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LovemyPALS

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Nov 21, 2009
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Lost a loved one
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Texas
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Little Elm
Hi All! It has been a while since I have been on here. Lots caused by working and taking care of my dad.

My parents do not have internet access. I have so many questions..I do not know where to start!

My dad uses the bi-pap to sleep. He has a ventalator he visits oftent to get the air he needs when he struggles a bit. He is whealchair bound with a head rest so he can keep his head up.

Imagine being is sleeping position or in his chair: Getting him to sitting position, then shimmy his way to the end of the bed to get in his wheelchair, then to the bathroom, then to standing up (scary and dangerous to watch him do this) to get on the toilet to do his business. He wants to continue to do this as long he can so can stand and get blood flow. although , it is a task on all of us. He needs assistance for every bathroom break. Many a time, he has had diarrhea and not made it. Intersting times!

What does one do when they can't make it to the bathroom anymore? Dad has a urinal to use, but he refuses to use it until he absolutly has to.

The Hoyer lift was a JOKE! My mom and dad live together, I am 20 min away with a full time job. You need like 2 peeps to work the hoyer. So what happens when he can't go to the bathroom anymore for #2's..? mom has bought depends, but that won't keep from making a mess.

I am dying to know what to do?!

any advice, suggestions, experience would be welcome!

:!:
 
Okay - first, the urinal. Once he starts using it, he won't turn back. It will be so much easier. As for #2, you can use a transfer board and a bedside commode. Since it will put him on the potty in a matter of minutes, that should alleviate the accidents.
 
HI Missy!
thank you for responding. I am desperate...


we have a transfer board and the 'belt'. we also have a bedside commode. It takes strength to lift a man up and move him. He is still about 140 lbs..losing weight fast. How can we pull him up, with the bipap on, put the belt on, get him to the chair, get to the bathroom, work the moves to get him on the commode etc. It takes like 20min!?

I feel there needs to be a easier less stressful way to do this.

He used the urinal 1x and won't use it again. His pride says, "I can still stand , pivet and hope my legs don't give out, and land on the raised toilet. Being he has no muscle to keep it all in, it's a race to the bathroom for my mom. My mom says, she is now intimate with with the bathroom. Many an hour spent in that bathroom.

Is there a easier way? 140 lbs? women? how can we continue to do this?

hospice comes tomorrow. What can help my mom on a daily basis and me when I am over there?

He is so humiliated. Is there a poop bag available? I have no idea..
 
Get Hospice to show you how to use the gait belt and how to transfer your father. My husband is 6'1" and weighs over 250 lbs, and I can transfer him by myself. (I am 5'3", and I'm not a nurse!) If he can still stand and pivot, it should be very easy. The arm of his chair will either drop down or pull away. All you have to do is put the commode right next to the chair. Will he let you keep the gait belt on him (loose) so that it is in place when you need it? That will make things go much faster. As for the urinal, maybe someone could remind your father that accidents are far more humiliating. Have you tried a condom cath (also known as a Texas cath - maybe that will persuade him!)?
 
Missy -

How are you transferring your hubs of 250 lbs? My mom and I both struggle to pick him up and move him! What are we doing wrong? The left arm of his chair pulls away, but he uses it for balance. he has no problem with keeping the belt on. what is a condom cath?

You are an agel right now helping me! My poor mom is 62 y rs old my dad is 68. My mom is broken due to being overweight..wrist, shoulder, leg, back...she can't handle this in the shape she is in and I can't be there.

Me..36 and am 135 lbs..I can't pick him up either!

How do I do this?

Suzanne
 
There are ways to make that hoyer work using only one woman, but someone who knows how needs to spend time training you, and your father has got to help you and your mother out, especially while you're learning the process. Is he still wearing trousers and underwear? He can wear diapers covered by a lap robe with his sweat pants pulled only part way up (Joel C can give you more information on the pants part) and no one will know by looking at him that he isn't wearing pants "normally" under a blanket. If he has diarrhea, undo the tabs on the diaper before hoisting him, but have HIM hold the diaper under him all the way to the toilet, and have a lined trash can there to receive the diapers. Or skip the diaper and have him sit bare bottomed on a blue throw out chux pad, again with partially pulled up pants and a lap robe for a sense of normalcy. I think using only the pad would make cleaning him up a real problem, however. The diaper is easiest.

If your dad falls, I pray he doesn't break any bones... but a slow slide to the floor may help him give it up and become safety conscious.
 
We have not had any substantial training! It has been sad actually. Those that came to train us didn't know how! We are very discouraged by the lift.

he is still wearing sweatpants and underwear. what is a lap robe? how can he hold the diaper under him when he can't? what is a blue throw out chux pad?

Am i wrong to find it hard to believe that there isn't anything to help with potty breaks? Either it truly is a lot of clean up, or they have a way to keep his #2 and urine in a bag so it is easy cleanup.

Is it really this difficult to get him to the bathroom to pee or bowel and have the caregiver be exhausted? I would think that they would have a device to help him so my mom isn't running all day long.

sorry...just feel like things could be easier for a hard situation and it isn't showing that way.
 
My wife transfers me easily by herself.

Sling
 
I can't really tell you how I do it, because the technique has changed as my husband has deteriorated. My husband still has fairly strong legs, but he has become significantly weaker in the core. I position the gait belt (about where a belt on pants would be), and on the count of three, I become my husband's core. He leans forward to help. But that is us. You need to get someone to help you figure out what works for your father.

A condom cath does send the urine in to a collection bag. Google it. You will see exactly how it works. As for #2, I don't know of anything that will collect it other than a diaper.
 
