My 81 year old mom had a stroke almost 3 months ago. A week later she had surgery to clear the blockage in her carotid artery. Since the surgery she hasn’t been the same. Multiple treatments for a UTI as well as CDiff. Shes bed bound, and in a diaper currently. She’s home now on palliative care, a few days ago. I’m fairly sure she still has the UTI, but working on getting that retested this week. She has chronic pain and is having delusions and is often unaware of where she is. Changing her diaper is like a battle. She tenses up and fights, even when I am not touching her, she’ll pull on the bedframe and then be in pain from that. I obviously can’t not change her diaper, but it is traumatic. I’m just pushing through at the moment, but any tips would be helpful. We do have the CNA coming tomorrow so I can see what she says, but I’m struggling.
In your case, I would tear the sides of the diaper (perforated edges). I would then turn her to one side - maybe pick the side she grabs since it may be a stronger side. Have her grab the rail as you raise her leg up a bit and with the other hand pull the diaper through.
New diaper lay on the bed just underneath her bottom when you return to her back. Move one leg to the side and pull diaper up and tape.
Good luck. Truly.
Also.... use women's pads we use for when we have our periods. Use 1, maybe 2 as liners and many times all you have to actually change are those pads that line the diaper. You can also use those on men to "wrap the penis". Easier to change and you might want to check them more often though to see if they have gone to the bathroom.
Is it fear - like she feels she is under attack and is vulnerable?
Is it pain? Is the pain from touching and cleaning her, or from turning on to her side?
It would be helpful to understand exactly what issue is causing this behavior so it can be addressed.
Every reply below is a good one. Two people to gently turn her on her side is ideal. If she is in too much pain to be moved, you can try no diaper for now. Use disposable pads underneath her - and large washable pads under that to better protect the bedding. I learned a trick to double up on the disposable pads. Poke a couple small holes in the top layer so liquid can soak through to a second pad underneath, to increase your absorbency. I just fold over the pad and make a tiny cut through the plastic barrier with scissors in a couple places.
You can lay a cloth diaper or small towel over the top of her to be replaced frequently and use a light weight throw blanket or sheet over the top because it will get wet. Having lots of throw blankets or top sheets on hand makes it easier to replace when wet and easier for laundering.
As for palliative care, you do not get extra resources of care without hiring people. Plus she is in pain. Palliative care does not include bumping up pain meds for comfort like hospice care, because her carer(s) feel that there is room to bump up the rule of rescue compared to the rule of comfort. She feels pain so she still suffers from her condition. What is her quality of life going forward?
They also have Tab Style diapers that are pretty easy to get on and off, even while bed bound. Plus, of course - a chux or two under it all to help protect the bed.
I'm sorry you are having such a hard time trying to change the incontinence brief. Or maybe padding disposable pads underneath her for the time being.