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Discussion

Frustrated, any tips?

I have a client that is bed bound and wears depends, and we put in bladder control pads as well in the depend. Then we have a chuxs under them to protect their bed. Well they have always been able to lift their hips for me to slide the depend under them, and then lift again to get the pads in the depend, and then once more to put the chux under them. Well they have for the last month or so not been raising their hips for me, and it is getting very discouraging for me to be able to do my job. It is not that they are unable to do it physically, but it is more of an unwillingness to it. Being stuborn and maybe getting a little bit more confused. I have tried to roll them to their sideand put the depend under them, but they are really heavy and they do not try to help me roll them. It is literally rolling dead weight and many times they come back on me and does not stay on their side. Also it is hard for me to put it exactly where it needs to be the first time. and if I try to pull or tug a little to change its position it rips on me, and then I can start all over again!! the pads are almost impossible to have it exactly the way it needs to be without them simply lifting their hips for me to put it under them. There is no hoyer lift or anything for me to use either. Anyone have any suggestions what I can do to be able to do my job easier for the both of us?

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    If your residents are not helping you then I would recommend getting tabbed briefs for them. Briefs are a thousand times easier to put on them then depends.

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    • Author

    Opps sometimes I say the wrong thing. When I said depends I was talking about the tabed briefs. they do not wear the ones that are like underwear. More like the adult diapers.

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    You can't roll/push them to their side, then put the brief under them then do the other side.I'm still doing clinical but that's what we do. Use the draw sheet to pull them to one side if they can't do it themselves.

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    • Author
    You can't roll/push them to their side, then put the brief under them then do the other side.I'm still doing clinical but that's what we do. Use the draw sheet to pull them to one side if they can't do it themselves.

    Thank you. When you say put the brief under them, and then the other side are they on their side, or laying flat on the bed. My problem with them laying flat on the bed is it just bunches up, and it won't go up on the hips like it is suppose to. Also for a draw sheet they have a silky like bed sheet that they are using. It is the only way the family care taker can pull them up when they have too. Traditional draw sheets do not work for them. They don't have enough strength to move them with it. So it bunches up under them and then the brief gets stuck and bunched up. It was so much easier when they would just lift up their hips because I could get the brief on top of the draw sheet without it causing too much trouble.

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    Okay try this: get your residents brief ready and other pads as needed. Roll the resident either away from you(if they had a bm)or to you if just urine.after Peri care of buttom. Take the brief and pads and tuck them as far under resident as possible. Then turn resident the opposite direction and pull the brief and pads to that side. If done correctly you should have the pad and brief on correctly. Fasten tabs and that should be it.

    I guess I have a concern that they are using slick sheets in the patients bed. I would be really concerned about them slipping out of bed onto the floor.

    I wish you all the best.

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    It's so difficult to do this by yourself when the client cannot support their own weight. Just a couple of ideas that might help.

    First I'd try to figure out an arrangement that doesn't require them to lift their hips 3 times, for example having the Depend and the Chux in one step while they are turned on their side as you do when changing an occupied bed and adding the bladder pads after she is rolled on her back again, then tape up the briefs. I know one lady who cuts the Chux into quarters, then folds and wedges it under from the front to soak up urine, replacing bladder pads.

    If she can hold onto the side rail and bend the knee on the uppermost leg you may be able to solve the problem of her rolling back on you before you are finished. If you have your briefs and Chux rolled well and wedged in as far as you can when she is turned on the opposite side you can grab and pull that layer pretty easily and avoid tearing the brief or underpad. You could put two layers of Chux and just remove the top one if they get wet.

    Just some ideas! Best wishes and avoid the temptation to put your future at risk by injuring your back just to get the job done.

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    • Author

    Thanks everybody. Yes it can be very hard to work with a client by yourself. I will be trying your ideas and hope it will go smoother for me.

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    • Author

    Just wanted to update you all, and thank you for all the advise. I did the things you told me to do, and I think it worked out tonight for the most part. It was still very difficult, and I did have to do the chux that was under them over again because I put it too high the first time. But over all I think with a little bit more time and patience and practice i think that it will work. Not at all as easy and much more time consuming then just having them be able to lift their hips. But at least i pray I got everything where it is suppose to be. Praying they don't leak tonight because that does happen if you don't get everything on just right. (sigh)

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