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marylpn52 Asked January 2020

How can one caregiver safely transfer an elderly frail female patient between hospital bed and bedside commode?

Also, how to provide proper, competent hygiene in genital and backside areas??

Beatty Jan 2020
Countymouse's reply came in while I was typing... Well that's experience right there! Respect!

Beatty Jan 2020
If able to weight bear & stand briefly it can be done ok: leaning on walking frame & pivot around to waiting commode (put at right angle to bed).

If unable to stand at all, a lifting machine will be required. They can be hired - costs will vary depending on type.

Really need a physio to review & recommend the best & safest way. They have a lot of tips.

Re hygyine: if bed-bound it's roll & wipe. If able to stand, good, but if not the hole in the commode comes in handy. If there is a handheld shower hose, bit of a squirt there at shower time works. Move the commode forward from toilet to gain access for carer to wipe. Front area a bit harder - sometimes a wash cloth works better.

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Countrymouse Jan 2020
Is the lady able to support her own weight? If she can stand and turn, this transfer should be comparatively straightforward. If she can't at all, then you'll need to consider options such as a hoist.

Intimate personal care: presumably you're carrying out these tasks while the lady is in bed? There isn't really any magic to it beyond patience, attention to detail, and a practical but sympathetic manner. Start with a warm room, good light, plenty of towels so that any part that isn't being washed can be covered to protect the lady's dignity. Have a capacious bin close at hand for any soiled disposables, and a laundry basket for soiled clothes or bedding or flannels/towels. Cover the bed with absorbent pads or more towels. Make sure that the bed is at a comfortable height for the caregiver, with the bumper rail securely up on the other side. Clear away any soiling with paper, then wipes; or use dry wipes and a cleansing foam for fragile skin (not baby products, which are for sensitive skin - there's a difference). Once the area is cleansed of soiling, then wash with warm water and mild soap or emollient cream, rinse thoroughly, and dry the skin carefully.

While you're doing this of course you will need to roll the lady onto her side, then back and on to her other side, and to move and position her legs from time to time. If she is able to do this herself, so much the better - just ask her to, and explain throughout what you're doing. If she isn't able to, you will need to position her gently and again explain what you're doing - don't just roll her around with no word about what is going on. Be mindful of any injuries or conditions such as arthritis and make sure that she is comfortably positioned with her limbs well supported. Make sure her arms do not get trapped under her by asking her to cross her arms over her chest when you are moving her.

Check skin folds for rashes or moisture lesions. Check pressure areas for skin breakdown.

Is the lady wearing continence care pads or pull-ups, or not at the moment?

Is there anything you're having particular difficulty with? Is the lady comfortable with having this care carried out? Is the caregiver used to doing it, or has s/he been dropped in the deep end with no training or guidance or support?

NeedHelpWithMom Jan 2020
It’s hard. Does she walk still?

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