Many home carers struggle with changing a nappy / diaper, or cleaning someone who is unable to get out of bed alone. This is also a good method for someone who is able to move around, but struggles with cleaning themselves, or finds toilets/showers a challenge. The same methods and techniques can be used for bedbathing. When doing this alone, using a sheet to help return the person to you at the end is sensible.
These methods are always easier with two people so there is one to roll, and one to do the changing/cleaning.
The supplies I use to keep the bed clean and also protect are slightly different from the video below, and are the following:
- Disposable Gloves
- Barrier Cream or Vaseline
- Nappy/Diaper
- Disposable Bed Pad
- Baby Wipes
- Senset Cleansing Foam or No Rinse Wash Cream
- Nappy Bags (Tesco Yellow Ones are the best I’ve found for the price in the UK)
- Optional Turning Sheet
The process is based around the idea of the recovery position. By cleaning this way for someone who is incontinent and especially bowel incontinent, the contents of the nappy are held in place at removal, instead of over legs, hands, back and more, as they try to remove it themselves, or you try to remove it from them. When wearing Depends type pull ups, they rip easily down the side for easier removal, rather than trying to get them down the legs to get them off.
How I do it, is to:
- Put on gloves. Undo side fastenings or rip the sides of pullups. Take the centre piece and roll it inwards then tuck between and under the legs.
- Push the side of the nappy as far under the body as you can on the side you intent to roll over onto and clean as much as you can.
- Roll the patient into the recovery position and remove the used nappy.
- Clean up the patient while on their side, and apply any barrier cream, ointment or vaseline. To clean, use baby wipes, or a mixture of baby wipes and a bowl of hot water to dip them into, so that it isn’t too much of a cold shock for your patient. For any stubborn residue, add senset foam or no rinse wash clean to a warmed wipe to lay on the skin, and leave for a few seconds to soften the residue, enabling a quick wipe to clean it off.
- Roll up the existing disposable bedsheet to under the hips, and insert a new one.
- Change gloves. Apply the nappy to the patient, checking for distance at the hips. If you are not putting on trousers at this point, pull the t-shirt down smooth over the top of the nappy at the back.
- Roll the patient back towards you, which should have them lying on their back. Clean any bits you have missed and apply creams. You will then be able to pull through the new nappy at the front.
- Roll your patient onto the other side, remove the old disposable bed sheet and flatten out the new one. Check the body for any missed areas for cleaning, and pull through the other side of the nappy. If not putting on trousers, pull the other side of the t-shirt down smooth over the top of the nappy to ensure no creases.
- Fasten the nappy at both sides, then use the rolling system to re-dress the patient. Remember to make sure the trousers are fully up and both sides, and any t-shirt and jumper are smoothed out at the back. Failing to smooth out creases can quickly begin bedsores in a patient who spends a lot of time in bed.
This video is a little different, but it gives you the idea of how it is done.
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