Caring for a dementia patient who also needs hoisting to be toileted

[nita]

My mother has got to the stage where she needs to be hoisted from chair to commode to bed to wheelchair. She needs two carers to hoist and toilet her. This means that she is only being toileted 4 times a day and having her pad changed at these times. Also, she is spending up to 9 hours in the night without being changed.

This regime has only just started. I cannot change her by myself as she needs moving in bed by rolling to one side and back again and it needs 2 people to do this. Similarly, in the day she is changed when she is hoisted from sitting so I cannot do this alone either.

I hadn't considered the full implications when she came out of respite and this is all new to me. I am concerned about her sitting in soiled pads and had somehow thought I would be able to change her in betweentimes.

Has anyone else cared for someone in a similar condition?

 

[PeggySmith]

Hi Nita,

I don't have a solution, just that as my MIL got to this stage and was in hospital, I was informed that she had to go into full time care. I was a bit uncertain at the time, but Now she's been in the home for 6 months or so, I realise that I wouldn't have been able to lift or move her if she'd gone home. I hope you get it sorted soon and I'm sure someone'll be along in a minute with some practical advice.

 

[nita]

Thank you, Peggy. I fear that is what might have to happen as I don't want my mother to get skin problems from soiled pads. The SW keeps emphasising that she would get 24 hour care in a home which I am a bit sceptical about as I know she can't always express her needs and I wonder whether they check on her that regularly. I know they told me that when she was in respite, they sometimes changed her pad twice in the night but those pads were ones I'd bought locally and perhaps not as absorbent as the ones the continence service provides. In some ways, I can give her more attention than she would get in care, but not so much in the personal care sphere.

My mother is probably still in the moderate stage of AD; her mobility was deteriorating even before she got dementia, in fact, ever since her second knee joint replacement operation which wasn't successful. After that she needed a wheelchair outside all the time. Then a lumbar fracture 18 months ago set her back both physically and mentally. We were practically lifting her to get her to stand and hold her zimmer frame and, in the end, it was decided that a hoist would be safer for her and carers.

I just wondered whether anyone has had experience of caring for someone with these problems and whether it is at all practicable or if I should let her go into care for her own sake.

Hi Nita,

I don't have a solution, just that as my MIL got to this stage and was in hospital, I was informed that she had to go into full time care. I was a bit uncertain at the time, but Now she's been in the home for 6 months or so, I realise that I wouldn't have been able to lift or move her if she'd gone home. I hope you get it sorted soon and I'm sure someone'll be along in a minute with some practical advice.

 

[nita]

Mum has been home from respite for a week with 2 carers 4 times a day. I am monitoring the situation as I am concerned that four pad changes a day is not enough. I can't do it myself while she's in bed as she needs two people to roll her to the side and change the pad which has sticky closures on either side. I did try to do it but couldn't fix the pad properly. Also, sometimes she needs her sheets changed. I hadn't realised how problematic this would all be as, before she went into respite, I was helping her stand and use the commode, also during the night. But now they think she can't weight bear and I was probably supporting her too much, semi-lifting her.

Anyone else in this situation, please?!!

 

[rajahh]

Mum has been home from respite for a week with 2 carers 4 times a day. I am monitoring the situation as I am concerned that four pad changes a day is not enough. I can't do it myself while she's in bed as she needs two people to roll her to the side and change the pad which has sticky closures on either side. I did try to do it but couldn't fix the pad properly. Also, sometimes she needs her sheets changed. I hadn't realised how problematic this would all be as, before she went into respite, I was helping her stand and use the commode, also during the night. But now they think she can't weight bear and I was probably supporting her too much, semi-lifting her.

Anyone else in this situation, please?!!

I am not in the same situation, but I do feel for you.

I just do not see how you can cope with these problems, on your own it is not easy saying yes to a care home, but I am having to do this now with my husband and understand some of how you feel

My husband wears pads all the time and I only change him morning and evening, I put cream on him or almond oil and his skin is not broken or sore at all

My husband does manage the toilet himself too with difficulty so it is only urine incontinence I have to deal with.

Jeannette

 

[Onlyme]

If your mum needs changing at night and uses a hoist then you need more help than you have at home.

At Mum's NH they have routine times day and night when they change Mum and strip the bed. Obviously if she soils herself in between she is changed. Mum can't express her needs now so the carers have got used to working with her.

