I purchased this toilet safety rail for my 80+ yr old Mom. She no longer has use of her left leg and getting up and down onto the toilet took all her strength away. She did not want a huge bulky toilet seat heightener, because she didn't want to subject her visitors to that. Easy to install, just unscrew the bolts that hold down the toilet seat and place the bracket on the porcelain rim, lining up the holes, then place the toilet seat over it and screw the bolts back on. Hint - you should be able to hold the bolt screw stationery with a screw driver while you turn the washer on the underside. I was able to loosen the washers with a gloved hand. Another tip: make sure that you have the arm rails going in the right direction so that the adjustment holes in the main bracket line up. Instruction leaflet is poorly written. I also had to put the arm rails into the bracket BEFORE I screwed in the bolts because there wasn't enough room between the vanity and the side wall. I also installed a suction cup grab rail on the side wall for extra leverage as she pulls herself off of the seat. Mom called me so thrilled the day after I installed it and thanked me again and again for making the bathroom visits not so exhausting.