Bathroom - How

Status
Not open for further replies.

tripete

Very helpful member
Joined
Dec 5, 2014
Messages
1,002
Reason
PALS
Diagnosis
12/2014
Country
US
State
PA
City
Lancaster
How do you go to the bathroom when you can no longer self transfer (I am getting close)? I have seen some comments about a lift? What about if your stomach and chest muscles don't work and you can't sit upright? Do you end up in diapers waiting to be changed?

I wasn't suppose to last this long.
 
The home health nurse cringes every time we do it but we use a standing sling with a Hoyer.
 
After Krissy couldn't use her limbs, the option we chose was very up close and personal.

I transferred my wife, lifted her from her PWC at the bathroom door, carried her to the toilet, then stood over her and held her to keep her safely seated. When she was done, I wiped her, washed her, and took her back to the living room.

After she stopped eating, she opted for a catheter, so she never get out of bed after that.
 
My wife uses the hygiene sling and 'seats' me on the toilet. For #1 it's either a hand held urinal or a condom catheter.
 
We transfer my husband by a lift onto a padded high back commode which we keep in his bedroom and next door to his daytime tv room. Somehow he is able to sit on it even though he doesn't seem to have any core strength.
 
If unable to sit on a commode it can work for #2 to be hoisted high enough to pop a bedpan underneath. A good sling well adjusted can work even with poor core and neck strength.

A dose of clonazepam can really help just before to keep you calm and relaxed so a result is easier.
 
Tillie and the others are right, Pete, it will take a lift and sling with head support (make sure the sling is the right size) in any scenario, whether lifting you onto/over the toilet, freestanding commode or a bedpan/bucket. Your ALSA chapter may have a loaner lift.
 
I lost my leg muscles before my core muscles. When I was no longer able to stand up from the toilet with assistance, we used a sit to stand machine to transfer to and from the toilet. When my core muscles went to the point the sit to stand was no longer effective, we switched to a lift, a ceiling lift in our case.

We use the ceiling lift to sit on the toilet. Many times I won't actually sit but hang just above the toilet.
 
I lifted Annie with a divided leg sling with head support and placed her on the toilet (we also had a bidet seat.) She also could lean against the straps with her shoulders for support, which is what she normally chose to do. After cleaning her, I placed her back in either her wheelchair or bed with a diaper waiting, which I then fastened after she was placed in it. The last several months she was unable to sit in her chair, so we only transferred to the bed, toilet, and shower chair. The reason for the diaper was that her sphincter muscles were affected, in spite of what most of the literature says.
 
Have you had an assessment done by an occupational therapist? This is exactly the kind of thing what they are trained to figure out for patients on an individual basis.

When my wife became unable to transfer herself, she had an assistant help her with a gait belt. If you don't have anyone to assist you, you could talk to your health plan about providing a home health aid to help you twice a day, in which case you would have to time your bathroom breaks to coincide with the aide visits. My wife used Oxybutenin to help control her bladder and a Hydrawand to stimulate BMs, so her bathroom visits were always at the times of the aide visits, and she never had to wear a diaper--ever.

When the gait belt became ineffective, my wife was prescribed a rolling, tilting commode chair. We used a lift and sling to transfer her into the chair. The tilting of the chair was very important for properly positioning her on it with the sling, because the sling naturally puts the body into a somewhat reclined position.

Although the commode chair came with a basin, I replaced the basin with a simple plastic splash shield so the chair could be rolled over the toilet, where she did her business just like anyone else. The Hydrawand was fantastic and kept everything clean.

Importantly, the rolling, tilting commode chair had a head/neck support. We used Velcro on the head support to attach a terry cloth headband, which we put around her head when the chair was positioned upright over the toilet. This prevented her from nodding forward. The armrests on the chair prevented her from falling to the side.

We know other PALS from support group who use diapers, so I guess that is okay for some people, but I think our no-diaper system worked pretty well.
 
Pete, I don't have any advice but wanted to let you know that You are in my thoughts.
 
3 things:

Unless the CALS and PALS are of respective sizes/builds/capabilities such that the CALS or person transferring can completely protect shoulders and other joints from subluxation while using the belt, gait belts should not be used. Once weak joints are separated, they don't go back in.

Most health plans are not going to send an aide 2x a day to do custodial care.

Rehab shower/commode chairs are a great thing. If you get one that tilts, a calf support is wise to allow the legs to relax and thus protect the knees.
 
I also don't have any suggestions but wanted to let you know you're in my thoughts.
 
Moved the repetition about hospice benefits to the original thread. Pete started this thread in re bathroom/lift issues so let's keep it on that.

Pete, are you working on getting a lift? Let us know what else we can address.

Best,
Laurie
 
No lift yet. I will speak with ALS assoc. next week. I still need to make the bathroom bigger.
 
Status
Not open for further replies.
Back
Top