 

[nita]

Thank you for responding, Onlyme and Jeannette. This is what the SW thinks - that Mum would be better off in a care home as she would have 24 hour care; they check on the pads every 2 hours (is this true?) so would better be able to respond to her needs. If she didn't want to get up early, they could come back later and try again which the community carers don't have time to do. I am a bit sceptical about this as, when in respite, half the time I visited in the afternoons, Mum was still in bed.

I don't think my Mum would express her needs either, only if they came up and directly asked her. Has anyone observed this happening in a CH? I didn't really see evidence of it when I visited. I suppose I am trying to convince myself that she would be no better off in care and that she can stay in her own home where she still knows her surroundings.

Jeannette, I am sorry to hear you are having to face this as well. It is a case of deciding where the person would be best looked after and happiest. It is such a difficult decision.

If you or anyone else could PM me about ways to best change a person in bed. Mum wears those very absorbent "nappy" type pads so it is difficult for me to do on my own. I hadn't realised it would be well-nigh impossible to do if they were seated in a chair!

If your mum needs changing at night and uses a hoist then you need more help than you have at home.

At Mum's NH they have routine times day and night when they change Mum and strip the bed. Obviously if she soils herself in between she is changed. Mum can't express her needs now so the carers have got used to working with her.

 

[Jessbow]

I think i'd be inclined to try non fixed pads & net knickets with a kylie under her. If she truly is bed bound most of the time , would her GP agree to a catheter?

How strong is she? with a rail, could she help roll herself - if she has something to hold/pull on?

 

[nita]

Thank you, Jess.

She is not supposed to be bed bound but she is at the moment. The continence nurse has ordered the pads with the belt at the waist that sticks on. At the moment she has ones I bought with stickers at the side. These are the most absorbent.

I agree that the non fixed pads would be easier for me to change in the night but are they as absorbent? It would involve her trying to lift her bottom for me to put it on, not sure if she could do that.

Not much strength as she has neuropathic pain in her arms and arthritis in the hands. Two carers can roll her to one side then back again. Poor Mum, she is doing an awful lot of rolling at the moment! She does have bed rails and can reach out but is not really hanging on, just putting her hand on it.

I think i'd be inclined to try non fixed pads & net knickets with a kylie under her. If she truly is bed bound most of the time , would her GP agree to a catheter?

How strong is she? with a rail, could she help roll herself - if she has something to hold/pull on?

 

[Jessbow]

Thank you, Jess.



I agree that the non fixed pads would be easier for me to change in the night but are they as absorbent? It would involve her trying to lift her bottom for me to put it on, not sure if she could do that.

You Could roll her towards you, so her hip was in the air, lay it down, then roll her back. Google the way to put someone in the recovery position, using their own leg as a lever, its not difficult


They are made for the job, so yes, they ar absorbent enough, especially with a kylie inder her.

 

[nita]

Thank you - I found a video on Youtube. It's not quite that easy with Mum as she has very painful arthritis and I wouldn't be able just to lift her leg over in the way shown. She needs some kind of support at the top of the body as well. She feels like a dead weight! I don't really feel happy doing it on my own; it's better with two people.

I don't think there's an answer to this problem of changing Mum by myself.

I was wondering if anyone had decided that their relative should go into a care home precisely because of this situation of needing to be hoisted for toileting because they were concerned about the infrequent changing of pads causing skin problems/infections?

You Could roll her towards you, so her hip was in the air, lay it down, then roll her back. Google the way to put someone in the recovery position, using their own leg as a lever, its not difficult


They are made for the job, so yes, they ar absorbent enough, especially with a kylie inder her.

 

[caring a]

changing incontance slip from hoist

hello everybody,,
havnt been on for a while,but hope some of you good people can help me with this question,,
mum has carers coming now and shes hoisted to toilet from chair,,once shes finished shes brought back to room and cleaned then incontance slip placed back on,,,,,however there seems to be an ever increasing debate which way to fit the slip,,some say it has to be fitted while in air on hoist other wont do it that way as they say dangerous and illegal,,they put slip on chair and hoist down onto it and fit,,,,
while both seem to be ok i would loove some clairity for my own piece of mind,,,
does anybody know if there is a right and wrong way to do this,,,,
thanks so much for your help.....
love as ever to you all..

 

[bemused1]

Caring a I don't think there is a right way, its the way that works . my husband has to be hoisted and to be honest I wouldn't do either. I always change my husband on the bed although I do use pullups on all in ones. Start on one side, roll, do the other side, adjust,hoist.
He also has the same problems as your mum but with practice I manage OK on my own despite the fact that he weighs something in the region of 18st.
I think every carer has a different way but doing it while she is in the hoist would be risky