTS provides a comfortable and effective hygiene experience. Rifton HTS is adaptable to most toileting needs and due to its simple construction and tool free adjustment capabilities it is very easy to configure a Rifton HTS which is perfect for special need individuals.

The Basics

Adjustments. With the Rifton HTS, adjustments are as easy as it can get. With no tools needed to adjust and easy markings is blue, one can easy configuring a Rifton HTS to the individual needs. You can follow the easy to follow guide with instructions to help you setup your Rifton HTS. 

Cleaning. Cleaning the Rifton HTS is very easy. The design of the HTS is such that accessories and components of the chair can be individually removed and thoroughly washed. You can wipe down the base, seat, back and accessories with disinfectant wipes or a 10% bleach solution. This also applies to antimicrobial form padding. To add to this, all mesh accessories are machine-washable.  

Sizing. The Rifton HTS come in three size variants, smallmedium and large. All of these can be adjusted to suit the needs. While choosing the right Rifton HTS, once should consider the user’s overall height and weight. One should also ensure that seat width, depth, and height adjustability are adequate.

Required HTS components are the seat and back with a seatbelt, arm rests (low, medium or high) and a base or mounting bar. 

More information about the Rifton HTS is located in its Product Manual (pdf).


Seat and Back Features (Chair Options and More)

Backrest Adjustments

  • Squeeze the blue backrest angle levers on either side of the backrest and move to desired position
  • Backrest adjust to max 6 degree forward and up to 18 degree backward
  • The backrest can also be completely removed for transport or cleaning 

 hygiene-toileting-system-backrest

Seat Depth

  • Lift the blue levers on the outer sides of the seat (behind the arm rests) to slide the backrest forward or backward
  • For each size, seat depth can be adjusted in four 1” increments to accommodate for growth
  • You can use this same adjustment to slide the seat off towards the front for cleaning underneath

hygiene-toileting-system-seat-depth

Seat and back pads

Although seat and back are made of natural contours molded into firm plastic for basic comfort, we highly recommend seat and back pad for greater cushioning and comfort.

  • They can easily snap on and off for cleaning
  • They are designed with contoured leg troughs providing abduction with ease

Two choices of seat pad are available:

Open seat pad

  • Has an opening at the back of the seat pad for easy access to hygiene areas even in seating position
  • With tilt-in-space option, tilting the seat forward improves the access 

Closed seat pad

  • Improved stability in seating position as the seat the closed in the back
  • It has a narrower hole it helps in extra support while seated

 Tilt-in-Space

Tilt-in-space is offered as an option on the mobile base with a footboard. This allows the Rifton HTS to be used as a shower chair. Roll the chair into a shower and tilt back to accommodate hair washing

  • To adjust the tilt, to release the two locking gas springs by using the trigger at the right rear of the seat
  • It can tilt 15 degree forward for transfers and hygiene care and 15 degree backwards for comfortable positioning or showering
  • It can be rolled into a shower and back tilted position can be perfect for hygiene care or showering

hygiene-toileting-system-tilt-trigger


Choosing a Base/Mounting Bar

A base or mounting bar is a required component when putting together a Hygiene and Toileting System. Five choices of bases are available:

  1. Mobile tilt-in-space with footboard. This base can be rolled over a regular toilet, used as a stand-alone commode or additionally (with the tilt-in-space), as a shower chair. The tilt-in-space also makes this base a good choice for clients requiring maximum support and comfort. Mobile bases come with four fully locking casters for safety during transfers and toileting. A footboard is required on a mobile base.
  2. Mobile non-tilt with footboard. Without the tilt-in-space, this mobile base is a more affordable option for using over a regular toilet or as a stand-alone commode. Mobile bases come with four fully locking casters for safety during transfers and toileting. A footboard is required on a mobile base.
  3. Stationary non-tilt. This base is used as a stand-alone commode. As it does not come with a footboard, make sure the frame height is low enough to position your client’s feet flat on the floor for added stability.
  4. Stationary non-tilt with footboardThis base is used as a stand-alone commode. The footboard is available for advanced positioning options of the lower extremities if required by the client.
  5. Mounting bar. The mounting bar allows the HTS to be used on a regular toilet. It attaches at the back of a regular toilet with the same bolts that secure the seat and lid to the toilet (see Product Manual for correct placement). Once in place, the mounting bar is used as the point of attachment for the seat and back of the HTS. Just insert the hooks at the back of the HTS seat into the sockets of the mounting bar and lower the seat onto the toilet bowl. A footboard can be specified if desired.

The mounting bar can remain permanently mounted behind the toilet, but can also be removed if the client moves to a different school or home.

