Personal care is basic: bathing, toileting, grooming, and managing menstruation or incontinence. These are fundamental needs, not luxuries. Yet for many disabled people, personal care becomes incredibly difficult or impossible without access to tools, help, and adapted spaces.
This page covers accessible personal care options, tools and techniques, how to ask for help without shame, and how to maintain dignity and self-determination around intimate care. It addresses everything from accessible bathrooms to incontinence management to adaptive hair and nail care.
Content note: This page discusses intimate care, incontinence, bodily functions, and the vulnerability of needing help. It also discusses trauma around personal care and violation of bodily autonomy.
¶ Historical Context and Who Built This
Historically, disabled people needing personal care were institutionalized and had their bodily autonomy stripped away. Staff controlled when and how personal care happened; disabled people had little choice or dignity.
The disability rights movement fought for personal care attendants hired and directed by disabled people (not institutions). The phrase "Nothing About Us Without Us" includes personal care decisions—disabled people choosing their own care providers and how care happens.
Consumer-directed care models (where disabled people hire and direct their own attendants) represent a major shift toward autonomy. Yet access to these programs varies dramatically, and many disabled people still rely on family (often unpaid) or institutional care.
Some disabled people self-direct all care; others need significant help. Both are valid.
Personal care includes all intimate care: bathing, toileting, grooming, menstrual care, continence management, dressing, food assistance if needed.
Care assistance can be provided by:
- Yourself independently (with or without tools/adaptations)
- Personal care attendants (PCA) you hire and direct
- Family members or informal caregivers
- Institutional staff (hospitals, group homes, nursing facilities)
- A combination of approaches
Consumer-directed care means you choose your attendant, direct care, decide how and when it happens. This is about autonomy and dignity.
Barriers often aren't the disability—they're ableist design, lack of tools, lack of funding for attendant care, and lack of accessible bathrooms.
Personal care:
- Is a basic human need: Not optional, not shameful
- Determines independence: Inaccessible bathrooms or lack of funding for attendants severely limits independence and choice
- Affects quality of life: Rushed care, painful techniques, lack of dignity damages health and mental health
- Is often invisible: People don't talk about personal care needs, so disabled people feel isolated and ashamed
- Requires self-advocacy: Asking for help, setting boundaries around intimate care, directing care appropriately
- Intersects with marginalization: Disabled people of color, trans disabled people, disabled immigrants have additional barriers and safety concerns with personal care
¶ Bathing and Shower Access
What accessible bathrooms include:
- Level shower (no curb to step over)
- Grab bars (properly installed, safe to grab)
- Shower seat or stool
- Handheld showerhead
- Non-slip floor
- Space to move in (wheelchair accessibility)
- Accessible toilet (correct height)
- Adequate lighting
- Ventilation to prevent mold
If you're renting:
- Ask landlord about accessibility modifications (grab bars, walk-in shower)
- Some modifications are legal rights (vary by country)
- Temporary modifications possible (suction cup grab bars, removable seats)
- Document requests in writing
If you're buying or renovating:
- Universal design includes accessibility for everyone (elderly people, injured people, disabled people)
- Accessible bathrooms are better for everyone
- Grab bars, non-slip, adequate space: smart design
- Plan for aging in place
¶ Shower and Bath Techniques
For mobility disabilities:
- Shower seat with arms and backrest
- Transfer bench (half in tub, half out, for transferring from wheelchair)
- Grab bars for stability
- Non-slip mat
- Handheld showerhead
- Shower caddy for items
- Space and time: don't rush
For chronic illness and pain:
- Warm water can reduce pain
- Sitting to shower (don't have to stand)
- Short showers if fatigue limits
- Bath for soaking (if accessible)
- Support person or attendant for help
- Climate control (hot and humid can trigger symptoms for some; cold can trigger for others)
For blind and low vision:
- Organization (same place for each product)
- Verbal communication with attendant
- Waterproof labeled bottles
- Safe bathroom layout
- Attention to water temperature (attendant should check)
For neurodivergent people:
- Sensory-friendly approaches (calm lights, low water pressure, temperature control)
- Time and space flexibility
- No pressure about frequency
- Support for sensory regulation
For people with psych disabilities:
- Accessible bathroom during crisis
- Support person present if helpful
- No judgment about not showering (sometimes that's depression/disability, not neglect)
- Gentle approach to hygiene during mental health challenges
Shower chairs and stools:
- With or without back support
