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More specifically, my mother knows when she has to move her bowels but cannot tell an aide, or the aides are too busy to help. Mom is wheelchair bound and cannot use the bathroom without help. Of course, i asked how they take of this but have not received
a clear answer. Are there any best practices to recommend how nursg homes should handle this?

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From reading other forums on this website, such bathroom issues exist even if the loved one was living at home and being cared for by a family member. I read quite a few posts about pee/poo on floors, rugs, bedding, car seats, etc. There is no perfect solution for such an issue.
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In my mother's case: she was in a N.H. but the aides preferred that she go in her pants because it was much easier on them to clean her up on THEIR schedule rather than to struggle with her to get her out of bed, into the wheelchair and into the bathroom. Then they pretty much had to wait on her to go & if they didn't wait they'd come when it was convenient for them, not immediately. Shameful, shameful, shameful!
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Yes, a lot of great answers and i appreciate them all. Thank u!
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I used a flat piece of foam on top of a moisture barrier to keep the skin dry and reduce the pressure to avoid bed sores.
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I think you know why...aides are too busy to jump.I have mom in a board and care, 6 residents and 2 caretakers. It is a tough job no doubt. Do check for bedsores. Calmoseptin, don't know if I spelled it right, but it is supposed to be one of the best moisture barriers. Check with pharmacist. It is over the counter but they keep it behind the counter....Anyway, you have a lot of good suggestions in this forum.
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Thank u again for these ideas!
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Great ideas from all the posters above. When I had the unfortunate opportunity to work in a nursing home while I was in nursing school there would be a potty schedule list where the patients would be offered the toilet on a 2 hour basis. Great in theory but nursing homes are notoriously understaffed and it does not always get done. Pull ups are great and provide a bit of dignity. They have pull ups that look almost like underwear, in different colors ect. It is such a precarious road we are on trying to maintain our elders dignity while keeping them somewhat clean.
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By law they are to check them every so many hours specially if they know they are consider to be called Incontinent . And they should be cleaned and changed. If you had your parent at home it would be the same thing if they couldn't tell you. You would have to check what what I had to do for my mother when she was at home with me. She at rehab now and she has to be checked. she off and on with the incontinent thing.
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Having a bowel maintainance schedule is very common in nursing homes as is toileting residents on a regular schedule just as you would with a todler. making sure the staff follow the rules is another matter especially with rude agressive patients The airhorn is an excellent idea and I remember the capt gave his mother a whislte. You could also use a bell or soda can with pebbles inside or install one of the wireless door bells at the bedside. sucess depends on the patient under standing what they have to do and why.
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I like the idea of an air horn. Perhaps also very simple button code could be used. When she needs to go, press the button 2x, or maybe 3x, instead of just once. Ask the admins to note the charts and put up signs where the buttons are located so anyone who sees it knows what it means.
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I think the idea of getting her on a morning schedule is an excellent idea. Does she pull her light for help and do the staff respond? If it is more a matter that she cannot communicate with the staff what she needs, try using a picture card. We use these a lot with my non-verbal students. Print off pictures of the top 3-4 things she might need (bathroom, drink, snack) and Velcro them in places she can get to them easily (make multiple copies). Then she can point to what she needs. I am assuming the nursing aids would rather get her on the toilet than have to change her, but I would sure keep a close eye on this.
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Oh boy I went through this with my Mom when she was in daycare. She had signs but they are too busy to see. She knew she had to go but didnt understand what was going on and would go into a small library room at the daycare and go in her pants. Eventually they learned that but still missed it a lot and I picked her up in her "extra" pants I sent in. Once she stopped going to daycare over 3 years ago she hasnt messed her pants once! (she was sick 2 times and went during the night) Her sign was sitting forward in her wheelchair and I would bring her in and she goes. If they dont watch her constantly, it will continue and how very sad it is when they loose their dignity like that. My Mom is on a good schedule now which took me 2 years to get her on and she does her bm's every morning on the toilet which I lift her on to. Can you go and give your Mom prune juice every night? My Mom has prune juice (4oz) every night, then 4 oz of caffinated coffee with 1.5 tsp of miralax each morning and then onto the toilet and whammo. You want her to go mornings if you can because thats when the Aides are around. My Mom is completely incontinent but I am trained to at least get her BM's. Good luck with your Mom!
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Using a schedule as mentioned above often helps. The person gets used to going at those times and it decreases accidents.
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Isn't that the truth wolflover!! I'm sure the CEO and director make a pretty penny while they hire part time so they don't have to pay benefits...we all know caregivers should make more money.. Or in our cases as family it would be nice just to get any money..
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if she knows she has to go and if she is capable of moving her wheelchair, maybe she could wheel herself down to nurses station and point to butt or something, or if she is in bed, push the nurses button until someone shows up. Its a shame our country advertises for nurses but don't want to pay them what they are worth OR the establishment can't afford to keep them all so they either hire part-timers or the regular ones are over worked. just not right.
hope you can get some ideas or help
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I finally used an air horn at home so I could hear even if I was outside. I made a lever to make it easier for mom to press the button on top.
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My mother will tell us verbally but she also touches her stomach . That was her first way of telling us right after her stroke . Hope this helps .
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Hi, I'm wondering how do you know that she has to go? What method does she use to inform you? Can you relay that to NH?
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My mom is pretty much continent but does have accidents every so often. They have started putting a pull up on her , but she is mobile and walks with a walker and can tell when she has to go the bathroom . I would talk with the nursing supervisor to get some answers. I usually get any problems settled very quickly when I go to the administration staff at the nursing facilitie.
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In grandmothers case the put her on the toilet on a regular schedule. I don't think she knew when she has to go though and she did mess up her depends sometimes. It's heart breaking.
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