Diapers

The first thing I needed to know is how to shift the patient on the bed so as to change the diapers. I asked the nurses at the hospital to show me how to do it.

Removing the soiled diapers was not difficult. After detaching the sticking tape on both sides around the thigh just below the waist, asked the patient to slightly lift the buttocks and then pull the diapers out. To put on a new one there is a different approach. Ask the patient to turn to one side, then placed the diapers on the bed and ask the patient to lie flat again. Then ask him or help him to turn to the other side so that the side of the diapers can be pulled out. Now he can lie on his back again and it is just a simple matter of folding the diapers and attaching the sticky tape to hold it in place.

Using diapers during the day is convenient and can be changed when the need arises. However at night the diaper is not adequate to absorb the urine. The diaper is completely soaked and the extra urine will flow onto the bed creating a messy job for the caregiver. I have tried using two diapers at night, making some holes on the inner one so that the urine can flow to the outer diaper. Even this was inadequate. The next morning the bed-sheet had to be sent for washing, the mattress and pillows exposed to the sun to dry.

Unfortunately I had no idea and neither did the hospital staffs inform me of another method especially for men. I learned of this other method very much later. This method is certainly more efficient if fixed properly. It consists of an external catheter (condom shape) which comes in different sizes and a urine bag. The two items are available at pharmacies and the cost is minimal. The technique is to wet the catheter and fold it back. Insert the head of the penis into the catheter, then hold it together with the catheter and fold down the remainder of the catheter to cover the length of the penis. Then use a sticky tape to tape round the penis so that the catheter will not slip out. Now attach the tube from the urine bag to the catheter ensuring that it is held firmly. The bag is best placed in a pail next to the bed.

It is totally unavoidable to face the smelly situation especially when changing the diapers. The diaper is usually soiled with urine or faeces or both. The patient has to be cleaned before putting on a new diaper. Here I must add that sometimes while in the process of changing a new diaper, the patient may urinate or pass motion without warning. Definitely the care giver will be upset or angry. However please remember that sometimes the patient does it unintentionally as he is not in control of his actions.

Bathing

There is a need to check the bathroom to see if it is big enough for two persons, the patient and the caregiver. It may also be useful if a handle bar can be installed on the wall for the patient to hold and stand. The patient is bathed once a day. Bathing is important to keep the patient clean so as to avoid unnecessary problems especially to the skin.

Commode

A bedside commode is a movable toilet, usually on wheels. It looks like a chair with armrests and a toilet seat. A commode can be moved to the side the bed if the person cannot use the bathroom. The chair can be made of wood, plastic, or metal and has a bucket or container under the toilet seat. This bucket or container can slide out for cleaning after use. Put some water into this bucket before use as that makes it easier to clean later. The commode may have wheels so that it can be rolled away when not needed. The wheels can be locked to prevent the chair from moving when a person is using it.

Urinal and Bedpan

For a man, a handheld urinal would be adequate for him to pass urine. This allows him to collect his urine by holding the urinal in front of his penis.

Bedpan is useful to pass motion. To use the bedpan, start by propping him up in bed. Then, sprinkle powder on the rim of the bedpan to make it easier to slip it under the buttocks. Then roll him over to one side, put the bedpan on the mattress at the level of his buttocks and push it down as you roll him back. Help him to adjust the position of the bedpan until he is comfortable. Give him plenty of time.

Keep the handheld urinal and the bedpan within easy reach for him. Note that he may be reluctant to ask for one, so ask him frequently whether he needs one. Always give him complete privacy and plenty of time.