- Adjustable height
- Padded or cushioned for comfort
- Waterproof materials
- Some fold for storage or travel
Transfer benches and tub seats:
- Half in tub, half out (for sliding transfer)
- Helps if you can't step into tub
- Adjustable height
- Check weight capacity
Grab bars:
- Installed securely (not towel racks)
- Correct height and placement
- Different diameters for different hands/grip
- Can be permanent or suction-cup temporary
Handheld showerheads:
- Allow controlling water flow and direction
- Helpful for people who can't stand
- Easier for washing areas you can't reach
- Often cheaper than full bathroom renovation
Shower caddies and organizers:
- Keep products within reach
- Prevent dropping things
- Organized so you can find what you need
Non-slip mats and treads:
- Prevent falls on wet surfaces
- Essential for safety
- Affordable adaptation
Bath lifts:
- Electric or manual lifts to help get into/out of tub
- For people who can't transfer independently
- Expensive but life-changing for tub access
Features:
- Correct height (standard, tall/comfort height, or adjustable)
- Space to transfer (wheelchair accessibility)
- Grab bars for stability and transfer
- Bidet (washes, reduces wiping difficulty)
- Raised toilet seat (easier standing up/sitting down)
- Toilet frame with arms
- Adequate lighting
- Easy-open doors and locks (for people with weak grip)
¶ Adaptive Equipment and Techniques
Raised toilet seats:
- Makes standing up/sitting down easier
- Reduces hip/knee flexion needed
- Available with or without arms
- Temporary or permanent installation
Toilet frames and safety rails:
- Arms for stability and transfer
- Adjustable to your height
- Can be standalone or installed
Bidets:
- Traditional bidet (separate fixture)
- Bidet toilet seat (replaces seat, has spray)
- Bidet attachment (adds bidet to existing seat)
- Handheld bidet or water bottle
- Reduces or eliminates need to wipe
- Life-changing for people with mobility, pain, or cognitive disabilities
Toilet paper aids:
- Long-handled grabbers for wiping
- Reduces reach needed
- Essential for many mobility disabilities
- Available at medical supply stores or online
Urinals and bedpans:
- For people unable to reach toilet
- Portable and available in various designs
- Reduce pain and transfer difficulty
- Dignity and access issue, not shameful
Pull-up style undergarments:
- For people with mobility or cognitive disabilities
- Don't require lowering pants as far
- Can be easier than other methods
Reusable options:
- Cloth incontinence pads or liners
- Undergarments with absorbent material
- Washable and environmentally friendly
- Lower cost over time
- Require washing and drying capacity
Disposable options:
- Adult incontinence products (pads, pull-ups, diapers)
- Various absorbency levels
- Convenient but generate waste
- Significant ongoing expense
Catheterization:
- Intermittent self-catheterization
- Indwelling catheters
- Reduces or eliminates need to toilet
- Requires supplies and training
- Can cause infections if not managed carefully
Managing during period:
- Extra protection during menstruation
- Communication with attendants about comfort
- Period products + incontinence management
- Integrated solutions
Cost and access:
- Many countries don't fund incontinence supplies
- High ongoing cost for disabled people
- Advocacy for funding is important
- Community sharing and mutual aid
- Some organizations provide supplies
¶ Grooming and Personal Appearance
Accessible hair washing:
- Sink with spray attachment (if bathroom accessible)
- Basin or bowl at accessible height
- Support person helping
- Seated shower for hair washing
- Dry shampoo if washing difficult
- Braids or low-manipulation styles if energy limited
Hair styling:
- Asking for what you need from stylist
- Accessible salons (wheelchair accessible, nearby bathroom)
- At-home styling if salons inaccessible
- Low-maintenance styles (short, natural, simple)
- No pressure to style if pain or energy issues
Accessible hairdressers:
- Call ahead about accessibility
- Confirm bathroom access
- Ask if they can work with your positioning needs
- Some stylists specialize in disabled accessibility
- Paying extra for accessibility is okay
Accessible manicures:
- Accessible salons or at-home care
- Support person helping if needed
- Short nails if mobility issues or sensory issues
- Medical nails cut short (if self-care difficult)
- No judgment about appearance standards
Pedicures:
- Foot soaking and cleaning
- Helpful if you can't reach your own feet
- Accessible salons (wheelchair space, bathrooms)
- Or support person at home
¶ Shaving and Facial Hair
Accessible methods:
- Electric razors (easier than razors, no cuts)
- Having a support person shave you
- Choosing not to shave (all body hair is valid)
- Hair removal creams or electrolysis if pain with shaving
- Waxing (if mobility allows)
Facial hair:
- Many disabled people choose to keep facial hair
- Saves energy and pain
- Society pressures (especially on women) to remove; resist this
- Your body, your choice
¶ Teeth and Mouth Care
Accessible brushing:
- Electric toothbrush (easier grip and movement)
- Long-handled toothbrush
- Support person helping
