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I have been instructed and watched videos on how to change a bed-ridden elderly person’s diaper. My only problem is that I am not strong enough to roll her and get this done. She has a painful knee and that leg can no longer be straightened. I have a caregiver for her 3 times a week for 4-5 hours and sisters who are here on the weekend, but still most of the time I am home alone with her. She is on Hospice and a catheter was tried for several months, but removed due to leaking and UTI’s. She will be 98 in December and placing her in a facility is not an option. It seems like I have tried everything, but hoping someone on this forum may have had experience with the same and can help. It seems like this is a 2 person job, at least for me!!

Have you had an OT assessment? Have you thought about a lift? Otherwise I think having a hospital bed that is accessible on both sides, height adjustable and has rails she can reach to assist you as much as possible is going to help, and slide sheet or pads are absolutely necessary.

(I have to add that even though my mom wasn't that heavy it was all still difficult and I spent time lifting weights to ensure I had the strength needed for her care)
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Reply to cwillie
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The caregivers have told you all they know I assume. You have watched videos? I have to guess that you have all the tricks such as the sheet roll where you pull her toward you using the sheet on the other side of her body, then secure that sheet to the rails; I am assuming you have a hospital bed so that you can raise the bed to a proper height? Pillows between her legs? Is she overweight? This makes me wish I could show you all the tricks I had as a nurse, but you have caregivers and I hope they shared all knowand you are still having trouble. We old nurses have the backs to prove that in the end, almost nothing works, and you are in trouble when there's only one of you.
My first inclination was to tell you that when you have tried everything it has to be recognized that there is nothing you can do but go to placement ultimately. I understand you feel this is not an option with Covid-19 afoot and upsurging again. You may feel "responsible" if she gets it? I can only say that I am assuming you are now in a hospice posture; pneumonia was once known as "the old person's friend" because it took them to final rest after many trials. If hospice is there she will be medicated beyond pain and air hunger, and pneumonia of one kind or other will almost certainly happen. There is even pneumonia caused by bedrest alone.
I am so sorry, and wish there was something I could tell you to help. Please try to use good body mechanics as much as you are able.
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Reply to AlvaDeer
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My sister could not be rolled because her back would spontaneously break, so she was just layed on washable chux that got changed as needed. They are stronger than the disposable ones and could be pulled up under her behind. If your mom urinates large amounts you could tuck absorbent pads to help catch some of it. This was the best solution that was worked out for my sisters situation. She eventually could not even physically deal with the pain and she had a catheter. It is just a difficult situation that changes day to day.

I am so sorry that you are losing your mom and she is suffering from a painful knee, hopefully hospice is keeping her comfortable. Please use the services they offer for you as well. May God grant you strength and wisdom during this difficult time. Great big warm hug!
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Reply to Isthisrealyreal
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The CNA from Hospice SHOULD show you how to roll her and she should have you do it several times so you know what you are doing.
I used a sheet to help me roll my Husband. No pressure on the shoulder or his hips that way.
You can also ask that they get you a Hoyer Lift that way it would be VERY easy to change her as well as the sheets when they need to be changed.
But using a sheet is a very easy way to not just roll someone but to help when you have to change their position. You place an extra sheet on top of the sheet (or just do away with a fitted sheet and just use a "draw sheet") and you gather that up and while you are on one side of the bed you roll the person towards you. It does take practice and it will not be perfect but the object is not perfection it is getting her changed, the sheets changed or her re positioned.
Trust me there were plenty of times when the tab brief I put on my husband looked like a 2 year old could have done better BUT it did the job. My object was to do it without causing injury to either of us.
The more you do it the better you will be and the more you do it the more you will realize you are your own worst critic. No one is going to complain that the brief is not on perfectly, that the tabs are a little off center, that it is a bit higher in back than the front. All that does not matter because in about 2 hours you have to do it all again!
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Reply to Grandma1954
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You are strong enough to roll her if when you make the bed up you use a sheet folded in half on the top of the sleep sheet and use it to roll your mom. Im almost 70 and I can do it. It's a trick taught to CNA's, Nurses, ect.
You might try pulling it up on line.
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Reply to bevthegreat
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Tell your hospice nurse about this problem. They are obligated to instruct you. Generally, bend her right knee keeping the left straight. Stand on her left and reach across her to pull the tug sheet toward you. This will start turning her hips, and the weight of her bent right leg will add momentum. Reverse to do the other direction. When her parttime caregivers are there, tell them you want to help with changing her brief and do it with them. You will get the tricks down.
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Reply to Karsse
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JustDaughter Oct 17, 2020
With my Dad we bend both knees when rolling. More momentum. I cannot believe I ever did this without a draw sheet! It is indispensable.
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As an RN, I will share my tricks - and I have had to take care of super heavy people who are hard to move:

Place a folded sheet that will span the width of her bed and reaches from hips to shoulders.

Place absorbent pads - like large puppy floor pads (cheapest) or bed pads that have plastic in one side - under her bottom area.

She doesn't need adult diapers that pull up like underwear. She will need adult diapers that remind you of baby diapers with tape on the sides.

Changing diaper:
1 - Loosen diaper tabs on both sides. Clean the area in front as best you can. Disposable wipes or warm, wet paper towels work well for this.

2 - I turn my patients by first crossing one leg over the other and the same arm over the body. Then, I stand on the side the hands and feet are on and use the sheet to roll the person onto his/her side. If you don't have a sheet try holding onto hip and shoulder to roll her onto her side.

3 - Move to other side of the bed and loosen diaper from backside, Clean bottom using disposable wipes or more warm, wet paper towels. Try to roll diaper to cover as much "dirt" to avoid more getting onto bottom.

