need logistic help for toileting

[Kristina1]

Hey everyone! I used to be able to stand for short periods of time while holding bars or my walker for support. So in the bathroom I would hold the safety bars while my CALS pulled my pants and underwear down. I can no longer stand at all, and we are at a loss as to how to pull down pants and undies in the bathroom. How do we do this? Our current process is terribly uncomfotable and probably unsafe. Help!

 

[nona]

Kristina, I switched to skirts and dresses and commando last year. At that point I could still manage myself but now that I need assistance the helper can hold me with one arm and pull up the skirt with the other. But commando is key, and it takes some getting used to. I always have a blanket over my legs while sitting.

I have a bunch I could send you that are too small for me and my Buddha belly.

 

[KarenNWendyn]

I had to give up standing against the walker too after too many falls trying to get out of the wheelchair. I have a unique wheelchair with a standing feature that I currently use (Permobil F5 VS), but I can foresee a point where even that may no longer work for me. I have a female urinal that my helpers place under me once they pull my pants down. Commando is too risky for me. I’ve developed urge incontinence that I never had prior to ALS. I still have to make use of incontinence briefs and pads. I am reading this thread with interest looking for alternative ideas.

 

[lgelb]

Diane H has some good recommendations for ladies, if you're willing to give adaptive slacks a try.

 

[KarenNWendyn]

Another thought if you can manage commando is to use the Pibella female urinal and a waterproof pad underneath.

I pee far too frequently to make hoyering to and from the toilet very practical.

 

[blitzc]

I’ve developed urge incontinence that I never had prior to ALS. I still have to make use of incontinence briefs and pads. I am reading this thread with interest looking for alternative ideas.

Me too! I can't get there and sitting fast enough so I get up and try much more frequently to avoid accidents. All ideas with loss of leg strength for toileting gladly accepted.

 

[beauty4everyone]

I spend every day in bed. (I'd like to get up, but that's a different issue.)
Since bathroom toileting is impossible for me, a bedpan works well. Ordered from Amazon. Be careful regarding SHAPE, SIZE, DEPTH. A piece of oil cloth from fabric store or similar tablecloth completely covering the area and protection-covered mattress, helps cleanup should accidents occur. You-tube has tutorials. If you have an Occ. Therapist, they can demonstrate. Requires CAL having strength to roll you to either side. Not perfect, but any choice has some challenges.

Rather than wait for "need", keep list of how much liquid you consume and when you usually need to "go". Plan a schedule to prepare 1/2 hour before. It takes about 15 minutes to prepare. Helps relieve stress related "accident" potential. (It's all just a thought.)
Good luck.
May Blessings abound B

 

[Fusia]

For those still using the toilet, possibly try an elastic waisted skort (skirt with shorts attached underneath) — the shorts would serve as underwear. When the skort is pulled down the "underwear " comes down with it.

 

[Jimi]

I live in my recliner/lift chair that I control hands free from my computer. Luckily I have managed to train myself with about 99% accuracy to go to the toilet for #2 at the same time every morning. I wear very loose fitting flannel pants (no underwear) with a modified fly ( added velcro to and extended the opening about 1-1.5 inches down) For #1 I use a urinal and raise the lift chair up high to give me a nice angle down. I'm thinking this would be workable with the right shaped funnel for a women. For trips to the toilet I use a u sling, tilting shower/toilet chair and a patient lift. Goes like this :
1) lift chair up, caregiver in front
2) pants pulled down on both sides - no need to go all the way just down on the sides/hips
3) while leaning forward on caregiver, sling is placed behind my back
4) lift chair is lowered down into a normal upright seating position
5) sling placement is finished - under the legs
6) patient lift hooked up and raised up - and pants can be tugged down farther
7) toilet chair under, tilted back. Lower in place.
8) sling removed from under my legs/butt, we leave it behind my back. Pants at this point should be only be slightly under the legs and come right off. Toilet chair moved upright and off to the bathroom
9) putting pants back on requires some patience but not much force. You have to work them up as far as you can before putting the sling back under the legs. Do this with toilet chair tilted back to reduce the weight on the butt. Helpful to bunch the pants legs up as high as possible first
10) While in the air, pull pants up farther
11) once back in the chair we remove legs part of sling and chair is raised back up and sling is completely removed from behind my back, we give the pants a little tug more while we are there
12) chair is put in zero gravity position and backrest reclined far back - a little tug on the waste of the pants simultaneously pulls them up more if needed and gets me properly slid back in the chair. Then get into a comfortable position and fix/un-bunch pants legs

