How do we coach bedridden MIL to go in diapers instead of bedside commode?

I had a homecare patient/client who wasn't able to use the bedside commode anymore. Her husband would call me in a panic when I'd be at my other job that she tipped it over again and was on the floor. So my very understanding other client would let me leave to rush over to their house. I would get her up (miraculously she was never hurt), then proceed to clean up the crap and piss that would be all over her and all over the carpet. She absolutely refused the idea of diapers and would become extremely argumentative when her husband and I would try to bring it up. So, I got yet another panicking call from the husband and I went to take care of it. I told them both that it was the last time I was going to run there and handle it and that either there was going to be diapers or they would have to find someone else to work for them. Then I put the commode into the attic. The lady going in the diapers wasn't a problem because for the most part she was incontinent. They will use the diaper when they have to go. That's all you can do if the commode or bedpan isn't an option.

I’m sorry, but I am confused.

In that she is too weak to transition to a bedside commode and too weak to lift pelvis up for a bedpan, I assume she is emptying her bowels into the bedding. Does she refuse to have someone put diapers on her? Or once diapers are on her does she refuse to release her bowels? Is she urinating into the diapers but not having a bowel movement?

Possibly she is currently constipated and unable to have a bowel movement.

Just make sure she is on a bowel program and she's going at least a few times a week (if she normally goes daily) otherwise you are going to deal with impaction, and it is horrible giving enemas. Bowels are the most stressful thing about caregiving. Impaction means the stool is stuck in there because it becomes a very hard round ball. It is like trying to evacuate a large hardball and it can't come out. It is very painful. If the family does nothing it can turn into a week without going and the stool can start coming out of the mouth (no lie). This can turn into a fatal aspiration pneumonia.

I found lactulose works very well. It is very safe even for kidney patients. If she has kidney problems, do not give anything with magnesium or phosphate based enema due to toxicity. Oil enemas or glycerine are safe for kidney patients.

Mobility is a very precious thing. That is why I kept my mom going as long as I could. Despite my mom's severe Alzheimer's disease she was only bedridden for 3 months and died age 90. She had Alzheimer's for about 12 years. (Over 10 years).

Bedridden means they are at high risk of impaction. so make sure she has a bowel program and keep her bowels moved on schedule--at least a few times a week if she normally goes daily.

Hello indyrach, I brought my Mom the bedpan for a whole year at night, it had to stop. We were exhausted. So after a hospital stay, they did not use bedpans, my mom felt sorry for us and went to Pampers at night for peeing . We went to Pampers at night at first, then to a soft towel between the legs for pepe which is easier to change if needbe. But why is she lifting up? We just turn Mom on her side and insert the pan underneath her a smaller softer bed pan version. Also, when hospitalized many times, they insist on bed poops, no longer provide bed pan, just lots of chucks and reassurance. When overweight, and cannot stand up, sitting in wheelchair, that's when a portable toilet is used and she is lifted by hydraulic lift if available or just by picking her up if she could stand and assist. But in bed for poops, we give her the bedpan and she sleeps in a soft towel for quicker changing for peeing. Hates to poop in Pampers, it degrading to them. I do not insist on Pampers for pooping. i put myself in her place. I wouldnt want to do that either. In nursing homes, theyll let you sit in it until they have time to change you. Just not good. They hired thr least staff and put patients that couldn't walk in Pampers and it hoped they only peed and changing them could be overlooked. Hope this helps. No convincing them to use Pampers. And I encourage them to eat fiber and to poop often for good health reasons.

If her mind is still good, this must be a very difficult thing to do. You are asking her to undo years of behavior. With my mother, who has advanced dementia, it happened as she regressed. Even with my mother, the aides try to take her in her wheel chair to the bathroom and have her use the toilet. She needs 1 or 2 aides to lift her from the bed to the wheel chair and then to the toilet.

I would start with getting rid of the label “diapers”. Incontinence underwear, special underwear, disposable underwear or simply “your” underwear all seem like better choices to me. Yes it’s basically the same thing but diapers are for babies and who at the end of their life wants to be reminded that they need the same care and treatment as their babies did? The other option might be to get some disposable Incontinance underwear that are more like underwear, they all rip off on the side if need be but many are more like underwear than diapers in appearance and this might make the transition easier. I think the more diaper like products are both less expensive and easier for one one confined to bed so I’m not saying forever but maybe waiting to go to those until she has adapted to disposables and the freedom to go in them when she needs to. Also don’t make clean up a big deal, make it quick and easy or even make it clear there is less to clean, it’s not as big a deal, when she uses the disposable underwear without embarrassing her...? Just thoughts I don’t have a definitive answer, sorry.

Imho, do away with the mindset, "diaper." Use the term feminine undergarment/pad. You can even say that you wear a protective pad even though you may not.