Son needs advice on how to toilet, shower and change clothing for bedridden Mom. Any suggestions?

While a bidet is a useful tool for those who are continent it won't work to clean up messes from incontinence because they aren't going to be quite so neatly contained to one area, if you've ever cleaned a baby's diaper you will understand what I mean. As caregivers we find ourselves doing things we never would have dreamed possible, I guarantee you that no daughter ever felt prepared to do those intimate tasks either.

In my opinion there is no way to clean up your mother with your eyes averted, you have to actually see what you are doing so that you can be sure everything is adequately cleaned and there are no sores or rashes developing from moisture or chafing.

I'm not really sure how you hope to accomplish showers if she is truly bedridden, aside from how you are going to be able to physically get her to the bathroom and into a shower often people at that stage aren't able to hold themselves upright on a bench or stool, and her ability to wash herself will be very limited. You might consider hiring someone to help with this task once or twice a week.

As for tech - there are special lifts, shower chairs, wheelchairs that can help with daily life, but none of them are cheap. Many (most) homes are not designed to accommodate the disabled so modifications might be necessary there too - wider doors and hallways and an all one level roll in bathroom that is large enough for her wheelchair and/or a wheeled shower chair. I think your best bet there would be to work with an OT/PT who can come to the home and guide you.

I do not believe that one person can care for a bedridden patient 24 hours a day.

Do you work? Do you hope to retire someday?

We are happy to listen to the complicated backstory that is leading your family to consider taking mother out of the NH.

I think that there are other solutions to bringing her home.

If your mom is bedridden, how will you get her to the toilet, carry her? My husband who was completely bedridden for the last 22 months of his life, in our home, was also under hospice care. Since your mom is bedridden she may qualify for hospice. I would certainly look into that. They will come a couple times a week to give her a bed bath. I had to hire an aide to come put my husband on the bedside commode every morning so he could poop. After he was done, she would hold him up, while I cleaned him up. Worked much better than trying to clean him up while laying in the bed. There is NOTHING easy about caring for someone who is bedridden. I sure hope you think long and hard before removing mom from the facility she is in now. You will be giving up your life as you now know it. Best wishes.

Clemente, Is your mom getting any help with her mental health challenges?

It is very normal for most folks (and elders especially) to be disoriented and confused when in a NEW unfamilar setting. But if mom is agitated and disoriented after several weeks in a new setting with attentive and caring staff, it is time to look to a geriatric psychiatrist to prescribe medications that will help her adapt.

It is not up to you to sacrifice your life, future and career to provide 24/7 intimate care for your mother. She will get better socialization and mental stimulation in a congregate setting. She will get care by trained staff. And you get to visit as a loving son,

BIG BIG BIG BIG MISTAKE taking her out of the nursing home if you are asking these questions. I would think twice before taking her out of the nursing home. And you will also need a LOT of support system, because you will be doing caregiving 24 hours a day, seven days a week. You will also need a LOT of money because you will not be able to work, and diapers cost about 75 cents to $1 a piece. The cost of gloves and wipes are astronomical. You will also need a ton of bed protectors because inducing bowel movements is very difficult and messy. Those are NOT cheap. Figure on changing your mom about 5-6 times a day for urine. You will need skin protection ointments as well. You MUST attend to her oral intake--fluids, nutrition, and oral care--you MUST clean her teeth afterward to prevent aspiration pneumonia. You have a LOT to learn. You will also need to learn how to use a Hoyer lift. You are supposed to have two people do it but I did it myself because there was nobody else around to help me.

You have to get used to it because your mom cannot do things we all take for granted, and the number one reason why people are institutionalized is due to inability to cope with cleaning bowel movements (BM)--much less induce them. If my mom did not have a BM in 4 days she would get impacted which means the stool would get very large and hard and cannot be passed. This would require an emergency room visit to get her bowels moving again, and it would be a terrible mess. So I had to put my mom on a bowel program which lactulose worked very well (she had kidney disease so I could not use milk of magnesia or any kind of phosphate type of laxative). Lactulose is very kidney friendly. Mom had a bowel movement every Tues, Thursdays and Sundays.

You should have been given some teaching on how to do hygienic care. If your mom is bed ridden you will have to do bed baths, and you will also have to prevent skin breakdown, which means specialty mattresses and turning her every two hours.

You cannot shower a bedridden person.

READ THIS AND READ IT WELL: You also CANNOT get sick because a bedridden person will 100% depend on you for your survival.

I’m not sure why your family would be choosing to bring her home now if she has already been settled in a nursing home, presumably because she is bedridden, since Jan but I certainly understand there are likely good reasons. I would however urge you to consider both the pluses and minuses of doing this, there is really no way one person even a trained health care worker, can do this alone full time for any extended time as well as the team of professionals she has in a NH setting. That said there is a difference between what being around “family” and professionals offer and the pluses and minuses of each are a hard choice to make.

