Do I need overnight care for mom?

Is there a reason that you are taking her out of a professional care setting?

Are you intending to try to care for a bedridden person with dementia on your own?

I'm not a professional, but, if they say she needs to be turned on a regular basis, I'd think that is required. I'd discuss it with her doctor or hospice team, if she's on hospice.

The problem is that you can not leave a soaked incontinence brief on without skin breaking down.

So, if she wets half hour after falling asleep then you have a good chance of skin problems.

You can check for the 1st week and see if 1 time a night would be sufficient and about what time it is needed. If she is completely bedridden she needs to have her position shifted every two hours as well.

I would not let the nursing home dictate what you need to do but, I would listen to their advice on how to keep her skin as healthy as possible. Once sores develop they are challenging to heal and can cause other issues.

Good luck with having her home.

My question is why are you taking her out of the NH? By the time people get to a NH home its because they need 24/7 care. Are you ready to give up your life. Hiring someone will be expensive. Was Mom private pay or Medicaid. If Medicaid, she might qualify for some in home care.

Hi jmorse. I use skin barrier ointments to protect skin and pads inside depends overnight. I am not changing Mom during the night. No skin issues but she is not bedridden. Not sure if your Mom is or not. Good luck!

I suspect that the NH is trying to discourage you from bringing her home. A good barrier cream might work, but I dont have any experience with this.

Have you asked for an independent evaluation of what her care needs are?

I did the same as you, kept mom at home, with just one shift of aid.  I put barrier crème on her and rotated her any time she woke up.  BTW, I REALLY doubt the NHs check anyone every 2 hours

There is a reason people are asking if you really want to do this. Hundreds of people on this board thought they could do home care too, and now they are exhausted, broken mentally (and physically) and wish someone had warned them. Your replies of "that's not what I asked" means people are saying something you don't want to hear. Consider why.

The fact that you're hoping you can skip the night diapers is but one indication that you don't see what is coming. She was placed in NH for a reason, and one of them was overnight care.

You will not be able to work from home AND take care of Mom at the same time. Your work or your mom will suffer. Again, multiple people on here thought they could do that too. Most have to handle several work interruptions daily to tend to their elder. Any sort of schedule you have now will be out the window.

Can you lift her every day?

You will need an aide, if not for this reason then another. Are you okay with workers (strangers) in your house overnight?

Can you handle multiple toilet visits, butt wiping, diarrhea, bed urine, and getting her undressed/dressed? Multiple times a day, and night too?

Are your toilets, bathtubs, etc handicap-ready? Will her bed have safety rails? Are meds stored safely?

There will be no more dinners out, no vacations. Friends and family will say to call if you need anything, but you'll find almost none will volunteer to stay with her if you want or need time out.

When do you plan to get things like errands and grocery shopping done?

If she worsens, how will you handle the medical needs? If she keeps you up at night, how do you plan to handle work the next day?

If you get sick, injured, or compromised, what plan do you have for her care?

Finally, consider she is set in a routine at NH. Taking her out of that and into a whole new one is a rough transition on an elder. If you end up having to place her again, that's another round of transition and newness she'll have to adjust to.

I've said before that people think they can "love their way" through caregiving. That love will be enough to sustain their energy and will. It isn't. Most on here loved their elder dearly and wanted to care for them. They had to place their elder to save both of their lives.

If you're bound and determined to move her to your house, certainly no one can stop you. Just go into this with open eyes and KNOW what you are taking on.

To my knowledge there is no incontinence product that will keep her dry all night so that you don’t have to get up.

I think it might be instructive for the OP to spend 48 continuous hours in the NH to see what her mom's care needs are. And if she sleeps through the night. And what her level of "need" is over the course of those hours.

Look, I'm all for home care if it is the best thing for everyone involved. I just want the OP to be fully informed about what the issues that come up might be.

The great thing about having my mom in a NH was that the care came to her.

There was a geriatrician, Advanced practise nurses, medtech nurses, podiatrist, audiologist, dentist, psychiatrist, dermatologist and eye doctor. All of those services were available "in house". No need to shlep mom out to have her seen.

Our only foray into the medical community was for a biopsy of what we all thought might be a new melanoma (it wasn't). But it was a heavy lift to get mom to and from the dermatologist's office, up on the table, etc for the procedure. I can't imagine having had to take her out for ALL of her medical care.

Keep your mom dry by applying a barrier cream such as Cavilon. It can be purchased at Walmart.

Every 2 hours sounds excessive but maybe once or twice would be helpful and keep her from having issues. Many people have issues with adult diapers, etc. not really doing the job and having accidents in bed. Waterproof sheets, chux, etc.

Good luck.

