Helping someone you're caring for with toileting in bed

Always wear disposable gloves when assisting with toileting. This prevents the spread of disease. Wash your hands before and after providing care.

When a person is mobile, toileting in bed should not be encouraged.

Toileting in bed for a woman or for bowel movements

Step 1

• Warm the bedpan with warm water. Empty the water into the toilet.
• Powder the bedpan with talcum powder to keep the skin from sticking to it.
• Place a tissue or water in the pan to make cleaning easier. Or use a light spray of vegetable oil in the bedpan, which will make it easier to empty the contents.
• Raise the person's gown.

Step 2

• Ask the person to raise her hips

Step 3

• If the person cannot raise her hips, turn her on her side and roll the hips back onto the bedpan.

Step 4

• If the person cannot do so, clean the anal area with bathroom tissue. Then use a wet tissue to further clean the area.
• After the woman has urinated, pour a cup of warm water over her genitals and pat the area dry with a towel.
• Wash the person's hands.
• Remove and empty the bedpan.
• Be sure to wash your hands.

Assisting someone with toileting in the bathroom or on a portable commode

Using a urinal

1. If the person can't do so himself, place the penis into the urinal as far as possible and hold it in.
2. When the person signals he is finished, remove and empty the urinal.
3. Wash his hands.
4. Wash your own hands.

Using a commode

A portable commode is helpful for a person with limited mobility. The portable commode (with the pail removed) can be used over the toilet seat and as a shower seat.

Using a portable commode

1. Gather the portable commode, toilet tissue, a basin, a cup of water, a washcloth or paper towel, soap, and a towel.
2. Wash your hands.
3. Help the person onto the commode.
4. Offer toilet tissue when the person is finished.
5. Pour a cup of warm water on female genitalia.
6. Pat the area dry with a paper towel.
7. Offer a washcloth so the person can wash his or her hands.
8. Remove the pail from under the seat, empty it, rinse it with clear water, and empty the water into the toilet.
9. Wash your hands.

TIP: TOILET SAFETY. Use Velcro with tape on the back and attach it to the back of the toilet or commode seat to keep the lid from falling.

Using the bathroom toilet

If the mobile person is missing the toilet, get a toilet seat in a color that is different from the floor color. This may help him see the toilet better. If he is failing to cleanse the anal area or failing to wash his hands, tactfully encourage him to do so. This will help prevent the spread of infections.

Caring for someone with a catheter

Incontinence

Incontinence is the leakage of urine or a bowel movement over which the person has no control. In addition to bladder management medications, treatments can include bladder training, exercises to strengthen the pelvic floor (Kegel exercises), biofeedback, surgery, electrical muscle stimulator, urinary catheter, prosthetic devices, or external collection devices. Talk to the doctor about the options or treatments for the person in your care.

If the doctor says he needs a urinary catheter, it's a device made from rubber or plastic that drains urine from the body. It is inserted by a nurse through the urethra (a tube that connects the bladder to the outside of the body) into the bladder (an organ that collects urine).

A Foley catheter stays in the bladder and drains into a bag that is attached to a person's leg, the bed, or a chair. When caring for someone with this kind of catheter (called an indwelling catheter), watch for these things:

1. Be sure the tube stays straight and drains properly. Check for kinks in the tubing.
2. Be sure the level of urine in the bag increases.
3. Be sure the drainage bag is always lower than the bladder.
4. Use tape or straps when securing a catheter to someone's inner thigh.
5. Be aware that in males, an erection is a common effect when a catheter is inserted.
6. Tell the doctor if blood or sediment (matter that settles to the bottom) appears in the tubing or bag.

NOTE: A Foley catheter greatly increases the risk of infection. It is a last resort to manage incontinence (leaking of urine or inability to control bowel movements).

Cleaning around the site of the catheter

1. Wash your hands.
2. Put on disposable gloves.
3. Position the person on his or her back.
4. Take care not to pull on the catheter.
5. While holding the catheter, wash the area around it with a washcloth.
6. To avoid infection, wipe toward the anus, not back and forth.

NOTE: To prevent foul odors due to the growth of bacteria in the urine drainage bag, put a few drops of hydrogen peroxide in the bag when it is emptied.

Changing a catheter from straight drainage to leg bag

1. Gather supplies: disposable gloves, a bed protector, alcohol wipes, and a leg bag with straps.
2. Uncover the end of the catheter and draining tubing; put a towel or other bed protector under this area.
3. Disconnect the drainage tubing from the catheter.
4. Wipe the attachment tube of the leg bag with an alcohol swab and insert it into the catheter.
5. Place the cap attached to the urinary drainage bag over the end of the tubing to keep it clean and prevent urine from leaking out.
6. Secure the tubing to the person's leg.

Condom catheter

The doctor may prescribe a condom catheter for a male if infections from the indwelling catheter become a chronic problem. The catheter fits over the penis like a condom. Leakage is often a problem with this type of aid. It is extremely important that a condom catheter not be secured too tightly, which can result in serious injury. Other products for male incontinence are available that are less constricting, such as Bio Derm's Liberty Pouch, which uses “skin friendly” adhesive.