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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?

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Go online and look for matrice protector or bedwetting bed protector. You can get them at Bed, Bath, and Beyond or Amazon.com. They are smaller than the matrice but still belpful. I think there are waterproof matrice protectors. also thatcover the entire bed just like regular matrice protectors. Ask the company you are getting the bed from where to buy a waterproof matrice protector that will fit the bed you are getting. As f o r bed sores you will have to get help moving her on the bed or learn how nurses do it. And change her position on the bed and get her to sit up however many times a day it's necessary to prevent bed sores.
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Yes, there are inexpensive fitted waterproof mattress protectors that are machine washable & dryable, and also padded. I'd get 2 so you have one to change to. Then use waterproof pads on top of that so you won't have to wash them as often. Also, it sounds like you will need home health care. Almost all drs and hospitals can tell you how to sign up. If she's low income, you can also get help paying for their services. You should not be taking on this task alone, reach out for help. There are people out there ready to help with this exact situation! Good luck.
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Extra large bed may be a real problem...at nursing homes, the mattresses themselves are covered with vinyl. Then they add mattress covers and sheets, etc., plus a 3' by 3' pad under the midsection of the patient....

wish I could offer a specific solution..

Grace + Peace,

Bob
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What bed is your mother using at the moment? I'm a bit puzzled about why you think she will suddenly be at *more* risk of developing pressure sores than she already is?

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.
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Gloves! Nurses' disposable gloves, in bulk.

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...
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My Mom's hospital bed came with a mattress that had a waterproof cover on it, so it is possible that yours will be delivered this way too. I put a foam waffle weave pad on top of that to prevent bedsores and a waterproof cover over that. Some mattress toppers come with the cover in the box. Then I used those disposable underpads over the sheets. The briefs were very absorbent in case of a leak.I would get slightly larger ones for her to give her room and for protection. My Mom ended up having a urinary catheter for many months later on though, and I put a plastic pan under that on the floor on top of a towel in case of a leak. Those disposable underpads were great and before she was completely bedridden I would put them on her wheelchair too.
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CG, is having mom at home the only option? If my mom had gotten to that point I would have been looking for a nursing home for her. The level of care that you will be providing is certainly not what I would have wanted or been able to provide.