I transferred myself until I couldn't do the pivot, and while holding onto the bars, just slid to the floor. Phil did get sciatica when using the gait belt--he's had it off and on for years. I have no torso strength but my hands work well enough to help tuck the sling inside my diaper in the back, when one of my girlfriends is my caregiver. If your dad has no hand strength at all, then don't be embarrassed to push the back of the sling under his butt. Honestly, though, in using a hoist and sling, the underwear has to go. Diapers can be pull ups or "regular". Depends is one brand that simply pulls apart, and then the tabs work (much easier with the sling). If he's not having diarrhea, the diaper stays right in the wheelchair, the sling pulled around him, and he's hoisted to the toilet and back onto the (clean) diaper. A CNA ought to be able to teach you and your mom how to use a hoist; nursing homes use them a lot.

A lap robe is like a small blanket. I like poly fleece, and they're similar in size to a throw often used on a sofa. I cover myself from waist to boots with mine. A beach towel would work in the summer.

A "Chux" pad can be found at Walmart, around the pharmacy department, near adult diapers. A rectangular pad. Usually blue, they come in various sizes. Patients lie on them, and a small one can keep a wheelchair from being soiled... but since they're plastic, I'm not crazy about the way they feel. A regular adult diaper is more comfortable, I believe. If he cannot hold a diaper under himself while having diarrhea, then the only thing I can think of is to first push that diaper down, but keep it caught in the sling: then when he's above the toilet, pull out the diaper. That wouldn't be easy.

Don't give up on the hoist and sling--someone who is in an ALS support group, your ALSA coordinator, a nurse--will know and be able to teach you both. My friends are not young or superwomen (well, they are super women in my opinion!) and have no trouble. If you can't find someone to teach you, bring it up at your dad's ALS Clinic, and see if you can't arrange to have someone come to the house... a PT, perhaps.
 
I'm still able to sit on the edge of my hospital bed, holding onto the railing (which is set half way raised, and the top of it just at the edge of the bed), and the way I get up is this: While lying down, with the foot of the bed raised, my knees are picked up, brought up to my hips, the bed is then lowered, and my knees are then put over the edge of the bed, and the caregiver steps back from my head another step while pulling me up by the arm until I'm sitting up.

A friend who is a CALS told me how she, a small woman, gets her 6 feet 5 husband up, out of bed, and I'll share her words:

"I would like to respond to your email regarding your concern about being lifted from bed. Since I don't understand exactly what you and your helpers are doing at this point, I'm just going to share how I take care of Arthur. We rent a hospital bed which, first and foremost, saves my back. I put it up and down as needed. We have a hoyer lift (actually it's "Invacare" but hoyer is the household name) on loan from the ALS closet. We purchased a sling for $300 which was a lot of money but so well worth the cost. It was the kind used at rehab last fall. It's mesh and if you're interested, I will tell you the details.

We learned how to use the hoyer at rehab. Arthur can no longer move anything but his head so I use a draw sheet on the bed to roll him on his side, where he is able to stay for the time required to get the sling half under him, positioned correctly. Then I roll him back on his back, pull the sling through to his other side, straighten it, attach the straps to the hoyer, lower the bed, and crank away."

An important note is that the sling you need for the easiest possible use has divided legs, and the two leg straps are crossed in front of your patient, forming an "X". This way, when you lift him, the back of the sling is above his butt, while the straps are under his upper legs. Mine did not cost as much as my friend's but is not mesh.

I told my caregiver about your dilemma this morning. She said that when my husband showed her (and my other friend) how to use it, it seemed very hard. But then Phil had each of them actually do it while he pointed out what to do, and they were able to do it. When they came here to hoist me without help, they were both nervous the first time, but since I'd been hoisted through all the practice runs, I was able to do the pointing out of problems. They did fine and so did I. The only problem we encounter now is if they talk to me while I'm hanging in the breeze... and I have to interrupt and ask them to finish the job. :mrgreen:
 
This may sound primitive but it is what works for us. My husband cannot stand or transfer etc. and he is also a big man. I use a lift and a sling to move him. The sling we use sounds like the one above but what we have done is get leg extension straps for the part of the sling under the legs. Then we put the straps across both legs together. When he is lifted it is like he is almost sitting. Sitting on the commode chair is way too uncomfortable and I know this sounds bad but I bought a big black bucket from the hardware and put it underneath him while he is suspended in the sling above the bed. That means he doesn't have to move too much and it can be quick when needed. Hope this helps,
Chris
 
Chris, I personally think whatever works best for you guys is great! And if the patient has diarrhea, your way is probably the best of all. If it's faster and is "clean" and your husband is comfortable, that's what matters.

I haven't had to use a black bucket since camping in the '80s, but my only complaint then was the mosquitoes. That wouldn't be a problem within a house!
 
heres an option for his pants. you can cut a pair of sweatpants- cut from the center of the waist in the back, all the way down to the crotch of the pants. Then you cut from the crotch out towards the sides. it makes flaps in the back. you can then put the pants on normally, and just tuck the flaps around your dads hips so they are not on his bottom.
if you cant find anyone to help teach you how to transfer him, it might work out using a bed pan.
 
You might want to look into a pivot lift. My wife was deathly afraid of the hoyer lift but the pivot life doesn't pick the patient up completely. You just lean them forward and pivot them up to a standing position bent over with the weight on their chest. It looks primitive and uncomfortable but Liz liked it. Despite what most of the documentation says, properly done it doesn't require the patient be able to stand at all. My wife was 180 lbs and our 118 lb nurse could get her onto the commode with little effort.
 
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