in the next month or so, a hospital bed will be arriving at my house for my mother to use, she's obese and has severe large swollen legs from lymphedema. so the doctor has ordered an extra large electric hospital bed. But my mother has incontinence, we use underpads and depends pull up diapers, and she has a commode she uses because the walk to the bathroom is to hard for her now. I'm worried about when she's in the hospital bed that the pee is just going to drip all over off the sides or something, is it ridiculous that it stresses me out just thinking about it? I know it's not her fault and she cant control it anymore, I've been trying to think about what i can do? buy lots and lots of blankets and sheets to put under her with the underpad? but then i think about how much laundry im going to have to clean and oh god i get stressed again. I've heard there's such things as waterproof protectors for a hopsital bed? do those things work? and I'm terrified that she's going to have pressure sores. I've heard so many horror stories of seniors suffering in their hospital bed. and I'm so worried that even though my mother wants this bed so bad. i worry it's not gonna work out and she's going to get terrible bed sores. I need advice! what can i do in the fight against the pee? and to prevent or keep ahead of possible bed sores?
Think carefully about this please. Caregiving in general is hard but caregiving for the obese where you place yourself in danger from heavy lifting, etc. isn't the sensible long term plan. Start to think of a back-up plan. Many facilities will not take the extreme obese as they don't have the installed equipment needed nor the extra staffing required (like a 3 person bathing team). She may need to go onto a waiting list at one of the few facilities that can do obese resident level of care. I'd like to suggest you take some time now to find facilities that will take her & place her on the list, then see how it goes at home. If it just becomes too much both for your sanity & back and her health, at least you have a countdown to get her into a place.
I won't say delighted, but you will be astonished at the variety and quality of incontinence products on the market. So many shapes, sizes and capacities - the manufacturers really do seem to have thought of everything. And remember, while it always feels worse when it's your loved one who you have to keep clean and dry, the chances are that she's nothing out of the ordinary compared to other patients.
I'm in the UK so my favourite online supplies companies probably won't be much help to you. But if you Google "continence care" and spend a morning browsing, you'll find not only all the product ranges but probably also quite a lot of helpful guides about what to look for and techniques to try.
Shopping list, if you're starting from scratch:
• A big pedal bin, and plastic bin liners to fit it, for used disposables.
• Another big pedal bin for laundry.
• You can get plastic disposable laundry bags that go straight in the washing machine. They have a soluble strip on them that dissolves in water, so you don't have to handle the soiled bedlinen again - you just put the whole bag in the machine.
• Bed pads. You can get disposable ones. They come in bulk packs, like diapers. Some tuck under the edges of the bed, if you're worried about them creasing under your mother. As well as the area of the pad, look for how much liquid it will hold. Some of them can cope with a couple of litres - and nobody pees more than that in one go, or not outside a urology ward anyway.
• Plenty of sheets. I used to use a fitted one as an under blanket, then a flat one on top of that. You can't have too many. Get pure cotton so that they can be boil-washed. I found good quality ones online at reasonable prices; and in America they'll be even better priced - so don't skimp. If your mother's hospital bed comes with an air mattress, you need to be careful about the fitted sheets though because if they're not purpose-designed they'll interfere with the pressure-adjusting action: check before you buy.
• Dry patient wipes. These come in packets like big tissues, but they're made of a non-tear synthetic fabric and are softer.
• Skin cleanser. I used Senset foam because that was what we got used to in the rehab centre, but I expect there are plenty to choose from. Tena and Johnson & Johnson will no doubt have their own brands. It's important to use a product designed for elders' skin, which is fragile in a different way from babies' skin.
And hand gel in a pump dispenser.
And wet wipes for you, not just your mother.
Oh boy it's all coming back to me...
There are many incontinence products available you should be able to find something that will work for you. That she has not gotten bedsores yet you must be turning her enough. At the very least I would have doc prescribe home health care so you at least have help with some things. Those providers will also be able to show you easier ways of doing almost everything.