- Water sprayer if fine motor difficult
- Mouthwash if brushing difficult
- Accessible dentistry (reclining chair, nearby bathroom, no judgment)
Dental access:
- Many disabled people avoid dentists (pain, fatigue, access issues)
- Communication with dentist about your needs
- Shorter appointments if overwhelm
- Pain management
- Sedation dentistry if necessary (with risks)
- Disability-friendly dentists exist; ask your community
¶ Menstruation and Period Management
Disposable:
- Pads (various absorbencies)
- Tampons
- Can be expensive
- Easy to use and dispose
- Some people have environmental concerns
Reusable:
- Cloth pads
- Menstrual cups or discs
- Period underwear
- Lower cost long-term
- Require washing and drying
- Reduce cost and waste
- Accessibility varies (some require insertion/removal ability)
Absorption solutions:
- Extra absorbency for heavy bleeding
- Combinations of methods
- Accessibility-first approach (choose based on your needs, not shame)
- No method is "wrong"
¶ Menstruation and Disability
Pain and disability:
- Periods can worsen chronic pain
- Fatigue increases during period
- Some disabilities make period management harder
- Heating pads, pain meds, rest: valid period accommodations
- No requirement to work/function normally during period
Cognitive disabilities and periods:
- Support in tracking periods
- Clear communication about period needs
- Adaptive products that don't require complex use
- Dignity and choice in management
Mobility disabilities and periods:
- Adaptive products (ones that don't require insertion/removal, or ones you can manage independently)
- Support person for changing products if needed
- Accessible bathrooms for product changing
- No shame in needing help
Managing periods when homeless or housing-insecure:
- Free period products through advocacy organizations
- Community sharing
- Reusable products more sustainable in unstable housing
- Period poverty is real and ableist
Personal care attendants help with:
- Bathing, showering, grooming
- Toileting and incontinence management
- Dressing
- Food prep and feeding assistance
- Menstrual care
- Medication management (sometimes)
- Other daily living tasks
What this means:
- You hire and direct your PCA
- You decide what tasks, how and when
- You manage the employment relationship
- You have autonomy over your body and time
- Different from agency-directed care (where agency directs)
How it works:
- You're the employer (or state/program is employer with you directing)
- You hire people you choose
- You train them your way
- You can fire them if it's not working
- You set schedule and expectations
¶ Finding and Hiring PCAs
Where to find:
- Care agencies (less autonomy but vetted)
- Personal networks (friends, family recommendations)
- Craigslist, Care.com, or local job boards
- Disability community referrals
- Word of mouth in disabled community
What to look for:
- Reliability (shows up on time, reliable transportation)
- Communication (can understand your needs, asks questions)
- Respectful (treats you as employer and person)
- Honest (admits mistakes, doesn't make excuses)
- Flexibility (can adjust when needed)
- Trustworthiness (privacy, respect for boundaries)
Training:
- Teach your PCA how you need things done
- Clear instructions and demonstration
- Patience with learning curve
- Ongoing feedback and correction
- Written instructions help
- Build relationship over time
¶ Paying and Supporting PCAs
Fair pay:
- Live wages (not minimum wage)
- This is important labor
- Fair pay reduces turnover
- Fair pay reflects value
Benefits:
- Paid time off if possible
- Predictable schedule
- Overtime pay
- Respect and appreciation
- Good working conditions
From disabled person perspective:
- Limited income and resources
- Can't always pay as much as deserved
- Acknowledge this reality
- Do the best you can
- Mutual respect despite economic constraints
¶ Boundaries and Relationships
Intimate care boundaries:
- Clear communication about what you need
- Respect for your privacy and body
- Right to say no to care from specific people
- Choosing people you're comfortable with
- Safety and consent
Emotional boundaries:
- PCA is not your therapist/counselor
- Professional relationship, not friendship (though may be warm)
- Don't over-disclose
- Maintain healthy distance
- Self-care for PCA too
Power dynamics:
- You're employer; they're employee
- Can be tricky with intimate care
- Clear expectations help
- Respect goes both ways
- Address issues directly
Finding reliable help:
- High turnover
- People not showing up
- Quality varies
- Backup plans essential
- Stress of constantly managing employment
Inadequate pay and funding:
- Most programs underfund PCAs
- Low wages cause turnover
- Disabled people can't always pay more
- Systemic problem
Abuse and exploitation:
- PCAs have power over intimate moments
- Risk of abuse, exploitation
- Report abuse to authorities
- Screen carefully
- Trust your instincts about who feels safe
Family as PCAs:
- Often unpaid or underpaid
- Can blur boundaries
- Can be convenient (same location)
- Can strain relationships
- Consider whether paying family changes dynamics
Some disabled people self-direct all personal care with tools and adaptations.
