incontinence care

[Roland]

Chris (67, AD 8-9 yrs) has needed a hoist for transfers since she had an epileptic fit 3 weeks ago and been unable to stand longer than a second or two. She sleeps from 8pm till 8am. She has had 2 kinds of incontinence pads (for 2 yrs) smaller for the day and larger for the night. Usually these are wringing wet in the morning although the bed is dry. A friend who is a nurse stayed with her last evening. She said Nursing Homes would turn patients over at 11 - 12pm. Also said its better to lay her on an incontinence sheet / square, not use a pad. Change it at same time. That way her skin would stay drier. So far there hasnt been any problem with her skin and she eats well (v slowly) so remains well covered. But the advice was prevention is better than cure. Start doing this now. Its another chore but maybe a necessary one. No sure who else would advise me on this. Couldnt see anything after searching this forum. Any ideas please?

Roland

 

[germain]

Hello Roland,

Are you in touch with a specialist incontinence nurse ? In my area these come via the GP.

There are several varieties of draw sheets/bed pads you can get - I think they're commonly called Kylie sheets - no idea why, and there are several companies who can supply on-line if your local service doesn't provide these.

Unfortunately we found that even with these our Mum still needed pads - otherwise the top duvet and cover would get soaked as well and these are very difficult to keep washing.
Mum slept so soundly that her pad & sheet could be changed without her waking - (nighties were much better than pyjamas for this.) Nappy rash cream & large baby wipes kept her skin very clear.
hope this helps

regards
Germain

 

[Margarita]

No sure who else would advise me on this. Couldnt see anything after searching this forum. Any ideas please?

I have no experience of that stage yet , but am sure someone on TP must have .

Sorry to read that Chris, is in this stage now .

 

[sad nell]

hello my husbanh has been doubley incontinent for some 3 years now, i use kylie sheets on the bed ,save so much on changing entire bedding, but also use tena comfort slip in pads with a light net to keep them in place , these work very well amd would say that it is just routine now and not a problem, the kylie sheets take some drying so you would need several , i purchase these on internet much chea[er than chemist , if i can offer any help please pm me pam

 

[jenniferpa]

I was wondering: most people in nursing homes are considerably older than Chris. Is it possible that the very elderly are more at risk from skin breakdown? I mean perhaps it's not so much the getting wet, as the fragility of the skin in the first place? Just a thought.

 

[germain]

Hi Jennifer

Well my Mum was 85. Only problems we had with her skin, even with double incontinence, was that each time she went into hospital she came out with awful bed sores which the CH then had to deal with !

Don't think/can't remember there were any specific skin probs caused by her incontinence although a relatively mild "turning hold" or arm lift could bruise her badly.

Germain

 

[jenniferpa]

I was just wondering if the reason the nurse suggested a "nursing home" regimen is because in nursing homes, you probably have to assume the worst case scenario.

I'd definitely be getting the incontinence (or should it be continence?) nurse involved. However, my instinct is to say if it's not causing any problems then why change a system that has been working to something which is much more trouble? It's not as if you wouldn't notice immediately if there were problems.

 

[lesmisralbles]

You might know that my hubby suffer's from number one and two.

Keep the skin clean at all times. Cream if needed.
Let air to the bottom half if possible.

I am useing several £1 plastic tablecloth's from the pound shop. Throw away after a few day's. They go on top of the bed sheet, which underneath has a matress protector. On top of the plastic sheet goes a towel, for comfort. And, keep the washing machine at the ready
Ron has a sheath, which work's great,"if not pulled off".
And during the day a leg sheath, which does work.
The number two's, well, that is somthing I will have to sort out this week. need pant's, but they are £8 to £10 per pack of eight. Not available on the NHS.

Barb X

 

[citybythesea]

Roland, I cared for my mother for several years and the last 8 months were sort of as you describe. Take the nurses advice. The pads she referred to make it much easier on the whole with changing. Personally I invested in some absorbant cotton pads that had a waterproof backing that I could throw in the washing machine with bleach. When changing the elderly you are at a disdvantage as you have to roll them, if the pads are used then you undo the strips on the "diaper". A fresh pad is rolled and the "diapper" is rolled into it so that when you roll the patient you can roll the messy one up and push it up as far underneath your patient as possible. The new pad and diaper is rolled out until it "bumps" up to the old one. The patient is then rolled back and the old pad is basically on the side and the new one is next to it and just needs to be unrolled the rest of the way.

Part of the reasonning behind changing out everything is that it keeps your sheets and the patient fresher. Sometimes they sweat and this causes extra bacteria to grow near the skin. Barb is right on keeping the area clean an "aired" out. Diaper rash creams that are made to keep moisture away from a babys skin work really well. Another thing I would recommend is an air mattress. This is a p;astic mattress that has honeycomb chambers in it with a little air pump attached. The pump rotates the ares that the air is in thus helping if you cannot roll a patient as needed.

Whether your mother were in her 30's - 60's or near 100 a nursing home would "move" her around in her bed to prevent bed sores. The best way I can describe why is like...say you park a car..the tires are soft, but the car is heavy, if it sits for a long time the tire literally becomes flat...then you have to work that flat spot out. With a person that is bedbound they don't have the circulation that a mobile person has and sometimes the xtra pressure is just enough to cause problems. Mosst of the time these problems are first noticed on the heel and on the buttocks. That is because the most pressure from the body to the bed are there.

I'm sorry if I gave more information and I'm sorry if I went to deep into this subject. Hope I was able to help you just a little.


HUGS

Nancy

 

[Roland]

Thanks a lot. I will read all you've said again carefully. I feel I've been given advice based on lots of cumulative experience. I will see if there's an incontinence nurse.

gratefully, Roland

 

[Skye]

Hi Roland

My husband John is in a NH, and is doubly incontinent. They use both pads and kylie sheets, as I did when he was at home. I imagine it would be very messy not to use pads.

They turn him and change his pad every three hours during the night -- something I couldn't have done at home, though I did have tremendous problems with over-production of urine at night.

So long as you are keeping Chris clean and dry, and she has no sores, I'd carry on as you are. Time to change when problems begin to arise. Though I would recommend buying some kylie sheets, they do save changing the whole bed every time there is an accident.

Jennifer, in our area it's 'continence adviser' -- sounds more positive. A lot of areas do use 'incontinence' -- I don't think it makes any difference, they all do the same job.

 

[citybythesea]

Roland, I'm not trying to be mean here, but another reason to think about changing now is tp revent the problems of bed sores. Bed sores are not easily treated for a person that is immobile, it takes time and patience and a lot of care on the part of the caretaker. When a bed sore arises the problem is there and the work begins. If you read throgh several posts that are longstanding and older posts you will find that once a patient has a bed sore it is really hard to get rid of. Preventative medicine here is for the best for you and Chris......I think to that maybe to talk with your friend she will be able to enlighten you as to why some of the practices are done.


HUGS

Nancy