This sounds terrible to say, but I'm glad my father passed away before I had to perform these tasks for him. 6' 4" and over 400 lbs. No way can I see that working out very well for me. Not to mention the childhood issues I had with him - I think I'd have had a hard time performing those chores.
MeatJeanne - you actually brought up an excellent point about the "equipment" that a male has, which has to be dealt with. It's extremely important to remember that in an elderly male, that "equipment" ....well, let's just say it - it hangs lower than it does in a younger man. This poses a risk for that equipment getting caught in things or pinched - especially where a hoyer lift is being used. I think all CNAs and caregivers that have to use this sort of equipment should be aware of this and educated on how to handle transfer of a male in a hoyer. My father was mishandled by the CNAs at the nursing home and suffered a pretty nasty injury that must have been very painful.
I have had no training whatsoever and I sometimes have to care for my wheelchair bound father who often has accidents. There is always a terrible mess and the smell is horrible, but hey, that's life. And that's how I treat the situation, no fuss, no big deal. I usually move him to his commode and shower him, but this isn't always necessary. Once patted down and powdered he is fresh and happy.
I asked my niece, who is an RN....she didn't live in this state. My husband had Alzheimer. I wasn't sure how to change pants in bed, and to clean him, or how to change the dirty sheets under him when an accident (he couldn't get up at the time). I too wondered about poop.... trying to find nice words here .... how to clean him properly since he had different stuff down there than I did !! Not being funny, just trying to offend. I did the best I could, made sure he was always wiped clean after with Wipes, cornstarch powder. He never smelled, no rashes. Home Health couldn't believe how well I took care of him by myself. In other words....NO question is silly or stupid. If you don't ask, it's an automatic no... so to speak.
I so wish I had found this forum long before, instead of a year *after*, my sweet lover's 10-year decline (including incontinence and forgetting how to use a toilet) following his diagnosis of Parkinson's disease (I was never completely convinced it wasn't something else that mimicked it and could be healed) and death in 2014 at a young age 77 following a fall. It would have made such a difference to have had the benefit of talking with all you knowledgeable, responsible and, most importantly, *real* people who have chosen to accept the oh-so-difficult role of caregiver. Now, at least, I know I will be better prepared when my mother gets to the point of needing care. Thank you all for being who you are and for sharing your questions, answers, observations, complaints, sorrow, humor, and brilliance. I tell everyone I know who is caring for, or will eventually care for, an elder about this site.
Again, I apologize for offending. I think perhaps I was not taking into account that the training for a cna "can be anywhere from 6-12 weeks and up to 6 months", whereas where I live a becoming a psw "includes a minimum of: 342 hours of theory (classroom) 10 hours of evaluation 280 hours of practicum (work placement)".
Grateful and others, I mean no disrespect, the question as written struck me as odd, especially coming from a paid caregiver, who should have had training to deal with these kinds of things.
Gratefulkat, it sounds like you may be fairly new to the caregiving career - if so, I commend you on doing a difficult job, and I'm sure you'll do it with the comfort of your patient uppermost in mind. That's probably why you're asking how to deal with this gentleman's BMs in the afternoon.
As others have mentioned, there are some logistics involved in this, depending on whether he has any mobility at all or not. I'm sure you can handle that part. If you've never dealt with a man before, the best thing you can do is simply do the task and not make a big deal about the fact that he's male. Treat him as you would any patient, male or female - with kindness and compassion, gentleness and lots of TLC. Clean him up, get him into a clean brief and/or clothing, and just keep talking to him the whole time, to distract him from what you're having to do. Before you know it, the task will be done, and neither of you will even think twice about it.
Thank you JohnJoe. I find it unsettling when remarks have sarcasm in them. This is a hard road to travel and nothing is ignorant or silly. I, for one, admire and respect anyone caring for these patients. My granddaughter is a CNA at a nursing home and am so proud of her. She has such horrid tales of other caregivers and does not understand why they are doing it if they don't put their heart and sole into it. My mom has dimentia with hospice and it is the most upsetting thing to go thru.
Yes GgJJ11 Id agree with You completely. Gratefulkat did ask a question simply because She is concerned about a technique in Care giving. The answer should be given without sarchism or abuse. 99% of Caregivers on this brilliant Site are so helpful and nice, but I guess You will always get that One.
I think it's GOOD that you're asking, gratefulkat; you will be a better and more caring caregiver if you continue to have concerns about what you are doing and if you are doing it in the very best way you can. I DO think that if you have been sent by an agency to this man that they have a big responsibility to train you. But perhaps you are not with an agency but have been referred in another way. That's ok and all the more reason you need to get all the information you can from all the sources you can and this is a great place and you've been given some good advice by other caregivers here. I assume from your question that you have dealt with incontinence in women patients before and, with the exception of where/how you position the penis (I THINK I would have just done that naturally, but I wouldn't have KNOWN it) the changing and cleaning should be pretty much the same. BM gets into all the crooks and crevices and in all the folds of both the male and the female bodies and both men and women must have all of those areas carefully cleaned EVERY TIME in order to avoid really nasty and uncomfortable infections.
I think if you PRETEND/ACT that you are totally at ease and comfortable with taking care of this aspect of your patient that very soon your FEELINGS will begin to mirror your BEHAVIOR and you WILL be at ease and comfortable!
