Old 01-29-2014, 09:29 PM #1 (permalink)
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Default CALS help PALS with bathroom

My mom was diagnosed in March 2013. She is unable to walk and is quickly getting to the point where she cannot support any weight on her legs. We have been transferring her manually from her lift chair to toilet, but she is overweight and its becoming unsafe for her to continue to move her in this manner.

We have hoyer with mesh sling but unless she is nude from waist down, not sure how that helps us. She has weak bladder after having 7 children so there is not a lot of time for transferring, either.

At night we use a bedpan in bed and that is working fine. Her lift chair is too narrow to use bedpan in it and she's not advanced to the point where she is bedridden all day.

I'm searching for help. I can still manage her okay but one sibling, who is much shorter than the rest of us, cannot so we are trying to get ideas quickly so we are all prepared before we can't lift her at all.
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Old 01-30-2014, 03:57 AM #2 (permalink)
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Default Re: CALS help PALS with bathroom

The cool thing is that she is female so a skirt or loose dress is acceptable. My PALS goes commando under his sweat pants as it is just too much to remove when he has to go to the washroom. She could wear her dress/skirt with nothing underneath, and when she has to void I would try a female urinal. I must admit I have never used one but if it did there would be a whole lot less lifting needed. I am sure there will be other females that can give you some other ideas.
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Old 01-30-2014, 08:51 AM #3 (permalink)
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Default Re: CALS help PALS with bathroom

Thanks, Paulette, for you advice. My sister in law is a whiz with making clothes so I could have had her make a few long wrap skirts for that very reason. We tried a female urinal in the past with hit and a lot of miss results. I guess we could try the bedpan in her lift chair if we recline her all the way. I'll have to try that.

Thanks again for taking the time to read and post some recommendations.
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Old 01-30-2014, 11:31 AM #4 (permalink)
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Default Re: CALS help PALS with bathroom

Another solution that is pretty drastic and not without risks is a suprapubic catheter. There are women on the patients like me si te who have chosen this and like it. You might want to read on there and see if you would even consider such a thing. There was a thread dedicated to it a while ago there.

You are smart to plan ahead. Transfer do get harder People do use the lift successfully for toilet transfers I know but it takes a little time no matter how skilled you are and she has her issue of urinary urgency
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Old 01-30-2014, 12:55 PM #5 (permalink)
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Default Re: CALS help PALS with bathroom

I no longer use my legs and l am transfered from the lift to a rolling commode, rolled on the toilet. I have nighties adapted with open back and velcro. I have bought day wear from an adaptive clothing store, tops open at back/velcro and bottoms that are put on while in the wheelchair that do cover the bum and snap at the waist. I go commando.
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Old 01-30-2014, 07:21 PM #6 (permalink)
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Default Re: CALS help PALS with bathroom

The urgency when she needs to go does complicate the problem and a suprapubic catheter may be the best solution.

A couple of things may help getting the hoyer lift or the female urinal to work better and faster. She will need to wear open back skirts or slacks and no undies(See ALS: From Both Sides ) Put a hand towel on her wheelchair cushion for comfort and absorbency. Get a hygiene split leg sling for her lift. (See ALS: From Both Sides ) It can be left in place behind her back all day but tug the leg straps out from under her thighs. They aren't comfortable to sit on. With the sling in place you can get the straps back under her legs and the straps hooked to the lift fairly quickly with practice. Forget about moving her into the bathroom, and over the toilet! Just Hoyer her up and slide the bedpan under her. Even if you aren't quite fast enough sometimes, a change of clothes won't be necessary. Being up in the lift allows an easy bottom wash and dry towel.

The female urinal may be faster and maybe I can help make using it more "hit" than "miss". A urinal can't work if she is sitting in a normal position in her chair. Standing in front of her, either pull the towel under her towards you or tug her knees forward until the "front of her bottom" is at the edge of the seat. If she is uncomfortable or can't breath well with her chin on her chest, recline her chair a little first. Position her knees to the sides as far as possible and put the urinal in place. If her inner thighs are as flabby as mine, that will require a little lift and tuck to get the urinal up against her. The main reason for leaks is not having the scoop of the urinal under her. Just pushing against her won't catch the flow of urine. Hold the urinal at a downward angle so the urine runs easily into the urinal and doesn't build up in the scoop to overflow.

Getting her her back up into the chair will require some lifting/ pulling and not all caregivers may be able to do it. To reduce the brute force needed, use the wheelchair's tilt feature to get her flat on her back. The less she is reclined for this, the better. The idea is to get her flat on her back but with her knees up high. The weight of her legs and bottom will push her back into her chair. A tug under her arms will help. When you sit her back up she may still be a little slouched. Lean her forward enough that you can grab the back edge of the towel and pull her back with that.

I hope one of these suggestions will help!
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Old 02-09-2014, 01:39 AM #7 (permalink)
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Default Re: CALS help PALS with bathroom

I started wearing sports trunks/shorts all the time. They slide off easier and feel comfortable. Once I'm up in the sling part of my rear is accessible for my caregiver to grip and pull my shorts part of the way down. Then when on the shower chair they pull the shorts the rest of the way off. Best part is they are real cheap at walmart so I can have plenty of spares for those sudden accidents.
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