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My 92 yr old husband has LBD … he no longer can or won’t use the urinals since he came home from the hospital..his doctor says he has a new baseline for his dementia … the problem is he is in bed almost full time and the depends don’t hold the urine… he uses a condum catheter which he pulls off and has developed an awful read on his back buttocks and upper thighs… the doctor recommended Hydrocortisone.. it has helped some on his thighs but his back is developing open sores… any ideas or things that can help him to stay dry…bed pads keep the bed dry but not him..

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I'm guessing that you are of a similar age to your husband? My advice to you is that no matter how lovingly given his care is now beyond what you can provide for him at home. Barrier creams like you use for babies can help but he needs to be checked and changed several times through the night as well as during the day, and he needs to be repositioned in bed so he doesn't develop pressure ulcers as well as skin irritation from remaining wet/soiled for long periods of time. Caring for someone in this state takes a lot of physical strength and stamina, at a nursing home there are 3 shifts of workers as well as patient lifts and other equipment to make the task easier on both the caregivers and the care recipient. I grieved when I had to place my mom into a nursing home but in many ways she received better care than I could have given her 🤗
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He should be changed about every 2 hours.
This does several things.
I ensures that the skin is clean and dry. Use a barrier cream much like the creams used on a baby. I made a mix of A&D and Desitin. Pat it on lightly do not rub it on and don't use a lot.
Moving him to change him also changes his position getting blood flow going. This can help prevent Pressure Sores.
If he can not get out of bed to make changing him easier it can be done in bed with him rolling from one side to the other or you can ask for a Hoyer Lift.
You would have to have him roll side to side to get the sling on.
Is he on Hospice? If so Hospice will provide a Hoyer Lift or a Sit To Stand. That might be easier. And either will make changing him easier.
You also should ask to have a Wound Care Specialist check on the wounds on his back. They can be very difficult to heal and can worsen in a matter or hours. This is a PRIORITY.
PLEASE consider Hospice they will be of tremendous help.
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This happened in hospital to my father. When the ambulance brought him home because none of us wanted him to go to a nursing home, his skin was broken down: surface rawness, like the top layer of skin was gone but no bleeding, and terrible redness - but not bedsores - front, back, and everywhere in between. (And his skin was in excellent condition before the hospitalization... If I could have stayed 24/7 at the hospital, as I always did pre-COVID, this wouldn't have happened; but I couldn't commute to the hospital daily, and my request for 24/7 stay was unequivocally turned down.)

A condom catheter was suggested, but there was concern that it wouldn't stay in place or would irritate his skin further. We went through several different barrier creams, turned him at least every 2 hours day and night (he was unbelievably weak and could barely lift a hand, much less move himself in the bed), did hourly checks for incontinence during the day, and kept him as clean as possible. We stopped using Bath Wipes and 3-in-1 foam cleanser after about a month, switching to hypoallergenic body wash w/ washcloths and plenty of plain-water rinsing, in case his skin was reacting to some chemical in the cleansers.

His amazing Primary Care Provider made a home visit and decided it might be yeast overgrowth, since new skin had finally grown back but the awful redness was still present. Applying Nystatin Powder to clean skin twice daily, with silicone barrier cream on top of that, has nearly brought his skin back to normal in less than a month!

We expect him to be incontinent the rest of his life now. Hospice had us start using a tabbed incontinence brief with an extra-long feminine pad up the front, during the night, followed by a thorough mini-bed bath in the morning - and now applying Nystatin Powder and a silicone barrier cream afterwards. Looks like this will remain a part of the routine and a lot more work than before hospitalization. BUT he did not get any bedsores!

The extra pad in the front of the brief at night has helped tremendously; it wicks urine away from his skin better, and he hasn't complained of it being uncomfortable.

Caring for an incontinent bedbound person is very hard, time-consuming work. Hoping that you have help! My husband is the primary physical caregiver here; and hospice gives us tons of suggestions and monitors Dad's condition closely, staying in touch with his PCP regarding med changes, etc. No way we could be doing this by ourselves at this point, because we don't know enough!
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cwillie Oct 2021
Feminine pads are not designed to be used as a substitute for incontinence pads, they work differently.
https://www.hcd.com/need-medical-supplies/bladder-pads-vs-period-pads-the-dry-facts/
And they do make incontinence guards specifically designed for men, you should be able to find them at your local drug store.
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cwillie - thanks for the specifics. After I wrote this, I wondered if what we have are designed for men... I think they are. Just very tired right now and didn't want to go check the package. Your info will be helpful to others, I'm sure. Thanks again.
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If you're anywhere near his age chances are that you're in no condition to properly provide hands on care for a bed ridden patient.
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