After shopping around, we purchased this for my mom, in her 80s. Now I'm wondering why I didn't have one of these sooner. The width has 2 settings and the height has about 5 settings. Adjusting it is as simple as pushing in the metal button, lowering or extending the pole until the button reaches the next hole. It attaches to the toilet by removing the entire toilet seat lid, placing this product over the holes, and then putting the lid screws through the product and re-installing the lid as usual. I like this model because having the legs on the floor gives it more sturdiness than the kind that just hang in mid-air. there can be a little movement of these rails if the washer inside the pole is not sitting correctly, but is otherwise pretty sturdy. I will provide photos later on.