Two types of mounting bars are available to fit either standard round or elongated toilets. To determine which type of mounting bar you need, measure from the centerline of the seat bolts to the outer edge of the porcelain bowl. Use a standard toilet mounting bar if this measurement is 17 inches (43 cm) or less. Use an elongated toilet mounting bar if the measurement is greater than 17 inches (43 cm).

Choose an HTS Configuration

The variety of bases makes it possible to use the HTS in three configurations: On the toilet, over the toilet, or off the toilet as a stand-alone commode. Before selecting a base, consider how the HTS will be used according to the guidelines below:

On the Toilet: A mounting bar is required to use the HTS on the toilet. A footboard can be used with this configuration but needs to be specified when ordering the product.

 hygiene-toileting-system-configuration-2

Over the Toilet: The mobile bases (with the commode pan removed), can be used over a regular toilet. To minimize splashing, adjust the height of the base so it just clears the top of the toilet bowl before rolling the HTS over.

 hygiene-toileting-system-configuration-3

Off the toilet: With the commode pan in place, both the mobile and stationary base options can be used as stand-alone commodes giving the user the option to toilet where convenient.

 hygiene-toileting-system-configuration-1


Adjustments on the Base and Footboard

Height Adjustment

  • to raise the seat, flip up the footboard
  • stabilize the base with your foot and pull up on the seat frame
  • to lower the seat, squeeze both height latches on the frame uprights and lower both sides evenly to prevent binding

This adjustment CANNOT be done with the client in the chair.

 hygiene-toileting-system-height-adjustment

Footboard Adjustment

The footboard, with angle and height adjustment, supports a user’s feet in the optimal position.

  • to adjust the angle, push up on both angle triggers while directing the footboard to one of the four angle settings 

 hygiene-toileting-system-footboard-angle-adjustment

  • adjust height, push both blue buttons on either side of the footboard while moving the footboard to the desired height
  • footboard adjusts in five 1” increments. Be sure the footboard latches into position

 hygiene-toileting-system-footboard-height-adjustment

  • the footboard can be flipped out of the way or used as a step for transfers (for individuals less than 150 lbs.).

Accessories

Accessories are available to customize the positioning in the HTS and accommodate a wide range of disabilities.

Headrest. The curved headrest provides support for clients with limited head control.

  • adjust height by pushing the blue headrest button and raising or lowering the headrest
  • loosen the two white knobs at the back of the headrest to fine-tune the positioning up or down, anterior or posterior

 hygiene-toileting-system-headrest-adjustment

Butterfly Harness. The butterfly harness provides anterior support while allowing freedom of movement.

  • to attach the harness, remove the center section of the seatbelt and replace it with the butterfly harness which has a built-in seatbelt
  • adjust seatbelt tension then clip the shoulder straps to the sockets on the backrest

 hygiene-toileting-system-butterfly-harness

Tip: For smaller users, thread the shoulder straps through the upper slots in the backrest, and then clip into place. 

hygiene-toileting-system-shoulder-straps

Anterior Support. The anterior support resembles a tray with a built-up and padded surface for leaning on.

  • adjust the tray depth, squeeze latch under the front of the tray and pull/push until it clicks into one of the three latched tray position
  • provides an excellent, forward-leaning toileting position with trunk and arms supported by the tray

 hygiene-toileting-system-anterior-support

Lateral Supports. The laterals can adjust independently to accommodate for spinal curvatures or trunk abnormalities. Lateral supports on Rifton HTS provide comfortable side-to-side positioning and alignment for individuals with limited trunk control. 

To install and/or adjust the lateral support:

  • loosen the white knob, insert key into extrusion behind the backrest
  • adjust the height, angle and width of the lateral to fit the user
  • lateral supports can be purchased either with or without a chest strap

 hygiene-toileting-system-lateral-supports

Chest Strap with lateral supports. The chest strap is used in combination with the laterals to provide anterior support.

  • thread the loop at either end of the chest strap over the knob and key assembly of lateral supports with chest strap buckle facing outward
  • loops can be threaded so that chest strap encompasses lateral supports, or so that it straps on the inside of lateral supports

 hygiene-toileting-system-chest-strap

Seatbelt. A seatbelt comes automatically with every chair. ALWAYS use a seatbelt to avoid falls or the risk of strangulation would be presented when using a chest strap, butterfly harness or anterior support without a seatbelt. The seatbelt is clipped into the slots behind the seat on either side of the chair.

Hip guidesHip guides provide additional lateral support to user’s hips and can be adjusted for seat width.

  • adjust the seat width by removing the arm rest and threading the arm rest support post through one of the two slots in the hip guide
  • notch in the slot should be facing the back. Replace arm rest to lock hip guide into position
  • easy removal of both the arm rests and hip guides makes it perfect for lateral transfers into the HTS

 hygiene-toileting-system-hip-guides

Pan. The pan is used for the stand-alone commode configuration (off the toilet).

