Old 07-09-2012, 11:03 PM #1 (permalink)
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Default diapers and bedside commode

Hi, I'm going to fly to Colorado to see my mom soon, her husband and caregivers are really struggling on the bathroom issue. She wears diapers but has become so weak that they need two people to get her transferred...the reason is one picks her up, the other pulls down the diaper and then make a pivot transfer to a bedside commode. Then the reverse with a clean diaper.

We think the next step is bed diaper changes--the problem is she cannot lay flat, so rolling her over is hard, she gets very sore in her joints and is a little heavy so it's hard to move her, then she slides down because we have her partly upright. We have a hoyer lift, a shower chair, and bedside commode. The question is if we get her to the commode how do you get the diaper off and one back on without two people? This is the only reason we need to have two people in the home and her husband needs a break, we have home care CNA's. She still wants to use the commode and I can totally understand but I just don't see a one person solution. (Also because getting the sling behind her and under her legs is very hard for one person, she is pretty much fully paralyzed)...anyway I'm going to visit to try to help them resolve these issues. I appreciate any suggestions!
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Old 07-09-2012, 11:29 PM #2 (permalink)
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Default Re: diapers and bedside commode

I know when I need to use the bathroom so I don't wear panties we keep a disposable pad under me and I order them from Sam they are size 30X36 they have one hundred in a box couldn't find them at Sam store but did on their website. We like them better than Wal marts
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Old 07-10-2012, 12:34 AM #3 (permalink)
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Default Re: diapers and bedside commode

Hello MLOx!

Caldona makes a valid point...see if she will go without panties in bed. I worked in LTC prior to this disease. They do make hoyer lift slings for the bathroom. They have a hole in them so you do not need to remove the sling. I would continue to use 2 people though for transfers for safety reasons being that she is pretty much paralyzed.

With regards to her sliding down in bed...is she in a hospital bed? If she is, you can always roll the foot of the bed up so she does not slide down so easily. I hope this helps.

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Old 07-10-2012, 07:37 AM #4 (permalink)
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Default Re: diapers and bedside commode

We use scissors to cut off the soiled diaper for easier removal. I wear one at night now and am able to remove it while seated on the toilet by having one leg lifted at a time. The disposable pad is a good idea. You can then tuck an open diaper or a folded pad between her legs while in bed. It may be time to consider using a urinary catheter. I think I would limit trips to the commode to accommodate BMs only. Safety in transfers has to be a priority. An experienced caregiver can demonstrate the moves necessary for changing diapers or sheets while the person is in bed. It does take a bIt of practice. I'm so sorry moving is painful for her. Daily ROM is critical
Early On as we lose function to help alleviate and/or prevent this type of discomfort. A good PT can show you some moves but it is uncomfortable/painful for the patient until the joints/ligaments are properly stretched. There's just so much to do in a CALS day/night that it's often difficult to fit PT in.
Good luck, let us know how you make out and what solutions you find.
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Old 07-10-2012, 07:44 AM #5 (permalink)
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Default Re: diapers and bedside commode

About sliding down in bed: Does the bed have the feature that tips the whole bed on an incline with either head or foot up? This is a great feature to have that allows the CALS to use gravity to move the PALS either up or down in bed." Draw " sheets are a must as well. Some call them "sliding sheets".
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Old 07-10-2012, 07:45 AM #6 (permalink)
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Default Re: diapers and bedside commode

Cindy they have a better sling then that it comes down to the crack of your butt then wraps around your legs and crosses the straps in the front between your legs before hooking it to the bar you don't even have to unhook to use the bathroom. It is easy to straighten, you can lean forward and someone can get it back in place if your in bed you can of course do the roll from side to side. I found this on the internet. It is well worth the $100+ dollars it wasn't much more than that, it may be a little more now.
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Old 07-10-2012, 09:13 AM #7 (permalink)
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Default Re: diapers and bedside commode

I'm not at that point yet, but I've learned that some PALS leave the sling underneath them in bed and just hook it back up when you need it. Do a search on the subject, and you'll find more tips.
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Old 07-10-2012, 06:37 PM #8 (permalink)
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Default Re: diapers and bedside commode

