Standard toilets in Western countries often do not meet the needs of elderly and disabled people with physical limitations. While the existing concept of barrier-free toilets and the emerging “changing places” concept offer more space and support, the fixed height of the toilet seat still imposes a major problem during all phases of toilet use and can limit the users' autonomy by requiring personal assistance. Thus, in the EU project iToilet an innovative ICT-based modular height adjustable toilet system was designed to support the autonomy, dignity and safety of older people living at home by digital technology enhancements adapting the toilet to their needs and preferences. The main requirements were: double foldable handrails, height and tilt adjustment, emergency detection and call, and ease of use. The ICT component in this approach serves a double purpose of enhancing usability of the base assistive technology while at the same time providing safety for independent use. A field test of a prototype system in real environments of a day care center and a rehabilitation clinic has been successfully finished. The application of the iToilet concept also in semi-public settings is currently studied in the Toilet4me project.