Poop related, beware if you have a weak stomach.
If you're still reading, thank you. I've been helping care for a woman who had a traumatic brain injury that has resulted in her being almost completely immobile. The best she can do is stand for maybe 60-90 seconds with support. 90 seconds is a stretch. So here's the issue: On days she has a BM, there will ALWAYS be a significant amount left in her crack. Worth mentioning, I've seen her have an entire BM and none of it is in the toilet, it'll ALL be between her cheeks. So the problem I have is that I'm not there until 4pm, so A) what's there has been there a while B) It’s a good amount C) She can stand for a limited time, and with support. So she holds the grab bar but I have to stand with my shoulder positioned to support her from falling backwards D) The sink is in on the opposite side of the toilet E) It's making her raw.
So questions are, what technique do I need to use to get her cleaned the fastest, and what is the best topical to help with the red/rawness? She's got an aloe cream that isn't cutting it.
For a better idea of what it's like, picture a flour and water rue that's half dried out that you're trying to wipe off a soft surface.
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The other option would be a Hoyer Lift with a Commode Hole. Oddly when my Husband was in the sling with either the Commode Hole or the split leg strap sling his position was much like it is when you see the commercials for the "Squatty Potty" this actually allowed for better elimination and it was easier to clean him while he was in the sling.
If any barrier creams are used use them lightly. I used to "pat" it on rather than smear the ointment on. It is difficult to get off so the heavier it is on the more difficult to get off it will be.
I agree with others who have said you or she might be at risk in this situation. Is she alone until 4pm? Are you working for a licensed, insured agency? Or are you family? One of you could easily be hurt if she falls. Also there is the risk of infection.
It sounds like you care a lot about this person. She may need a higher level of skilled care than you can provide. I know that is a heartbreaking decision. I’m am facing the same type of decision myself right now.
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Keep the area well coated with zinc oxide diaper cream and/or Vaseline.
You soften the fecal matter in this way and then begin gentle wiping and cleaning. Then use a barrier ointment in the area to prevent further feces from getting there. GLOVE UP!!!!!!
(I'm thinking of a baby in a diaper, who poops and all the poop shoots right up the back--this sounds similar but with considerably more acreage involved.)
Sadly, she really needs to be on a toileting schedule--but that requires focus and direction and can be time consuming..but it's better than the alternative!
Personally, this would be the time when the LO needs more care than you can provide.
Find another client to work with.
Next is, is she actually being "toileted". Because honestly (more graphic content) if the cheeks don't get stread, the poop gets smeared into the crack where it stays and cements with time. NO ZINC ointments (that white sticky oily stuff) as you cannot wash it off a sore bottom for the life of you and it will hurt).
Yeah, it is a problem. As to cleanup, she should sit on the toilet and you are going to have to apply some warm wet clothes for a while to soften this (which will be VERY MUCH HELPED if you used the A&D consistently.
Some "form to the stool" can help. While most people think citrucel and metamucil are for constipation, they actually can be given for diarrhea and soft stool as well. They add bulk and form to the stools. You don't want constipation for sure, but you do want some form. Using citrucel sometimes gives one daily formed stool in the a.m. daily and not a lot of smear throughout the day. I like citrucel over metamucil because while they are both fibres, one former ferments differently in the gut. To me metamucil often causes gas, which leads to less control of stool, while citrucel tends not to. Citrucel is getting more difficult to find on shelves while Metamucil as
bought them out I am told. The shelves that is.
Your titling is fun, and you can bet everyone will read it, but don't worry about graphics here. We are into caregiving and it is all about mess. Sure do wish you good luck.
If anyone wants to invest, in this home, in a bidet, now is the time. Even those hemorrhoid pans you kind of set into the toilet, fill with warm water can be of help. Don't know WHAT amazon calls THEM. Bottom soakers?
Again, good luck. As a nurse I sympathize. Sore bottoms are no joke and can lead to bedsore.