Toileting Bariatric Patients

[Toileting Help]

What are some of your challenges when toileting bariatric (obese) patients?

[pielęgniarka, RN]

Good hygiene, in all those those nooks and crannies.

[BackfromRetirement]

The transfer from bed to w/c or toilet chair. Chairs are not wide enough, the bathroom is not big enough.

[Not_A_Hat_Person, RN]

Transferring from bed to commode, especially if a Hoyer lift is involved.

[rnewell]

encourage clients to help himself as possible.

[mamamerlee, LPN]

How did the pt manage prior to hospitalization? !!!!

[caliotter3]

It can get dicey when the patient is capable of helping to clean themselves or reposition, but refuses to do so.

[pers]

Like mamamerlee, I want to know what they were doing at home prior to being in the hospital. Their needs may be different in the hospital environment but it gives me a baseline of what I can expect or at least a goal for where they should be prior to discharge.

[iriska_meller]

The most recent... A very obese man, and he needed a urinal, but could not reach the area himself (abdomen in the way...). In addition, he either had a "peekaboo" member or it was hiding somewhere in the layers of fat. So I lift the gown and look... and I see nothing. Nothing that tells me where I should aim. Being that the guy is totally alert, I can't just start poking around looking for it... I almost asked "where is it" but bit my tongue soon enough. I was SO embarrassed.

[BackfromRetirement]

For some reason, obese men tend to retract their member up into their abdomens. Obtaining a U/A by cath is difficult ro say the least. I have a patient who is unable to use the urinal because he cannot reach that far. We pad him very well to save him the embarrassment of using geri-briefs.

[casi, ASN, RN]

One of the biggest difficulties I've found is innapropriate equiptment. You can't put a 400lb person on a comode that is only 3ft wide. They just aren't comfortable.

Our hospital also has special bariatric rooms where the toilets are mounted to the floor rather than the walls. I guess there have been issues with wall mounted toilets not staying mounted.

[guest2210]

Having been a bariatric patient, I can tell you-post op, things are different then when I was at home before surgery. I had an open RNY which made movement post op very difficult when it came to using the bathroom. I used flushable wipes which helped alot. Some patients have told me they used various tools-like a backscratcher, wooden spoon handles, anything they could find to help them out once they got home.