  • slide the pan into the slots underneath the seat from behind the chair
  • the pan was designed with extra depth to prevent spillage when used with the tilt-in-space base
  • smooth contours and a pour spout make cleaning up simpler and easier

Deflectors. Deflectors keep clients and caregivers clean during urination.

  • a low deflector is already built into the foam seat pad
  • if more protection is needed a removable standard deflector and splash guard are available

The standard deflector requires the integral skin foam seat pad for mounting. It slides into the notches in the foam padding at the front of the hole.

 hygiene-toileting-system-splash-guard

The splash guard offers full protection. It mounts at the front of the toilet seat and is held in place by the seatbelt.

 hygiene-toileting-system-standard-deflector

Bowl Adapter. The bowl adapter is a soft blue plastic insert that is used to accommodate situations where the hole in the HTS is not completely aligned to the hole in a regular wall-hung toilet.

  • bowl adapter inserts at the front edge of the hole under the seat pad
  • It can also be used with the large HTS to create a secure fit over a round-front toilet

 hygiene-toileting-system-bowl-adapter

Abductor. The foam-covered blue abductor provides comfortable positioning and alignment of the lower extremities.

  • slide the abductor into the slot at the front of the seat while depressing the blue clip
  • the abductor attaches adjacent to the standard deflector to help maintain the position of the deflector while abducting the legs

 hygiene-toileting-system-abductor

Ankle Straps. The soft mesh ankle straps provide proximal control and positioning of the feet of those with limited muscle control while still enabling a moderate range of movement.

  • tabs at the end of the straps slide into the slots at the back of the footboard
  • ankle straps can be adjusted both in length and in snugness

 hygiene-toileting-system-ankle-straps

Calf rest. The attachable soft mesh calf rest is available for added comfort and security behind the user’s legs especially when the footboard is extended and angled up.

  • loop the calf rest webbing around the uprights and thread it through the metal ring at the front, engaging the hook and loop snugly around uprights.
  • the calf rest attaches on the footboard uprights

hygiene-toileting-system-calf-rest

Note: the calf rest cannot be used when the footboard is in its highest position. 


Versatility

Toileting and bathing are the two code functions for which Rifton HTS is designed. To enhance the functionality of the rifton HTS, it can be used with the tub base and the portability base.

Tub base 

  • Both the small and medium HTS seats attach onto the tub base
  • With a reduced footprint, the tub base can be used in even narrow tubs

 hygiene-toileting-system-tub-base

Portability kit 

Rifton are leaders in HTS systems and when it comes to portable HTS, Rifton HTS stands out. 

  • it is a light-weight folding frame combined with the small or medium seat and back 
  • can be stowed in a carry bag to make toileting possible while traveling
  • the portability kit gives children greater independence, and their families greater freedom to travel 

 hygiene-toileting-system-portability-kithygiene-toileting-system-portability-kit-1


Transfers with the HTS

Lifts and transfers present a major challenge to successful toileting. The Rifton HTS makes them easier with a variety of features. 

Sit-to-stand transfer: To achieve sit to stand transfer

  • flip the footboard up and using the tilt-in-space (if available), tilt the chair forward.
  • this allows active participation in the transfer and also makes it easy for a client who has poor muscle control 

Lateral transfer: For a lateral transfer

  • remove the armrests and lateral supports from one side of the Rifton HTS
  • allow a client to slide over from a wheelchair

Step-pivot transfer: 

  • the weight capacity of the footboard is equal to the maximum working load of each size
  • the footboard can be used for step-pivot transfers into the Rifton HTS 

Note: Do not use the footboard as a step when it is angled up.


Optimal Toilet Positioning with the HTS

The Rifton HTS has the capability to support optimal toilet positioning for people with disabilities. The squatting posture is the most effective position for bowel and bladder elimination, this is backed by research. Squatting posture are:-

  • relaxes the puborectalis muscle
  • straightens the rectum and
  • works with gravity for faster, easier, and more complete elimination.

There is significantly less incidence of constipation and bowel diseases when you practice Squatting posture. This is confirmed from studies of people in the West who have adopted this natural method.

One can achieve the Squatting posture as follows:-

  • Tilt the Rifton HTS posteriorly and adjust the backrest to its most forward position
  • Allow the knees to be placed than the hips for more effective elimination
  • Adjust the footboard height to squarely and comfortably position the feet as well
  • An anterior support is recommended to further support the user in this forward-leaning posture

Note: Although this positioning is effective, it may not be ideal for every user. Positioning should be done according to what is comfortable and achievable for the user.