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.
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The fact you are even worried about this issue, and the fact she is obese tells me you are NOT prepared to handle this situation and you need to get professional help or put her in a facility where they can manage her multiple challenges.
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Desitin maximum strength cream in the purple box is what was recommended for my dad when we saw the first sight of a bed sore. We used other ointments first prescribed by the doctor that did not really work but then the Hospice nurse said she recommends this cream because it is such a good barrier cream. We reapply every time he uses the bathroom and is healing nicely.
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Hi. I suggest a water proof mattress liner. If it's two expensive if you cut large plastic garbage bags and place them over mattress before sheets. Have a back up or two of sheets. This will prevent the mattress from getting wet. Some hospital beds are "air mattresses" you could ask your case worker if that is covered by your insurance. A patient should be turned on side every few hours so we use pillows and if you mom can pull herself by side rail to lay on her side you can place pillows behind her back. Also place one or two pillows between legs and heels with knees slightly bent while on side. There are also padded foot/heel protectors. There is egg-crate foam. I would wrap pillows, foam and anything that could get wet with a garbage bag prior to pillowcase. Just make sure it's not abrasive maybe an extra blanket. You don't want her skin directly on plastic bag. Desitin or any baby diaper rash cream will help as a proctective barrier on perineal area. Did anyone suggest or talk about a hoyer lift? Idk if you insurance covers that but they are great for lifting/bathing and can be operated by one person. Please do not attempt to lift her yourself. You must protect your back and neck.
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Also bed sores occur in stages...first area is reddened. If you want to take a measurement to see if it advances but assessment is critical to preventing bed sores. They don't just get to worse stage over night. Also eucerin creams will help if you moisturize her legs and arms. Bed sores develop mostly on sacrum (butt/tailbone) and heels. There is a product called duoderm which is like a 4x4 large adhesive think bandaid type which we used on bedsores. Good luck. If she's at home on hospice I'm sure you will have hospice staff and help with her care.
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Most of the hospital beds that I have seen are a waterproof material. All you need to do is wipe them down if they become wet.
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.
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My mom, who is 100% bedridden with declining health, suffered with urine backup to her bladder for years, and has bowel/urine incontinence now. Her urologist felt it was time to put her on a permanent catheter 4 years ago because her incontinence was getting worse. That may be a solution for the urine incontinence issue. The catheter is changed once a month by a home healthcare nurse, or her urologist in the office. We were changing her every 3 hours, cleaning and washing her afterwards, buying large amounts of throw away underpads for the bed, and she was starting to get urinary tract and bacterial infections every month because of the urine soaked undergarments being left on her until we changed her. If she is on medicare, ask her physician to do a "medical necessity" order for a Tier 3 or 4 "geriatric" bed which is wider and has a controller that hangs at the end of the bed that automatically floats the mattress up and down and back and forth to help prevent bed sores. Not sure if Medicaid covers this. Also, when Hospice started with mom their aides (and our family as well) started using Calseptamine ointment on mom's bottom after baths and after every cleaning/changing to keep her from getting bed sores -- and it has worked. She got one skin scrape, but has no bed sores because this ointment heals and keeps her skin from being irritated or dry. I hope this helps
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Mom has recently been admitted to a nursing home because of further declining health. She is being taken care of by Hospice nurses and aides in the nursing home also. We are in process of selling moms house and medical equipment. I am not advertising this, but if you are in need of an electric hoyer we would be willing to sell it to you for under $1,000. We are also selling her electric wheelchair which is in storage if there is a need.
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Mattresses for hospital beds are all waterproof so you don't need to worry about that. All the above advice is appropriate. Buy several full size under pads because the waterproofing on the mattress is very hot and uncomfortable. Enquire about a 'monkey" bar that attaches to the head of the bed if she is able to use her arms to lift her bottom off the bed. This will assist you greatly. The disposable under pads known as Chux are relatively expensive so investing in several washable ones may save money. Pull up diapers probably won't be practical for an obese bedridden patient .
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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For my dad I was using the destin on the areas that had the potential to get "nailed" with urine and then is use coconut oil for the rest of his skin. I rub it into his skin until it absorbs. My dad is underweight, severely so I'd imagine this would take longer for your situation. But it keeps his skin beautifully and it has the added benefit of touch. He loves it. It is extra work, but the dreaded bedsores are probably even more work so every day he gets a coconut run at least once or more depending on his fluid intake. I'm going to break up my posts because there are a few things to say and stuff can get overwhelming without a space.
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I also purchased loads of poise overnight maxi pads. I found those 99 cent store places ( where everything is not always 99 cents ) will get in large amounts in bags that have been opened but the product is still fine and savings are significant. just insert them where the pee will be headed towards. A lot of times I found I could remove the pad and the diaper was still dry even though the pad was saturated. Saves time!