I moved my husbands hospital bed from the bedroom into the kitchen/dining area when we went from a twin-xl hospital bed to a larger hospital bed. Makes moving the Hoyer lift easier in this area rather than a more crowded bedroom. And I spend more time in this area of the house and if I had left the bed in the bedroom he would be by himself much of the time. He sleeps just fine with light and noise, if he is tired he sleeps. (I do transfer him from bed to chair then back to bed during the day.)
Bedsores are not just "BED"sores they are pressure sores so any portion of the body that has pressure on it can be prone to sores or ulcers. The heels, back, buttocks, head are all sites for pressure ulcers. A person can get a pressure ulcer if there is little movement of a portion of the body and if there is pressure on the skin. My husband developed one on his heel. Not moving the feet once they were elevated created pressure on the heel so the skin began to breakdown.
Moving a person even just a little bit every 15 to 30 minutes can help increase the blood flow to the area that had pressure on it.
If your Mother is bed bound ask about an air mattress. The one on my husbands bed can be set to let air in and out of chambers so there is always movement so no one part of his body is contact with a surface for an extended period of time.
The other mattress we has was a memory foam mattress but again with air movement so that there was some movement. Not as much as this one. But...(knock wood) I have not had any issues with his back, shoulders, buttocks or hips.
Gloves
Wipes
A&D as well as Desitin are both used. A&D daily the Desitin once in a while. His body responds better to Desitin than to other creams used by Hospice. But A&D is the "go to" ointment.
What ever you use remember two very important things.
CLEAN and DRY
A&D is also very good in creases and skin folds. Not only is it a moisture barrier but it is a great lubricant for the skin so if there is rubbing there will not be the chafing.
You do not mention if she has any other medical problems
One of the things that you may find that will make your life easier is a piece of equipment called a "Sit to Stand" with the equipment you place a sling around the persons body and attach it to the equipment and the equipment, either hydraulic or electric, will help the person stand up. They have to be able to support their weight and hold on to the equipment. If she can not support her weight then a Hoyer would be what you will need. But using this you can help her and not injure yourself. And you have to keep your safety in mind foremost.
Another bit of advice ..
NEVER try to lift your Mom if she happens to fall. Call for a "Lift Assist" I call the non emergency number for the Fire Department and just say I need a lift assist. No transport to the hospital and that there are no injuries. I get a few young guys that will come in and lift my husband off the floor and place him on the bed or on the chair. I sign off that I needed no medical transport and they are off.
If your Mom has a DNR (a POLST is better) make sure that is posted some place where it is easily seen. (POLST by the way is Physicians Order for Life Sustaining Treatment and is much more detailed than a DNR)
And getting back to other medical conditions, if your Mom is Hospice eligible they will help you with all these things as well as train you how to use all the equipment.
Hospice also provides all the supplies you need. If you choose to use supplies other than what they provide you will pay for those.
Keep all receipts that are for medical purposes as they can be deducted as a medical expense.
And do not worry too much, things will fall into place and you will be amazed at what you can do.
One last bit of advice...
Get help. You will need a break and you can not do it all. So go easy on yourself and either utilize volunteers or hire a caregiver at least a few hours a week. Then get out of the house and do something for yourself.
The mattresses on hospital beds may be a lot thicker than a normal mattress so you may need to acquire sheets with deeper sides. Thrift stores often have a lot of bed linens just be sure to get something that can withstand a hot wash and bleach if needed. I would recommend at least six pillows with waterproof covers. You will need two for her head (better quality), one under each arm and two for her legs. Continue to get her out of bed as long as she is able and just a few steps will help her circulation.
Use of a Hoyer lift may be too dangerous for one person alone so you really need help from either hospice or public health. Ask your Dr to prescribe. At the very least they will send someone in several times a week for baths.
It is of the utmost importance to keep Mom clean and dry. if this is impossible when you are alone with her for long periods simply put another waterproof layer over the wet linens and a fresh sheet and she will be fine till someone arrives to help you. You will lean as you go along and there are plenty of people here with practical experience ready to share. There are also videos on U tube that demonstrate how to change a bed with a person in it. Watch them with Mom so she will know how to help. Stop worrying you will do fine.
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