4 - Place new, clean, open diaper along side of butt cheek that is clean. Do all steps 1-2 to roll her onto other side of body.

5 - Finish cleaning skin as needed. Then move clean diaper over this butt cheek. Part legs gently to bring front part between legs.

6 - Roll onto back to secure tapes on sides of diaper.

When a person has diarrhea, my colleagues and I find it easier to not use a diaper and just drape a large towel through the legs and try to allow as much air as possible to the bottom areas. We pad the bed generously with absorbent pads to avoid having to change the bed often.
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Reply to Taarna
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First of all... I want to mention something that many don't seem to know about? Those pads that we use for our periods. Put them inside their pullup... diapers... depends... whatever you wish to call them. You can use two. Get the ones that really absorb the most and sometimes, if you check them enough, that is all you have to change most of the time! For men, I take one and wrap around more towards the END of the penis. Then take another one, so it goes UP between his legs. Many times, I have to only change my patient's pullup one time a day. I put on a fresh pullup every day.

Are you using a turn "sheet"... but instead of a sheet I need to use something of much stronger material. Right now, I am using a wet-proof pad for turning him but he is nothing but skin and bones. For bigger people, it is very difficult or depending on how much they weigh... can be impossible for one person to take care of them and NOT hurt yourself in the process.

A turn Pad ---- take some stronger material other than a sheet if you have it otherwise use a sheet..... blanket.... Fold it until it is in a rectangle and you will have several layers of "cloth" which makes it even stronger. The size does NOT have to be perfect but you will put this underneath them to help you turn them. It should reach close to the bottom of their neck...and then far enough so their buttocks are laying on it.

Also.... have several of these on hand. One is not enough. They will "jiggle" around in bed and will not stay in place so... will have to replace these from time to time. Of course, they also will get soiled and need washing.

Several thing to help when turning them also:
1. When they are ready to be turned...... put their head down.... and put their legs up. Hopefully, you have a bed where you have controls to put their head up/down and legs up/down. If you don't please check and see if you can get a motorized Hospital bed. This would greatly help.

2. Also.... about the bed.... get a bed that also has a control where you are able to bring the whole bed up. Like me, I am tall so this keeps me from having to bend over so far to take care of my patient. Saves my back.

Sometimes they can lay on their back, bend their legs and push up to get their buttocks off the bed long enough for you to push a menstrual pad underneath them. Or.... a menstrual pad sitting on a diaper... .depend.

3. When you are ready to turn....does she have one side that she can turn to better than the other?
a. Put the head of the bed down.
b. Put the bottom of the bed up.....legs up, if you can.
c. Also... have them bend their legs at the knee as much as possible.
Also, they may be able to help by crossing one ankle over the other: if they
are turning to the left, cross the right leg over the left leg as much as they
can. Ankle crossed over other ankle.
d. Some people can help while others cannot.
Some people can help a little. Allow them to help as much as possible.

If you are turning her to the left.... stand on her right side.... grab that turn sheet with both hands... on hand up even with her right shoulder... and the other, somewhere across her buttocks. ...... pull up on it while turning her to the left.
e. If she is able... and you may have to do this part----grab their hand and
help them grab the bar (in this case, the bar would be on her left) to help
them turn themselves or at least keep her from turning back the other way.
over once you have turned them.

Of course, if you have 2 people, it is much easier to do this. When you have her start to turn to the left, the other person is to be standing on her left and is to grab that turn sheet from you when you start the turn; they can grab that turn sheet at some point from you.... and hold her over while you position the pillow behind her.... behind that turn sheet... blanket..... pad....whatever.

I hope this helps.
I feel for you. Been doing this for 30 plus years. It is NOT easy.
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Reply to DonnaF777
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BurntCaregiver Oct 26, 2020
You're right. She needs a turn pad of a stronger material. I always used one with a heavy beach towel laid length-wise under it. I disagree with you about using a pull-up though. When it's at the point when a person is bedbound, then you need an actual diaper. For my bedbound, diaper-dependent clients I use to buy a pack of baby diapers to line the actual diaper with. I would just trim them up a bit and take the tabs off. This was like a miracle to keep skin dry and prevent breakdown. Baby diapers are made from different material then adult diapers are. They stay dry even when urine soaked. I'd show up for work to do the AM care and the diaper would weigh a ton saturated with urine from the overnight. Yet the surface would be dry as a bone.
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This may not help your situation, but when my dad became bedridden, I couldn’t roll him either. I was lucky and found an aide who was able to do a split shift - she came 2 hours in the morning and two hours in the evening before bedtime. Hospice folks worked with me and came around mid-day....so this schedule worked well. My dad slept most of the day at that point. Wouldn’t know what to do without new immigrants willing to pitch in and help out in the healthcare field. Very grateful!
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Reply to jakefix
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A Hoyer lift with a "Turn Sling" may help your situation. Although I do not have the turn sling yet, that is next on my list. It works the same way as a slide sheet or turn sheet except you connect one side to the bed rain and the other the lift. Then the lift does the work.

This may take longer and not be worth the trouble as you have to disconnect from
the bedrail and lift and then reconnect the opposite sides to the lift and bedrail. (The lift does NOT need to be moved around the bed)

I am blessed as my wife's insurance has approved 56 hours a week of help. Although it is very difficult to fill that many hours with willing help. We do have one aide that comes for 2 hours daily, 7 days a week from about 7 to 9 to help transfer her from her wheelchair to the bed. change her, and clean her up . The other aides all work mornings till early afternoon.
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Reply to garylee
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jwmaio Oct 17, 2020
Hospice will pay for a hoyer lift. You may have to purschase the sling (Amazon)
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