Sounds like a lot of work, but the chair and hoist do all the heavy parts and the time from chair to toilet is less than 5 minutes. I'm 5'9" 155-160#, caregiver is 4'11 115#

All my best, Jim

 

[blitzc]

Jim, amazing info and instructions.
My question is how much room does your bathroom have for all the equipment? Is there any possibility of a photo? So many concerns for those of us not using these modifications yet.

 

[Kristina1]

I ordered some adaptive clothing that I'm hoping will help. We'll see.

 

[Doglady]

I’ve gone through many stages of adapting to toileting. Got a suprapubic catheter to manage urinating a few months ago and happy about it in spite of some infections. Today everything is working perfectly. I’ve got the bm regulated to the same time each day 99% of the time with the help of a small daily dose of Miralax. We now use a hoyer to put me on my shower commode chair in my bedroom as the bathroom is too tight for the Hoyer. There are nice commode bags and liners which make clean-up simple. Prior to this process we’ve used transfer boards and a standing lift. The standing lift is very nice while you can still bear some weight because the caregiver can pull pants up or down very easily. I used adaptive clothing also but those aren’t helpful any more. My favorite were the pants with a flap in the back. This hasn’t been a matter of one solution but rather frequent adjustments as my condition progresses. Good luck and be flexible!

 

[Jimi]

Jim, amazing info and instructions.
My question is how much room does your bathroom have for all the equipment? Is there any possibility of a photo? So many concerns for those of us not using these modifications yet.

Cathy, I don't have the resources for anything fancy. But I am kind of a minimalist and am very organized. I wrote up a description of the use of home automation/technology that I have made use of to adapt to my new normal. It's a PDF I attached to another post. I have a feeling that it was a boring bunch of info to most.
Anyway, basically I live in one master bedroom with my wife. One single bed for her. Two power recliner/lift chairs (one that I have converted to a "smart" chair for controlling my position hands free). A small cart for breathing equipment and my computer that can be easily rolled aside to facilitate lift use. A couple cheap plastic drawer sets for commonly used items. A bookshelf with stereo, TV, and another computer that I control with a camera and my head movement. Fortunately I found a place with a large walk in closet which easily fits the patient lift and much more because of generous shelves. I do sponge baths that have worked out just fine. The pictures don't show the scale of it very well, but there is plenty of room to do everything easily and if you were here in person I think you would see that it's not terribly cluttered. It's my techno bubble. Seating, lights, fans, TV,stereo,heater, phones and computers are controlled from my chair with my head. I guess what I'm trying to express is that it's possible to be comfortable and mentally active in an apartment with no modifications and on a modest budget. It does require letting go of your old way of life. I my case going out and getting into buying a wheelchair van, burdening the people who already do so much to run me around, or going through so much trouble to take a shower like the old me, just wasn't feasible. All in all, I'm hanging in there with no medications of any kind. No pain , no depression and a decent amount of laughter! All my best, Jim

 

[KarenNWendyn]

Jim, what kind of commode chair is that? Does it recline?

 

[Jimi]

Showerbuddy SB3T. Yes it tilts. I just recently bought the optional air cushion seat and I am not sure how I feel about it. But as I have lost muscle on my behind it was getting more difficult to be comfortable so I finally decided to try