You also mention that “our family” is hoping to bring her home which sounds like there are other family members involved and part of that decision, are they part of the solution and care team if you bring her home? There are many parts of caregiving that are a new level of intimate for a child caring for a parent, a son doing for his mom and if those jobs could be spread out between family members as well as perhaps some in home professional, unrelated care help, maybe someone that comes in a few times a week to shower her, change the bed and give everyone a care break. I use some examples here but it all depends on the patients needs so there are many variations here some that insurance may cover even or depending on the state maybe a program designed to allow LTC patients to be cared for at home and her doctor or the facility should be able to order an evaluation that will include a social worker or nurse coordinator who can give you ideas about how to provide what is needed to provide the best possible care for everyone.

If you are choosing to bring her home for yourselves as well as her happiness, kudos to you I totally understand the drive, just make sure you remain open to the possibility that in the end moving her might not be the best thing for her or you. If your mom is aware of things having you clean her up, cleaning up after her it’s going to be as hard on her, maybe even harder, as it is on you and for some the loss of dignity, if you will or the facade of control over those things is just too much and good professional “strangers” often have the skill and removed standing to make that at least tolerable for our loved one’s. Try to keep that in mind as you make this decision too. Again each situation is different and I can’t tell you what is best for you, your family and your mom I can only urge you to weigh it all out as you face these tough decisions and tell you my heart goes out to you.

One person cannot do that alone. I did this for two weeks and it was hard when my mother first became ill with what led to her being hospitalized the first time in this process I'm going through. Thankfully I had the assistance of her close friend who lives next door, who is a certified, medical technician and nursing professional, and had personal experience of caring for an incapacitated son for thirteen years, who she moved back home early on into his care. You're going to need to be trained, by competent caregivers to re-position her, bath her in bed, and deal with her toilet needs. More than likely, you'll have to have a portable toilet right next to the bed, and are always going to need a second person to help with these tasks. Plus you're always going to need home care professionals on hand at various parts of the day, with back-ups on call from the homecare network. If you have adult siblings, you will have to get them onboard to come, assist with these duties, and relieve you, because you're going to need it. You don't realize how quickly you can crack up, and just burnout, and break down, no matter how much resolve you head into this with.

This is really hard. I was faced with the same issue caring for my mom and, with my wife, my mother in law. Two responses. The first is practical. There is on the market a toilet seat that is inexpensive that is very easy to install that provides cleaning functions for both the back and front. The brand name is Toto Washlet. We got ours at Cosco. I wish we had had it for caring for our moms. In addition if you can get a walk in shower, one big enough for a wheelchair, this would be really worthwhile. More than once we had to take my mother-in-law in her wheelchair into the shower to change and clean her after a messy bowl movement.

Now to the spirit: what got me through dealing with caring for my mom in such an intimate way was realizing that now I was caring for her just as she had cared for me. As for private parts I always tried to be conscious of her modesty but on those times when that was unavoidable I remembered that not only had she and I been one body, this was my gateway to life itself. She was to be honored in any way I could help her and comfort her. I came to this acceptance—and this was really important—through prayer. At the start I felt as you (which is entirely natural) and prayed for the strength to do what was necessary. That strength came and with it a new and deep and living connection with my mother; one that put to rest years of strained relations and gave me a wonderful gift after her passing.

May God bless and protect you and give you strength in gifting back to your mom the care she gave to you.

Hello Clemente, I am a healthcare provider who works in a nursing home, so I hope my answer helps you understand the scope of what caregiving a bedbound person entails.

1. If you have no experience, you will need professional assistance to care for your mother, especially in caring for someone who is dependent and bed bound. You should call home care service agencies to find out what services they provide and what the cost is. Then you can see if you can afford it. If your mother is on Medicaid, you can see if she is eligible for home care and how much. If professional aides are contracted to help your mother, you can learn from them how to assist your mother. DO NOT do this unprepared as you will quickly be overwhelmed and it will likely be very unsafe for your mother (and possibly yourself), increasing her risk of bed sores, infection and possible injury. You may find that her staying in the nursing home is the most realistic avenue for her care. Make informed decisions and know what your options are.

2. Not all people are cut out to be the caregivers of their parents. Some sons are able to provide the kind of care she would need, and some, like yourself, are uncomfortable with it. If that's the case, you might want to look into alternatives. To truly provide the necessary care in toileting, bathing and cleaning, you will see everything. A bed bound person will most likely not be getting on a toilet unless they are high level and can stand and walk. But then they are not truly bed-bound. So forget the bidet.

Your question is understandable, but it also reveals that you are not knowledgeable in how to care for a dependent bed-bound person. This is not your fault. As with anything, one needs to be taught. Don't assume it's like caring for a relatively healthy mobile adult. There's a lot to know.

Good luck with this. We are all glad you reached out with your question. Take care.

Clemente, I care for my father at home. I have never had children and like you, it is the opposite sex. You need to research skin breakdown, bed sores, etc. If you fully understand the seriousness of skin breakdown, you WILL be motivated to keep her clean, even in areas to clean that are uncomfortable for you. Wear gloves. I use baby shampoo, instead of soap. It's easier on the skin. See my profile for some other suggestions. I recommend watching a professional caregiver bathe her first.