As to the incontinence, you might consider the Pure Wick system.   It has one end that you place between her legs, and it draws urine away.   They used it at the hospital the last time my mom was there.  It will cut down on pads getting overwhelmed

I posted on LoopyLoo's answer up above. She mentioned a lot of things I'm dealing with, in trying to take care of my wife at home. But in reading all of the answers I can see that no one answered your question. So I hope this helps. I use "always discreet underwear" overnight maximum on my wife. I buy them thru Amazon. I also put 2 "certainty under pads" down on the bed, one half way over the other. Then I put a heavy pliant plastic barrier cross ways over those and top that with 2 more pads. Otherwise I'm up to my ears in laundry. Even though the diaper manufacturers say they don't leak. Some do. You can get these items at Walgreens.

I would change my Husband before he went to bed and I would change him at least 2 times during the night. Actually once was before I went to bed then the other was about 3 am.
You can get mattresses that are alternating pressure mattresses that reduce the need to change position as often but she should be repositioned fairly often (every 2 hours is standard)

Changing her every morning is obvious but bathing her every morning is not necessary and can sometimes lead to skin issues as well. Cleaning the areas that become soiled, wet is important but a bath or shower is not necessary.

You might want to contact Hospice and see if she would qualify for Hospice services. You would have a Nurse that would come see her weekly and a CNA that would come in 2 maybe 3 times a week to bathe her, order supplies and help you out for an hour or two. you would also get the proper equipment that you will need. A good Hospital bed, a Sit to Stand or Hoyer Lift if either are needed, or you will get them when they are necessary.

You should also start looking for caregivers, either an agency or if you are going to hire privately. Even if you do not need one over night having someone come in a few hours during the day several days a week can be a lifesaver (and sanity saver)

I cannot see why she would need to be changed at all during the night. If she goes just before bed and you put a Maxi (8 drop) incontinence pad on, then it will last till morning. There cannot be anything more disruptive than having to get up and change someone during the night. It will shorten your life and destroy your sleep pattern. That's what we do with my 94 year old heavily incontinent mom and it works fine. I don't know if 8 drop is available in America. Take a look on Amazon. I found these there
TENA Intimates Overnight Absorbency Incontinence/Bladder Control Pad with Lie Down Protection.
Oh and I meant to add also that you will need to put down incontinence mats on the bed just in case of leakage. I seldom have a problem.

The answer to your question is “YES.” You should be following these instructions as an older persons skin becomes very thin and prone to infection. It’s best to be overly cautious so that any issues don’t develop and you keep things under control.
You seem very defensive when some responders offer you constructive advice. Removing someone from skilled nursing is a major undertaking and will require You to provide full time, around the clock care.

For Five years my mom was changed each night before bed. Then first thing in the morning. I used Sam’s club depends with one Sam’s club pad inside. Mom’s crack on her bottom was coated each evening/ morning with Desitin. I bought the adult wipes from Sam’s club and used these to keep her bottom area clean and wiped down prior to using the Desitin, I also reapplied the Desitin when ever she used the bathroom or once she was bed ridden when I changed her. Every few days I applied the Desitin under mom’s breast and if needed in leg joint or anywhere else I thought might need it.

I borrowed a hospital bed from the Lion’s Club and I purchased a pressure mattress.
From Amazon I purchased washable bed pads, One was placed under the Sheet and one on top. I also purchased disposable pads to have as back up. Most nights mom did not leak. I used a washable pad on moms recliner and later on the wheelchair.

I never had to roll or reposition mom, mom never got bed sores. Desitin was my mom’s best friend along with the alternating air pressure pan. Later on when mom was having trouble standing I was able to get a Hoyer lift. This became my favorite device and my mom loved it. I used the split leg harness sometimes and other times a short full harness I purchased from Amazon. Mom was in a seated position in these harnesses vs the V position. I was able to move her. easily from bed to recliner or wheelchair very easily. We never used overnight care. I used a small camera that if I woke in the night I could check on mom easily.

Make sure mom is kept clean down there and use barrier cream. Try and get and alternating air bed pad for your mom to sleep on. Get her out of bed during the day. Wishing you the best. Get help for a few hours each week to give yourself a break, if mom is not ok the be left alone. My mom passed away at home in August.

Now my dad 97 needs a little help here and there bad knees. He is incontinent sometimes but not always. He keeps a urinal near him. He uses the Desitin also. More places on him for protection day and night. Mostly he coats himself. On bad days I do, we joke about greasing him down. Dad’s of sound mind which makes it easy. He is able to still live on his own. We live across the street. I go over a few times daily and always at night to make sure he is safe on stair lift transfers, because of his bad knees.

I wish you the best ask your doctor what durable medical equipment you may qualify for through medicare. If the nursing home has physical therapy they can possibly order a wheelchair if needed before she leaves. If you are in the US check with the Lion’s or Rotary club to see if they have a lending program. My mom had her hospital bed for 5 years from the Lion’s club.

