Toileting someone who is immobile

[Marnie63]

This is new territory for me. Mum, with VaD, had a stroke three weeks ago. She's still in hospital but hopefully coming home next week (equipment delivered and ready at home, carer visits to restart when she's home).

Mum is currently catheterized, but they will be removing it soon to see if she can empty her bladder after the stroke. When she needs a No 2 they either hoist her onto a commode or, more often, offer a bed pan. She cannot transfer to a commode or toilet. I'm finding this hard to come to terms with, but also to understand what should be happening in a hospital environment. She usually has to wait ages for either option as they are so understaffed on the ward. Usually she ends up doing it in her pad as often no one responds in time.

What is the 'normal' procedure in such cases? Will she just eventually become doubly incontinent because of her immobility? We've had three weeks of this and I just don't know if they are doing the right thing or not?

As for coming home, no idea what I'll be doing when the carers aren't there! I guess I'll just have to wait until they come to either change her or help me toilet her.

Does anyone care for someone at home with these immobility challenges? How do you cope?

 

[Beate]

I agree. She should not be discharged into your care unless you know how to deal with her immobility and toileting, and until you are also ready to deal with it. You might find that it's more than you can cope with, and then you must say so. It will not make you a bad person, but unless you know exactly what her care situation will be like you should not accept her home.

 

[Nigel_2172]

I have exactly this problem with my wife who is generally doubly incontinent and is also immobile. While we have a hoist, without which I wouldn't cope at all, it is of little or no use for toileting simply because you end up with the sling between them and the toilet seat and extracting the sling when it is being sat on is near impossible. I have discussed this time and again with the movement and handling adviser who can offer nothing of help for this scenario. Sorry to say but I end up having to lift her out of the wheelchair and onto the toilet, at the same time taking her clothes down. Having to support her afterwards while getting the clothes back on is damn near impossible. I can just about manage at the moment but the time will come ... Sorry I can't be more positive. Please, if anyone has any advice I'm willing to try anything!

 

[DMac]

I had a friend who died very recently from motor neurone disease. Whilst he was living in his own home, and was completely immobile, he had the most sophisticated hoist I have ever seen.

It was basically an overhead electric pulley. It occupied the entire width of his room. The sling encased virtually his entire body, apart from the 'toilet area' (if you know what I mean). In fact he had 2 slings so one could be washed. He had 4 care visits a day, two carers each time. The carers would attach the handles of the sling (which was left underneath him on his chair during the daytime) to the motor of the pulley, which would pull him up out of his bed/chair and then across to the commode. This required no lifting at all from the carers - the pulley did all the work. By the way, he always had a kylie sheet on his chair in case of accidents.

There are clever machines out there. It may be worth asking the occupational therapist at the hospital to see what's available. Under no circumstances should you be put at any risk from having to lift or manoeuvre your mum. Good luck. xx

 

[knoxy07]

This is new territory for me. Mum, with VaD, had a stroke three weeks ago. She's still in hospital but hopefully coming home next week (equipment delivered and ready at home, carer visits to restart when she's home).

Mum is currently catheterized, but they will be removing it soon to see if she can empty her bladder after the stroke. When she needs a No 2 they either hoist her onto a commode or, more often, offer a bed pan. She cannot transfer to a commode or toilet. I'm finding this hard to come to terms with, but also to understand what should be happening in a hospital environment. She usually has to wait ages for either option as they are so understaffed on the ward. Usually she ends up doing it in her pad as often no one responds in time.

What is the 'normal' procedure in such cases? Will she just eventually become doubly incontinent because of her immobility? We've had three weeks of this and I just don't know if they are doing the right thing or not?

As for coming home, no idea what I'll be doing when the carers aren't there! I guess I'll just have to wait until they come to either change her or help me toilet her.

Does anyone care for someone at home with these immobility challenges? How do you cope?

Hi ,
Sorry to hear about your mum,
I had the same issue regarding catheter & the situation, stand your ground,speak to the ward doctor and insist she keeps the catheter in for a period of time she's at high risk of pressure sores & skin break down, as long as she has plenty of fluids & keeps the area clean she shouldn't attract a UTI, district nurse should come & change the tube every three months, I really feel keeping it in is the best option for now, why in the first place do they catheterise each patient in hospitals straight away when they shouldn't? Because they don't have time to keep changing pads & don't want the paperwork when they develop a pressure sore.

 

[LadyA]

I have exactly this problem with my wife who is generally doubly incontinent and is also immobile. While we have a hoist, without which I wouldn't cope at all, it is of little or no use for toileting simply because you end up with the sling between them and the toilet seat and extracting the sling when it is being sat on is near impossible. I have discussed this time and again with the movement and handling adviser who can offer nothing of help for this scenario. Sorry to say but I end up having to lift her out of the wheelchair and onto the toilet, at the same time taking her clothes down. Having to support her afterwards while getting the clothes back on is damn near impossible. I can just about manage at the moment but the time will come ... Sorry I can't be more positive. Please, if anyone has any advice I'm willing to try anything!

Hello Nigel, and welcome!

What you need is a specific toileting sling for the hoist! http://www.arjohuntleigh.ie/product...slings/clip-slings/toilet-sling-head-support/
As you'll see, it leaves the "appropriate area" free, so you should be able to leave it on while your wife is using the loo!

PS. Slings are generally made from the same fabric as sliding sheets. Designed to move easily against itself. So, (hard to describe!) to remove a sling relatively easily, you take the opposite side, and bring it sort of diagonally underneath, so the fabric is sliding against the rest of the sling? If you look on YouTube, I'm sure there would be demonstrations.
Getting back on is a different kettle of fish!