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Alzheimer's patient is bed ridden and can't open her legs for us any more to clean her personally area when changing her adult diaper. Any suggestions on how to keep there legs open and get some air while you clean that area good?

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If the patient is bedridden, chances are he/she has some contractures (arms and legs tightened up). Often the legs seem like they are "welded" together.
If the patient is a woman, we are taught, from an early age, to keep our legs closed. No woman ever sits with her legs wide open. It's an unnatural position for a lady.

Try to remember to explain what you are doing before you start cleaning her, even if you don't think she'll understand. It's just common courtesy. Try rolling the person on their side and cleaning them from the back. Sometimes it's the only way to get to the area.

P.S. Remember, if it's a female, to wipe from the front to the back to avoid a urinary tract infection.
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This is a tough one... We call it the vice grip at my house ;-)... My mom's grandfather was a minister so we always say he would be proud of her for keeping her knees together. It does make changing tough. As others have said, roll her on her side clean from behind. It helps if she can bend her legs...on her side with legs bent like being curled up... Then you have better access. If you have a helper, she may allow her knee to be gently lifted giving better access.

Be sure to tell her each step as you do it. This is such intrusive care. Think about it, if you can't make sense of many things going on around you and now someone is poking and prodding an area you have always guarded...I think it must seem like being molested, repeatedly. My heart broke when I first noticed that my mom no longer understood I was helping with this intimate care. She was quite upset and would say, "my mommy said no." Bless her heart. I am very careful to talk to her a bit first, and tell her each step and that I am just helping freshen her up. Like I said, a tough one.
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The aides in the nursing home clean my mother with her lying on her sides, rolling her over to do the other side and stopping to wash the front as she is turned. During the manoeuvring they also remove the soiled diaper and insert a clean one. You can keep her propped up with a pillow behind her back.
You can watch some good videos of technique by search YouTube for CNA training - diaper changes.
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One of the best aides at mom's facility is very chatty and keeps telling mom to help her while she rolls her side to side - fortunately she's very fast too

Sometimes mom will try and say 'take care of the baby,' but sometimes she screams as if in pain - I suspect from her compressed vertebrae

I've discovered it's best for me to step out as when she sees me it is harder on her and then she tells me ' do you know where she's putting her hand?' Yes, she's cleaning you - tell her thank you
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Oh Grammy, your mom's "my mommy said no" is just heartbreaking. As my 97-year old mom would tell me over and over, "We're all living too long." So sad for all of us to be put in these situations.
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Yes, the aides always tell mom exactly what they are doing, and I guess I'm fortunate in a way that my mom spent enough times in the hospital through her life that she gave up those feelings of modesty long ago. If you get to be an old person who has never exposed themselves to anyone except a spouse or the doctor it has to be very traumatic.
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Yes, heart breaking. Now she does better with it all.
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