Personally, I would find that being very matter of fact about this task -- and maybe chattering about something very ordinary but pleasant as you are are doing this care -- will distract both you and the gentleman, allowing him as much dignity as possible and you as much ease as possible. Think ahead of time about a nice story you could be telling him as you care for him -- about your pet or your child or about the town where you grew up. You can interrupt your "chat" to ask any necessary questions or tell him what you're going to do next but if you are otherwise gabbing about something else you may find you are both more at ease -- that this is "no big deal". Good luck, gratefulkat! Let us know how it goes and do keep asking questions!
I would think if the man is lying down, you would roll him to the side, place the brief under him, roll him back on top so that it is positioned centerly, like someone said about the penis, make sure pointing down. when taking off old brief, it would be like doing a baby I guess, only thing is you would have to roll him on side to remove from under him. And also, when cleaning off the man, depending if he has been circumcised you must make sure you clean all around the folded skin area or he will end up with an infection. make sure totally dry when putting brief back on also. But if you work for an agency you should have had some kind of training on working with both men and women. Wishing you luck. just be gentle and tell them(patient) what you are doing so they know what to expect.
Hello, I care for my brother in-law who is 51 and has major incontinence. I would start by calling them briefs instead of diapers, more respectful to the patient. Next, make sure your using a quality brief. Until you get to know his restroom habits, suggest checking him every two hours or so. Putting on a brief on someone standing I found its best to: 1) Stand in back, 2) Put brief through their legs, 3) With your leg that's closest to the person hold the brief against them w/ thigh. 4) Reach around and connect tabs on side closest to you. Move to other side. 5) Ask them to stand as straight as possible, helps get brief tighter. 6) Attach tabs on opposite site.
TIP: Most briefs have a colored line down the center that when wet usually turns blue for an easy visual check.
Hmm, I'm not really sure what the problem is or what you are asking. So he has his BMs in the afternoon, so what? Are you saying that as an afternoon caregiver you normally don't have to deal with feces and can't handle it? If so, I suggest you are in the wrong profession! Toilet him after lunch if that is when he goes, change him if he no longer uses the toilet. If you really want a reason to whine you should try dealing with someone who is soiled at 3 a.m. as well as multiple times through the day (sigh)
Well there is one difference. When you put a diaper on a man, position his penis so it is in the center and pointing down in the direction of his knees. If you don't do this, the urine will end up running out the side of the diaper. Buy some Tranquility Premium Overnight diapers for night. They hold a lot and will last through the night.
If you work for a caregiving Agency, then I would check with the Agency or with other caregivers within the Agency to give you some ideas on how they handle this situation when it was new to them. There really shouldn't be any difference between taking care of a man or a women when it comes to bodily functions. Eventually you will get use to it.
MeatJeanne - you actually brought up an excellent point about the "equipment" that a male has, which has to be dealt with. It's extremely important to remember that in an elderly male, that "equipment" ....well, let's just say it - it hangs lower than it does in a younger man. This poses a risk for that equipment getting caught in things or pinched - especially where a hoyer lift is being used. I think all CNAs and caregivers that have to use this sort of equipment should be aware of this and educated on how to handle transfer of a male in a hoyer. My father was mishandled by the CNAs at the nursing home and suffered a pretty nasty injury that must have been very painful.
In other words....NO question is silly or stupid. If you don't ask, it's an automatic no... so to speak.
As others have mentioned, there are some logistics involved in this, depending on whether he has any mobility at all or not. I'm sure you can handle that part. If you've never dealt with a man before, the best thing you can do is simply do the task and not make a big deal about the fact that he's male. Treat him as you would any patient, male or female - with kindness and compassion, gentleness and lots of TLC. Clean him up, get him into a clean brief and/or clothing, and just keep talking to him the whole time, to distract him from what you're having to do. Before you know it, the task will be done, and neither of you will even think twice about it.
I think if you PRETEND/ACT that you are totally at ease and comfortable with taking care of this aspect of your patient that very soon your FEELINGS will begin to mirror your BEHAVIOR and you WILL be at ease and comfortable!
Personally, I would find that being very matter of fact about this task -- and maybe chattering about something very ordinary but pleasant as you are are doing this care -- will distract both you and the gentleman, allowing him as much dignity as possible and you as much ease as possible. Think ahead of time about a nice story you could be telling him as you care for him -- about your pet or your child or about the town where you grew up. You can interrupt your "chat" to ask any necessary questions or tell him what you're going to do next but if you are otherwise gabbing about something else you may find you are both more at ease -- that this is "no big deal". Good luck, gratefulkat! Let us know how it goes and do keep asking questions!
1) Stand in back,
2) Put brief through their legs,
3) With your leg that's closest to the person hold the brief against them w/ thigh.
4) Reach around and connect tabs on side closest to you. Move to other side.
5) Ask them to stand as straight as possible, helps get brief tighter.
6) Attach tabs on opposite site.
TIP: Most briefs have a colored line down the center that when wet usually turns blue for an easy visual check.
I hope this helps you. Good luck.
Richard K.
Toilet him after lunch if that is when he goes, change him if he no longer uses the toilet. If you really want a reason to whine you should try dealing with someone who is soiled at 3 a.m. as well as multiple times through the day (sigh)