Nursing Homes and Diapers

What to Ask Nursing Homes About Diapers


Last updated: April 07, 2008
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Adult diapers hardly seem like a hot media topic. But they’ve been just this in Canada lately, thanks to the Ontario Health Minister saying he’ll wear a diaper to judge their comfort. This in response to claims that the Canadian government doesn’t spend enough money on staffing in state-run nursing homes, leaving residents in soiled diapers. (In spite of his threat, George Smitherman, the health minister, apologetically backed down from his diaper test drive, as reported by lots of news sources, including the Toronto Star.)

Check out blogger Rositta’s (a self-described cynical "middle-aged broad") take on the issue.

Wherever your parents happen to live, if they're in a nursing home, staffing is critical, especially when it comes down to how best to care for our elders in diapers. Talk about being vulnerable. They are -- especially when we can't check on them as often as we'd like.

Being a strong advocate can help. Here are some tips:

  • Ask your parents’ nursing staff how often they change diapers. Some do this on a regular schedule, regardless of use. Others change as needed. Ask to see charts documenting changes.
  • Talk to your parents about their diaper comfort. Not an easy topic, I know, but they may be relieved to confide in someone. Are they feeling OK, or can something be done differently.
  • Check your parents’ bodies for rashes or redness in the private areas. If you see anything unusual, immediately tell and show the nursing staff.
  • Talk to staff about any concerns. Thenwork with them on changes.

If you aren’t feeling reassured, consult with your parents’ long-term care ombudsman, a federally funded service that helps nursing home residents address care concerns. To find your parents’ ombudsman, use this handy state-by-state tool from the National Citizen’s Coalition for Nursing Home Reform.

Image by Flickr user jcortel under the Creative Commons attribution license.

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9 Comments So Far. Add Your Wisdom.

over 5 years ago

Great article. My parents are in a nursing home and these steps are great advice www.ionmeds.com


over 6 years ago

These comments are super helpful, Rudee. Simple, practical hints that can make the diapering business easier for the caregiver, and safer and more comfortable for the person needing care. Lucky Detroit patients if they're under you care.


Anonymous said over 6 years ago

Hi Kate and thanks for your post on my blog. I do have some practical advice from a mom perspective. I have a profoundly impaired autistic daughter who is not continent. Keeping my house from smelling like a nursing home is a goal! Rachel gets a shower each and every day. Sponge bathing is not an option. We just do it. It takes about 30 minutes but is the highlight of her day. I keep a mattress pad on the mattress but cover that with a waterproof sheet. I then cover that with a top sheet which is the only thing that must be laundered daily. Before I figured this trick out, I had to wash the sheet AND mattress pad. They also have waterproof mattress covers that zip. I use one of these as a duvet cover for the down comforter she needs in the winter. That is a pain as it has to be cleaned at a laundromat. I wipe down the waterproof sheet daily by hand and replace it a few times a year. This routine saves the mattress--once that gets soaked, you've lost the battle. Use a barrier cream like Critic-Aid Paste (available without a script and on line). It takes only a thin layer applied to the bum and is effective in "preventing" breakdown. Or make your own paste: equal parts Vitamin A & D ointment mixed with zinc oxide diaper cream. This concoction provides a barrier but is easier to clean off than just plain old desitin cream. Recognize yeast skin infections. Red. Looks like "prickly heat". Is your charge a diabetic? Overweight? Smells AFTER a bath or shower? It may be yeast. Look under breasts, abdominal folds. If so, go to the foot care aisle of the drug store and buy some athletes foot powder (I like Desinex). Clean and dry the skin. Sprinkle the powder on areas of concern. Wash and dry skin before reapplying. Yeast loves warm and moist environments and needs antifungals to dry. I think that covers it! Rudee www.nursingpurls.blogspot.com


over 6 years ago

Your experience as a nurse gives you valuable perspective Rudee -- thanks for sharing. Have any related advice for people caring for their incontinent parents at home? (Thanks for the address to your blog. Your post on heparin was super thought-provoking.)


Anonymous said over 6 years ago

In my practice, I don't put a diaper on my very sick patients. It delays identification of a need and leads to skin breakdown. I don't want patients lying in soil for prolonged periods. Also, diapers seem to smoosh bowel content up into the genitals which can only lead to bad infections. On patients who are less ill, I think diapers are a bit demoralizing. As a mother of an 18 year old incontinent daughter, I use a pull-up type diaper that is more like panties. I toilet her religiously so she doesn't walk around in soiled diapers. She has NEVER has a urinary tract infection and never had skin breakdown. She isn't toilet trained, I am, but she is better for my effort. My last tip is to use a barrier cream like Critic-Aid Paste made by coloplast. I apply a thin layer to almost all my patients bottoms. It works to prevent breakdown. Perhaps in time, George Smitherman will learn what it's really like out there. The hard way. Rudee www.nursingpurls.blogspot.com


Anonymous said over 6 years ago

It is not just nursing homes that are the problem. As soon as an elderly person with some mobility issue, ie a walker, gets admitted to hospital they are automatically put in diapers. It's easier for the staff than it is to toilet them. It's not just diapers going to landfill that is the problem, an elderly person with some health issues can die from a simple thing like a bladder infection that can turn into septic shock and death. Just ask me, I know all about it. http://theviewfromher.blogspot.com


over 6 years ago

It's so great for this topic to generate helpful hints from people on both sides of the nursing home experience, patients and caregivers. Kay, your fax idea, and making friends with cleaning staff (another set of eyes on your mom). And the suggestion for bowel/bladder training -- I'll have to learn more about this. I also see a blog topic on "green" less toxic diapers. I know they're out there. Thanks for the ideas.


Anonymous said over 6 years ago

I have worked in long term care facility's for over 20 years, the best ones don't use diapers routinely but put residents on a tolieting schedule, yes I have worked short staffed more often than I have worked fully staffed, but it can still be done . Also all of these diapers are ending up in our landfills which is disaster for the environment. Ask occupational therapist for help in a bladder/bowel training program for these facilities. The money will be well spent


over 6 years ago

Two things helped me through the time my Mom spent in an Assisted Living Center. The first was a fax with the facts. Each time something good, or bad, happened, I sent a fax to the administrator. Without saying so, she knew we both had a copy. The second one is I befriended the cleaning lady, who had a special connection with my Mom. She couldn't accept gifts, but she could give me her home address. I sent gift cards periodically (ie WalMart). Many times she called me to give me a heads up about my Mom. These two steps were tremendous help during a long, four-year journey.


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