¶ Techniques and Independence
Self-catheterization:
- Reduces or eliminates toileting needs
- Requires some hand function and coordination
- Training needed
- Supplies and sterile technique important
- Reduces infections with proper technique
Adaptive clothing:
- Easy to dress/undress
- Minimizes reaching, bending, complexity
- Zippers and buttons easier than snaps
- Front-opening easier than pullover
- Minimizes care attendant needs
Seated showering:
- Allows independence in bathing
- Reduce pressure to stand
- Accessible bathroom essential
- Grab bars for safety
Feeding tubes:
- Reduces need for hand-feeding
- Autonomy in eating
- Supplies and training needed
- Some people choose despite some function
Accessible kitchen and bathroom setup:
- Everything reachable at your height
- Organized so you can find things
- Reducing energy and pain
- Independence with function preserved
¶ Cultural and Global Perspectives
Communal care:
- Family and community provide care as normal
- Not institutionalized model
- Collective responsibility
- Less stigma in some cultures
Gender and care:
- Female relatives traditionally do care
- Changing dynamics with feminism and disability
- Cultural expectations vary
- Balancing tradition with autonomy
Privacy and modesty:
- Cultural values vary greatly
- Someone bathing you may be intimately vulnerable
- Respecting cultural modesty in personal care choices
- Finding caregivers aligned with cultural values
Institutionalization vs. community:
- Some cultures heavily institutionalize disabled people
- Others emphasize community care
- Both have advantages and disadvantages
- Disability justice prefers community-based care with autonomy
- Often less formal care funding or structure
- Family and community care more common
- Informal economy and private payment
- Community mutual aid and care-sharing
- Less institutionalization (advantage and disadvantage)
- Disability culture strong in some communities
Sometimes disabled people can't do personal care independently—illness flare, mental health crisis, depression.
Response:
- This is valid and temporary (usually)
- Reduce expectations (not shameful)
- Ask for help
- Dry shampoo instead of washing
- Accessible bathing (seated, minimal) instead of full shower
- This passes
- Gentle with yourself
If you become incontinent:
- Not shameful
- Not regression
- Manageable with right support and supplies
- Many disabled people navigate this
- Dignity maintained with proper care
- Access to supplies is a right
¶ Mental Health and Self-Care
During depression or mental health challenge:
- Personal care becomes harder
- Not failing/weak
- Shower less often; that's okay
- Use dry shampoo, baby wipes, minimal care
- Simplify everything
- Reach out for help if possible
- This doesn't last forever
¶ Funding and Policy
Advocacy priorities:
- Adequate funding for personal care attendants
- Consumer-directed care options
- Funding for adaptive equipment
- Accessible bathroom funding
- Period poverty and supplies
- Incontinence product access
What we should demand:
- Living wages for PCAs
- Training and benefits
- Flexible funding (not restricted to specific tasks)
- Disabled people's autonomy in decisions
- Community-based care, not institutionalization
Mutual aid:
- Disabled people sharing personal care skills
- Peer support in self-advocacy
- Community equipment sharing
- Emotional support around intimacy and care
- Normalized conversation about bodily needs
- Identify what you need: Bathing, toileting, grooming, menstrual care, other?
- Assess what you can do independently: Be honest about capacity
- Research support options: Family, friends, paid attendants, programs
- Request help: Practice asking without shame
- Set boundaries: What you need, how you want it done, who you're comfortable with
- Test and adjust: First attempt might not be perfect; adapt
- Ask what they need (don't assume)
- Respect autonomy and choice
- Maintain dignity (privacy, respect)
- Consistent and reliable
- Handle intimate care matter-of-factly
- Ask before touching
- Respect boundaries around body
- Medical supply stores: Grab bars, raised seats, shower chairs
- Online: Amazon, Etsy, specialized disability equipment sites
- Community: Disability organizations may have equipment libraries
- DIY: Some adaptations you can make yourself
- Medicaid: Covers some personal care attendants and equipment (US; varies by state)
- Veterans benefits: May include personal care funding
- Disability benefit programs: Research your country's coverage
- Nonprofits: Sometimes fund equipment or attendant care
- Personal care attendant manuals: Online guides for hiring and managing
- Disability organizations: Resources about personal care and attendants
- Incontinence support groups: Online and in-person
- Menstrual equity organizations: Resources and product access
We welcome contributions from:
- Disabled people sharing personal care experiences
- PCAs sharing what makes work meaningful and respectful
- People working on menstrual equity and incontinence access
- Adaptive equipment innovations
- Cultural perspectives on care
- Global approaches to personal care
[Link to contribution form]
Last updated: November 22, 2025
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