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If you are worried about the pee dripping down once in a blue moon. Get a roll of heavyweight plastic at Home Depot or lowes that they use for green houses and put two strips on the floor on both sides and use duct tape on the edges to keep it from moving and flipping up on you.
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And I hate to say it, but those awful moon boots would probably be a good idea to prevent heel ulcers if she is bedridden for long periods. Though she does still get up if I recall.
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Ferris has a good point is that there may be more issues coming into play especially due to your mother's weight. Are there mobility problems that would cause risk of injury to you or her? I know you mentioned a bedside commode so that is an indication. Would be glad to offer suggestions if I knew more.
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Hello Caregirl, I am an RN who has experience in Home Health. Please make sure her bed is provided with an overhead bar that attaches to the headboard and extends over her providing a dropped down triangle grab bar she can reach up to and help with as much lifting and turning that she is able to provide. A real concern for me as far as incontinence was urinary tract infections. UTI should be one of your first thoughts if she has any change in mental status or lethargy, or signs of blood in her adult diapers. At least get it ruled out. Double pad her night time adult diapers...even with over-sized maternity pads. Find out from your local Area Agency on Aging or Council on Aging if your mom is eligible for any community services. They are NEEDS based, not MEANS based.
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Someone once told me to shop for incontinence supplies on-line and look for a nursing home supply. Boy, were they right! North Shore Care Supply has tons of incontinence products, they've thought of everything. Abena is the best brand in adult diapers and briefs that I have found. Extremely high quality and they don't leak! They are more expensive but have to be changed less often. They're made in Europe. I order them on Amazon usually through North Shore Medical, but you can also order directly from North Shore Medical. They ship them UPS and you have them within a day or two. I would also check to see if they have waterproof mattress covers, I'm sure they do. As an added measure of security you can use "chuks" underneath her. I agree that you will need help moving her. There is an ointment called Calmoseptine that you can put on her bottom daily to help present sores at least in her private areas. I'm not sure about her legs,etc. Is she ready for hospice care? If so, they can be a big help to you. Good luck.
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Get some help..You will need it to keep turning her every few hours. Those incontinence underwear do work.And you can easily cut them off on the sides after she has used them. CVS or any drugstore carries them. Also, lots of moisturizer in the area. You don't want the skin to dry out. Try not to stress. It is not silly...but it is harmful to you and drains you of energy. Good Luck! Malachy
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CareManager- the triangle trapezes you mentioned are quite flimsy- one caller referred to them as "killer trapezes" as several snapped and fell on his face. Also a triangle has to be grabbed dead center so it doesn't tip- making it ineffective in transferring to a wheelchair from the middle of a bed. Just wanted you to be aware there is a 36" long trapeze bar that is very strong and can be grabbed anywhere along its length without "tipping". Fantastic for people wanting to remain in a wide bed (for comfort, space, or remain sleeping with their spouse). They use it to scoot across the bed to get to the edge of the mattress where transfers become easier and safer.
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Friendlybedguy,Thanks for clarifying the need for a STRONG trapeze bar. I once cared for a 450 pound person and the trapeze bar was a tremendous help.
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A local fabric store might have a great solution for an under pad. I purchased long length of "rubberized sheeting" the same stuff that is used in baby cribs. It is waterproof with a soft flannel like material on it. You can cut it to length and it is washable. I used these for a long tome then took a few and cut them again and gave it to a friend that made bibs, or as they are called now..clothing protectors.. Double the use and pretty inexpensive. Even better if you use a coupon at the fabric store!
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You are on a hard road. Be sure to get a memory foam mattress pad or there are mattresses that are made for pressure release. This means they fill with air and give pressure relief at intervals via a motor system. The Doctor has to justify it with a diagnosis to merit it if insurance is to pay. An egg crate memory foam is the economical route to help with pressure relief. Then the waterproof covers and pads to guard against accidents. Lots of good advice on here!!
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Is mom -although obese -still able to do her ADL's or is she dependent on others for her to transition from hospital bed to chair or commode? If she had a sudden weight shift could she totally on her own pull herself up & off? If there was a fire, could she get up & out?

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.
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You need PEOPLE to help you! Who are you talking to? Ask the doctor or the hospital for a Social Work referral. My local Senior Center put me in touch with an agency that will do a needs assessment. You are not the first person to face these problems. If you look for the right kind of help, I bet they can relieve your worries and provide concrete help. They can even give unbiased advice about when to surrender her to professionals.

I feel your panic, and it's a valid response to a HUGE responsibility. But panic is not your friend. Beg an organized friend to help you with planning. He or she might even make a few phone calls to help. For me, when I get even one straw removed from my camel's back, I feel real, disproportionate relief.

Keep posting, because we understand what you're going through.
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Buy some toddler size pillows, they are very handy if you have to prop her on her side for bathing or changing sheets. Definitely get waterproof pads, ones you can wash and triple rinse. Antifungal sneaker spray will prevent odors.
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