Technology

Family caregiver – Part 7 – Toileting the wheelchair patient at home

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My husband uses a catheter only on road trips, not at home. It is usually mainland generally. I keep a listening ear to your call and look forward to taking you wherever you need to be to answer the call of nature.

* A bedside urinal is kept on your nightstand for overnight use. Sometimes he feels safe enough to use the urinal himself without waking me up. It’s fine when it works. Lately he uses the urinal, puts it back on his nightstand without my help, and then a couple hours later tries to use it again when there is still urine from the previous use. You can guess what happens… I started placing reusable bed protectors on the floor against the bed and hung over the side of the bed to catch accidental spills. You can never have too many bed pads.

* I have considered using an external catheter at bedtime. I know of one family where the husband does use a Texas catheter at night. Apparently, that man is not as restless as my husband. I’m afraid the way my husband is tossing and turning as part of Parkinson’s disease, he would be wrapped up in the tube and the collection bag would be useless. So the urinal is our only option for now. And a pair of reusable bed protectors on the bed. You may have luck with the catheter, or with the absorbent underwear. My husband will not wear the underwear at all.

* There is a urinal in the bathroom for when you can’t stand on the toilet. One in the basement for when you’re working in the shop, one near the kitchen table for sudden urges that don’t make it to the bathroom. A urinal stows in the basket of your scooter, stored indoors in a discreet cloth bag. With a box of packaged tissues next to it.

* Pop-up facial tissue boxes are everywhere for use with the urinal or to wipe your nose.

*A box of disposable latex gloves is kept in the bathroom for use as needed.

* Adapting clothing helps to dress and groom. Try to have the male patient wear pants that are loose around the waist and hips and have a long zipper. Try to remove underwear. I changed the zipper on his pants to be longer, extending to the crotch seam. Zippers can be added to the legs to go over leg braces. Zippers can open a tight neckline. Velcro can be used instead of zippers. A seamstress can fix/adapt clothing to make it easier to get dressed and function. My experience is with a male patient. I can’t imagine how a woman comfortably copes with incontinence.

* To protect the wheelchair seat from wetting accidents, small absorbent pads, such as a miniature bed pad, can be used. Short of the special pads, a layer of folded hand towels will help.

* A reusable waterproof bed pad and bed pad with handles can be useful for protecting bedding from wetting accidents and for moving the patient around the bed. If the bed pad has handles, it is easier to grasp the handles than to grasp a fist full of cloth to reposition the patient. A bed pad with handles can also be used to protect a recliner and help position the patient.

* If using a bed guard to reposition the patient, to lift them towards the head of the bed, remember that when you raise the bed guard, the bedding is now exposed without protection. You will want to have a second absorbent pad under the pad that will be used to change position so that when it is pulled toward the head of the bed, there is still protection under the patient. I use a total of 5 bed protectors in various positions on the bed, including the one with handles. Plus the one I left on the ground.

*My husband uses a men’s split front toilet seat. He helps position him so he can use the bathroom properly. When he sits for an extended period of time, I place a pillow or two behind him, since this type of seat does not have a lid to lean back on. I make sure the pillows are “old” in case they get dirty or fall down the toilet.

* There are grab bars around the perimeter of the bathroom. When I roll her wheelchair to the bathroom, she can grab the bars along the wall to help herself up and onto the toilet. I stand behind him and help him up by holding him under his arms until he stands up, or as close as he can get. Then I step to the side and push the wheelchair out of the bathroom so that it is behind me and then, getting into position behind him again, I can help him up to the bathroom or stand up if he’s willing to try. On days when he’s not as strong, he’ll use the urinal sitting in the wheelchair, or I’ll use the seatbelt to transfer him to the bathroom.

* Sturdy grab bars were installed on each side of the toilet for him to hold onto when standing on the toilet or getting off and off the toilet. They work very well. We had them professionally installed during some other modification job. They are almost 2″ in diameter, stick out of the wall on either side of the toilet, and slide out of the way when not needed. VERY helpful when I have to climb around him to get into the bathroom, as for his morning wash. I carry him first in the wheelchair and then I have to move to face him. I have to get between the sink and his wheelchair. To do this, the grab bars need to be up to allow room for me to once I pass ahead of the wheelchair, if he decides to use the bathroom, I do the best I can to the side and lower the bars.My husband says our bathroom is the size of a postage stamp.It’s a little bigger than that, but not much: 6 ft x 8 ft. We also widened the bathroom door frame, so his wheelchair could fit through the opening.

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