Not sure of the whole situation, but I would assume it would be just like a baby in some ways.  Even if she sleeps thru the night, you could still change/clean her.  I am not sure if NH check all their residents every 2 hours for that but maybe there is something out there (desitin) to be used on her skin to help seal out water (even vasoline) that way you wouldn't need to change as often.  So if you hire an aide to change her every 2 hours and she is sleeping, you can do it also, with the help with above mentioned items.  wishing you luck.

I doubt very seriously anyone at any facility would be changing your mom during the night.

Im sure your can get night time pullups or thicker diapers for Adults just like ones for children.

I doubt your mom wants to be woke up during the night anymore than you do.

Besudes the overnight diapers. Always use a thick babycream to help her not get a diaper rash.

You can also set up a Baby Monitor or a Nest Camera where you can check on her at any time 24 7 by using your computer or cell phone.

You're fortunate she sleeps thru the night unlike my 96 yr old Dad who won'ts a snack at 2 or 4 AM

In my experience, Poise pads are better than any overnight "pull-ups" I've used. Which I believe were the Walmart overnight absorbency; cheap. I think just trial and error; process of elimination. Good luck.

so after reading everyones answers and I guess some helped you and some didn't.  So I am going to provide another answer.  IF you are not sure of the answers given here........take some time and google about adult diapers and what are rated the "top notch" for wetness retention so that you and your mother can sleep the full 9 to 6 each and every day.  And if you have a good support system, maybe you can all come up with a routine schedule where you take turns getting up every 2 hours IF you can't find a great adult diaper product.  wishing you luck in this big adventure.  I hope no one hurt your feelings and none were intended I am sure.

My mom broke her back and had to spend a great deal of time in bed for a few weeks. She was used to sleeping long hours through the nite but would get up to void herself as needed. We were warned to change her position and brief (which she ended up wearing) to avoid skin breakdown and sores. We opted to use heavier briefs and a waterproof pad under her to allow her to sleep more. Thought it’d make dealing with back pain better if she was more rested... Turned out to be a bad choice! She developed skin breakdown and several sores. Although small, they were incredibly painful. Wound care people became involved-it was a mess. We healed her sores and got help to reposition her and change her briefs regularly. It was a painful learning experience for Mom especially, but for us as well. This is our story, I hope yours is much better! Good luck.

Mom has had good luck with the TENA Overnight Extra Absorbency brand. Yes, they are soaked through when Mom finally gets up each morning but, oddly enough, the wetness is not next to her skin and has all soaked through to the gel or whatever is in place in the undergarment to absorb the urine. Mom (90) says they are comfortable. They are more expensive, but worth it as far as I'm concerned.

During the daytime, I have her in Tranquility brand with the orange crotch that is in place to be extra absorbent.

Mom always applies a barrier cream each time she goes to the bathroom (after she cleans herself with disposable cleansing wipes). There is an absorbent cloth pad under her fitted sheet on her bed and a soft, disposable pad on top of the fitted sheet.

So far, she has had no skin issues (knock on wood!)

Hope this info helps.

I had a urinary catheter inserted for my mother. I was having to get up several times a night and it was literally driving me to a nervous breakdown due to lack of sleep. Laundry and changing sheets was a daily chore.

This has been a life saver! Home health comes out once a month to put in a new catheter and we use an overnight bag all the time (verses a leg bag) and I only have to empty it once when she gets up and again b4 bed.

Seriously consider this!

Change her before she goes to bed and change her when she gets up in the morning. You may have to change her during the day also. Once you have cleaned her with cleansing wipes, you can treat any area with liquid resistant salve or if it looks like a rash might be developing you can treat it with A&D rash treatment cream. I've been changing my wife for 8 years and it has worked out just fine. I don't have overnight help.

Most bladders can hold urine for 8+ hours - the amount of time most people sleep. If mom can move herself in her bed, you do not need to check her every 2 hours to turn her in her bed. Try a super absorbent diaper at bedtime and check her before you go to bed. Change her in the morning. My Gram used diapers and always soaked them overnight, but she had excellent skin care regimen so she never had breakdown.

Imho, although every two hours seems to be bordering on the extreme, perhaps once during the night is more along the norm.

I thought I saw something new on tv (commercial) for incontinent females, It was like an insertion item that absorbed/vacuumed urine into a container.

Don't know if this is a complete solution to your problem, but some nursing homes do not use diapers at night, but simply a large absorbent quilted under-pad that may need to be changed perhaps once during the night. If urine is not in prolonged close contact with the skin (as with a diaper), problems with skin breakdown are less likely. Limit evening fluid intake. Toilet just before bedtime. No need to check every 2 hrs. Just check and/ or change, if wet, once midway through the night. Wash and dry skin thoroughly if wet and place a new under-pad.
I would suggest avoiding thin under-pads with a plastic lining, as they are not very absorbent and the plastic can hold moisture next to the skin.