Thank you all, the RN was out at the house today to see if they could train the caregiver and her husband to do a bed change, mom doesn't spend much time in bed, I think it feels uncomfortable. But they were practicing a sheet change and mom got increasingly anxious and felt like she couldn't breath, so much so they gave her some atavan, her face is also swelling due to edema, she has progressed extreamely rapidly this last two months. They asked if she would do a catheter, she doesn't want to. The RN is worried, her husband has hurt his wrist and knee and he is very very anxious about all of this. I think either the catheter or bunching up pads under her and keep the lift sling under her during the day (she has a nice one that I think we can use for the commode -will find out this weekend). The nurse basically says she needs to be in bed, transfers are out, she says it's a "total" lift, just three weeks ago mom could put weight on her legs...now she can't do anything and is losing the ability to write, I think she is scared. Very scared, and I don't know how to make her comfortable. Thanks for all of your ideas, I think we will play around with them and see what works best. Thank you!
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Old 07-10-2012, 07:32 PM #9 (permalink)
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Default Re: diapers and bedside commode

First of all the nurse can make suggestion they can't tell you to do it because first of all I can not lay in bed it hurts me too much and sitting in my chair, if you get me to were my butt is as close to the back of the chair as it can be I am talking about getting behind me and pull me back or push on me in the front and then I don't hurt anywhere and until someone has been were we are why should they tell us were we should be. In fact I have already told a nurse that as long as I can talk I will be making my own decisions and to ask me if they want to know something.
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Old 07-11-2012, 06:43 PM #10 (permalink)
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Default Re: diapers and bedside commode

Thank you Caldona, I agree, my mom doesn't like the bed, and she is like you where she wants her back all the way back in the lift recliner. The problem is that no one can lift her fully anymore, so we need two people and it's wearing down her husband 24 hrs a day. So I want to come up with a plan to change the pads without getting her up, I think we will try some of the suggestions here. But I totally agree, there is so much loss assoicated with this disease at least give control in daily care.... thank you for your encouragment to stick with my mom's wants/needs.
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Old 07-11-2012, 07:55 PM #11 (permalink)
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Default Re: diapers and bedside commode

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Originally Posted by MLOx View Post
Thank you Caldona, I agree, my mom doesn't like the bed, and she is like you where she wants her back all the way back in the lift recliner. The problem is that no one can lift her fully anymore, so we need two people and it's wearing down her husband 24 hrs a day. So I want to come up with a plan to change the pads without getting her up, I think we will try some of the suggestions here. But I totally agree, there is so much loss assoicated with this disease at least give control in daily care.... thank you for your encouragment to stick with my mom's wants/needs.
I have put this on here before but what my husband did is he bought a track for double sliding doors then he drilled holes every 16 inches because that is how our joists is apart he painted it the color our ceiling is then he used a 3 inch leg bolts using a washer with it and bolted it to the ceiling he bought a deal that will slide on the track it also turns all the way around then he got I think a heavy duty chain link(he is not in the room right now can't ask him) that he hook through the thing that slide on the track and the arm of a hoyer lift. We bought a 500 coffing hoist off of the internet. There is no lifting just a little pull we liked it so much we now have three much cheaper than medication.
They don't even unhook me when I use the potty we use to but I told them they didn't have to they wipe my butt after they raise me up I am for what is the easiest for everyone

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Old 07-14-2012, 10:24 PM #12 (permalink)
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Default Re: diapers and bedside commode

Hi all, I'm visiting my mom now and have a question about using hoyer slings. we have a U-shaped sling and we put it on the middle loop. To use the commode do we use the shortesatom longest loop. The middle keeps her at an angle and I haven't tried the other loops but I think that might make it easier to use the commode....
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Old 07-14-2012, 10:52 PM #13 (permalink)
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Default Re: diapers and bedside commode

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Originally Posted by MLOx View Post
Thank you Caldona, I agree, my mom doesn't like the bed, and she is like you where she wants her back all the way back in the lift recliner. The problem is that no one can lift her fully anymore, so we need two people and it's wearing down her husband 24 hrs a day. So I want to come up with a plan to change the pads without getting her up, I think we will try some of the suggestions here. But I totally agree, there is so much loss assoicated with this disease at least give control in daily care.... thank you for your encouragment to stick with my mom's wants/needs.
I forgot to tell you we also lean my chair back so far before putting me in my chair it makes it easier to place me then we finish adjusting my chair
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Old 07-14-2012, 10:56 PM #14 (permalink)
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Default Re: diapers and bedside commode

We put mine on the first loop if it is down to my crack maybe a little past I sit up straight I weigh about 165 and my sling is a medium
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Old 07-14-2012, 11:23 PM #15 (permalink)
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Default Re: diapers and bedside commode

l just ordered a u sling .my has four loops two on top and two on bottom
what hook do you put the loops on to stay in a sitting position

I wear house dresses with no underwear and sit on a pad in my lift recliner and bed to pull me up and turn me and use a fracture pan to urinate . They are flat and easy to slip under butt .I only leave for bm and to go to bed and in the morning to my shower chair .And back in my recliner .
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