Ashwin Lewis
Changing an elderly person's diaper while they are sleeping can be a daunting task, but it is important for maintaining their skin health and hygiene. It is crucial to ensure that the process is done with sensitivity and respect for the individual's comfort and dignity. Here are some steps to guide you through the process: Firstly, gather all the necessary supplies, such as a clean diaper, bed pad, gloves, wipes, and barrier cream, and keep them within arm's reach. Ensure privacy by closing doors, curtains, and blinds. Wash your hands thoroughly and put on gloves to maintain hygiene. Communicate with the person and explain that you will be changing their diaper. Remove any obstacles around the bed to ensure a safe space. Unfasten the tabs of the soiled diaper and tuck it under their hip, then roll them onto their side to remove it. Clean the diaper area thoroughly and check for bedsores. Let the skin dry before applying protection cream and positioning the new diaper, securing it with the tabs. Finally, wash your hands again and ensure the individual is comfortably positioned in bed.
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What You'll Learn
Prepare the bed and patient
Before you begin, ensure you have all the necessary supplies within arm's reach. This includes items like wipes, fresh diapers, plastic bags, and skin cream. It is also recommended to have a hospital bed, as it can make the process easier and more comfortable for both the caregiver and the patient.
If the patient is awake, communicate with them in a tactful and respectful manner. Let them know that you are there to change their diaper and clean them up. If they are able to assist, ask them to spread their legs to make room for the diaper change. If the patient is asleep or unable to move, gently roll them onto their side, supporting their hip and shoulder. Ensure their clothing is not in the way, and remove any items that might hinder the process.
The caregiver should maintain a calm and positive attitude throughout the process, ensuring the patient's comfort and privacy. It is important to work efficiently to avoid causing embarrassment to the patient. If you feel uncomfortable or inexperienced with the task, consider seeking guidance from a healthcare professional or hiring a homecare nurse.
While changing the diaper, be mindful of the patient's skin. Keep the area clean, dry, and rash-free to prevent skin issues like bedsores or tissue breakdown. If the patient is at risk of skin ulcers or has existing sores, be especially gentle and treat them appropriately.
By following these steps, you can ensure the bed and patient are prepared for the diaper change, making the process smoother and more dignified for everyone involved.
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Remove soiled diaper
Before removing a soiled diaper, it is important to communicate with the person you are caring for. Explain that you are going to change their diaper, and try to do so in a tactful and respectful way. If the person is wearing clothing that might get in the way, it is a good idea to remove it.
To remove the soiled diaper, first unfasten the tabs. If the person is lying down, roll them gently onto their side, away from you, with one hand on their hip and the other on their shoulder. If they cannot roll onto their side, you may need to bend their legs at the knee and cross one ankle over the other, with the right leg over the left if they are turning to the left, for example. You can also place a menstrual pad underneath them to lift their buttocks off the bed.
Tuck the side of the diaper farthest from you under their hip, and pull the diaper out from under them. Roll the soiled diaper inward as you remove it to contain any mess. Place the soiled diaper into a plastic bag and seal it.
Now, use moistened wipes to thoroughly clean the diaper area, both front and back. Avoid pressing or rubbing the skin too hard. You may need to roll the person onto their back or side to clean hard-to-reach areas. Place the used wipes in the bag.
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Clean the patient
Before you begin, ensure you have all the supplies you need within reach. These include moistened wipes, a plastic bag, barrier cream, disposable gloves, and a fresh diaper. If you are using a bed protection pad, have that ready too.
First, roll the patient onto their side. If they are unable to do this themselves, place one hand on their hip and the other on their shoulder, and gently roll them away from you. If the patient is wearing clothing that may get in the way, remove it.
Next, use moistened wipes to thoroughly clean the diaper area, both the front and the back. Avoid pressing or rubbing the skin too hard. You may need to roll the patient onto their back or side to clean the areas you cannot reach. Place the used wipes in the plastic bag.
Let the skin dry before proceeding. If the patient has been wearing the soiled diaper for a long time, check for bedsores and treat them appropriately.
If you are using a bed protection pad, place the patient on their side and fold the pad in half. Place one half near the patient's back and straighten the other half onto the sheet.
Finally, apply barrier cream to the buttocks.
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Dry and moisturize the skin
Diaper rash is a common issue for babies, but it can also affect adults who wear diapers. To prevent and treat diaper rash, it is important to keep the skin clean and dry.
After removing the soiled diaper, use moistened wipes to thoroughly clean the diaper area, both the front and the back. Avoid pressing or rubbing the skin too hard. If the skin is very raw, you can soak it for 10 minutes in a mixture of warm water and 2 tablespoons of baking soda. Then, gently pat the skin dry with a soft cloth. Do not rub, as this can irritate the skin.
Allowing the skin to air dry is also beneficial. If using a towel, make sure it is clean and dry. Avoid using talcum powder, as this can be harmful if inhaled.
Once the skin is dry, you can apply a protective cream or ointment to the buttocks. Diaper rash creams form a barrier on the skin, repelling moisture and protecting against irritation. Look for products containing zinc oxide, which can aid in treating and preventing diaper rash. Apply a thick layer of the product to the entire diaper area.
After applying the protective cream, you can position the new diaper, ensuring it is not too tight. Friction can make diaper rash worse.
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Put on a new diaper
Putting on a new diaper correctly is important for keeping the skin clean and free from infection and perianal/perineal dermatitis (a.k.a. diaper rash). It also helps to minimise abrasion that contributes to the onset of difficult-to-treat sores.
Firstly, ensure the person's clothing will not get in the way of the diaper change. If necessary, remove the clothing completely. Wash your hands carefully with medicated soap, and consider using rubber gloves to avoid accidentally touching urine or faeces.
Open a fresh diaper and tuck the side farthest from you under the hip. Flatten and position the rest of the diaper on the bed, smoothing the sheets underneath. Roll the person back toward you onto the diaper, then pull the diaper between their legs, removing any wrinkles. For a snug fit, stick the top tabs facing downward and the bottom tabs facing upward.
Before leaving, check that the person is properly positioned in bed. Move them regularly so that pressure is not placed on the hips or other parts of the body for too long. Keeping the skin clean, adjusting the body position every two hours, and keeping bed linens fresh and smooth can help prevent bedsores and make life easier for both of you.
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Frequently asked questions
Before you begin, ensure the room is free of any obstacles or hazards. Close doors, curtains, and blinds to ensure privacy. Prepare a bed protection pad, towel, or underpad to place underneath the person, and have a pair of medical gloves ready.
Communicate with the person respectfully, explaining that you're there to change their diaper and help them get cleaned up. If they're wearing pants or shorts, gently pull them down, or pull up skirts or dresses above the waist.
Slide the diaper inwards, tucking any mess inside, then roll it towards the person to cover the soiled portion. Undo the tabs and dispose of the diaper in a trash bag.
Use moistened wipes or dry wipes to thoroughly clean the front and back areas, avoiding pressing or rubbing the skin too hard. Dry the skin, and apply barrier cream to the perineum to moisturize and protect against rashes and irritation.
Position the person on their side, then place the fresh diaper under them, tucking it under their hips. Roll them back towards you, pull the diaper between their legs, and fasten the tabs for a snug fit.
Tips:
- Opt for adaptive clothing with features like Velcro closures or elastic waistbands to simplify the changing process.
- Engage the person in conversation or play music to create a positive distraction and make the process quicker and more pleasant.
- If you feel uncomfortable with the process, consider hiring an experienced nurse for homecare.
