Someday, due to an injury or declining health, you or a loved one may be unable to get out of bed and use the bathroom. It seems an unlikely scenario – but happens all the time in the real world. At that time the patient has 3 choices when needing to use the bathroom for a bowel movement or urination.
Soil the bed. This is not acceptable and makes life for your caregiver and family members unpleasant, to say the least. It is also very unsanitary and can lead to serious infections etc.
Option 2 is to start using incontinence briefs or pull-ups. Properly used this option is quite easy, keeps everything clean and takes little time for your caregivers to replace throughout the day or night – once they gained the experience needed. They can be found anywhere elder care products are sold. Their only drawback is they can be expensive for folks who have limited resources.
Opt 3. Is to use a bedpan whenever possible, as the care recipient “needs” dictate and use the convenient incontinence products mentioned above during hours of sleep or travel.
In Book 2 of my caregiving series, I delve into this subject in more detail. For this simple blog post, I’ll try to cover the basics of bedpans and their usage in a short amount of time.
Bedpans are sometimes the ideal solution for the immobilized patient that is confined to bed and come in a wide array of colors, sizes, and shapes and are designed to be durable and easy to clean. Most feature a plastic guard to prevent spills and have a tapered end for easier positioning and some are designed with a handle for easier placement and removal.
About 60% of bed pans look like an undersized toilet seat and function just about the same way- so these are easy to figure out. The big or widest end goes under the buttocks and the narrow end goes forward or where the urine is expelled.
Another 40% are much smaller in size and looking at their side profile take the form of a wedge and are called (fracture pans) with an easy to use handle for carrying after they have completed their duty. The handle side is carried elevated and the reservoir end holds the contents. Often the contents are more than the size of the reservoir so you must carry it tilted to avoid spillages.
Both types function acceptably, however, some patients prefer one or the other mainly due to personal preferences.
On these smaller units, the thin side or wedge side is inserted under the buttocks and the wide deeper end is positioned for urine outflow.
How to use a bedpan
First set-up your supplies, normally a couple of washcloths, (I always have a few extras nearby just in case) 2 towels, 2-3 plastic bags, a basin of warm water and a supply of disposable gloves positioned nearby, then wash your hands and don a pair of disposable gloves.
After making sure the patient has adequate privacy, (close the windows and door) have the patient lift themselves upwards if they can, or roll over onto their side if they can’t, and help them lower their disposable underpants.
Now insert the bedpan (deeply) with the correct end to the rear, so the waste matter will be contained in the bedpan and then have them roll back over and open their legs so you can confirm they are centrally positioned on it, then if possible raise the head of the bed so they are in a semi-sitting position.
They don’t need to sit straight up (45-60 degrees is best) but being on an incline (sometimes called being in the standard Fowlers’ position) promotes emptying one’s bladder and feces. Lastly, cover them with the sheet for privacy.
Tip. Sometimes with an enormous patient, I may layout a disposable incontinent pad (or heavy towel) first and put the bedpan on it, in case of overruns, to save time changing out bedding after an extra big discharge. Becoming familiar with your care recipient will help decide if something like that may contribute toward keeping things clean.
Also with the large or obese person you may need to hold their legs open (with a rolled up towel) so there a gap, for urine to escape down into the bedpan, otherwise the urine can become trapped between their legs and travel downwards, and you will end up with an dry bedpan and a urine soaked bed at their feet.
Now remove your gloves and dispose of them properly and wash your hands thoroughly and step out to permit the patient privacy unless it’s unsafe due to weakness or another reason.
After the job is completed (they have called, signaled or enough time has elapsed), wash your hands and again don gloves and have them lift up, or turn onto their side again (supporting the bedpan so it doesn’t roll over likewise) and carefully remove the bedpan being vigilant not to spill the contents.
Put a towel or plastic bag over the bedpan and lay it in the bathroom or on a flat surface if you can’t get to the bathroom quickly, and never down near them or on their tableside table or nightstand.
Cleaning or “perineal care” – overview
Thoroughly soap, wash and rinse with warm water, using the washcloths separately, the patients (male or female) genital area first and afterward the buttocks.
Always wipe (front to back) so you’re careful not to introduce any fecal matter from the rectum to the urethra, and ensure they are clean and dry when finished to prevent infection and eliminate embarrassing odors.
While wiping turn the cloth so each swipe is using a clean area of the cloth. Be gentle as this area of the body is sensitive. Finally, thoroughly dry the area to avoid any chapping developing or bed sores.
Always check for signs of infection, like swelling, sores, lesions, rashes, and boils, and if observed report them to your nurse.
When finished cleaning — pull up the underwear, or position and firmly tape the briefs closed (not hanging loosely), and direct them to roll back to a comfortable sleeping position then offer a damp cloth (or the basin of warm water) to allow the patient to wash his/her hands and use a drying towel, so they are able to sanitize their hands if the patient so desires.
Lastly cautiously take the soiled washcloths/ towels and bag them for laundry (to reduce odors) and take the filled bedpan, and empty it slowly down the toilet, flushing at the same time and then clean the bedpan according to your procedure. Then you may remove the gloves and wash your hands.
Some key points of perineal care
Try to perform it regularly as part of their daily cleaning and bathing schedule, especially after using the bedpan or toilet or an incontinence episode.
Whenever in bed keep the patient’s body covered as much as possible during the procedure to help provide a sense of warmth, dignity and avoid unnecessary exposure.
Your first couple tries of providing “peri care” may prove to be intimidating, however, it’s a very important part of the overall care plan for obvious reasons and to avoid odors.
It’s important the first couple of times to obtain a coach (for training purposes) like another experienced caregiver, nurse, or your healthcare provider.
Be sure to congratulate yourself on a job well done.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
Again I break this procedure down more thoroughly in Book 2. 🙂
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