How to change a pad on an elderly person: a step-by-step guide

According to the Centers for Disease Control and Prevention, urinary incontinence affects up to half of older adults, making proper pad changes a common necessity. This authoritative guide provides the essential knowledge on how to change a pad on an elderly person, focusing on maintaining comfort, hygiene, and dignity throughout the process.

Quick Summary

Assisting an elderly individual with a pad change requires preparation, a gentle and respectful approach, and a focus on proper hygiene to prevent skin irritation and infection. Following a methodical process ensures safety and comfort for both the caregiver and the recipient of care.

Key Points

• Gather Supplies First: Collect all necessary items like a new pad, wipes, and barrier cream before starting to ensure a seamless change.

• Communicate with Kindness: Explain each step to the elderly person to maintain their dignity and help them feel more at ease during intimate care.

• Roll, Don't Lift: Use the rolling technique to change the pad, which is safer for both you and the individual and prevents spills.

• Ensure Skin is Dry: Always pat the skin completely dry before applying a new pad or barrier cream to prevent skin irritation and infection.

• Choose the Right Product: Select the appropriate incontinence pad type (e.g., brief, pull-up) based on the individual's mobility and level of incontinence for the best comfort and protection.

• Perform Regular Skin Checks: During each change, check the skin for redness or sores, addressing any issues immediately with proper care or medical advice.

Preparing for the Pad Change

Before you begin, gathering all necessary supplies is crucial for a smooth, efficient process. Having everything within arm's reach prevents leaving the individual unattended and ensures the change is completed as quickly and respectfully as possible.

Supplies You Will Need

• New incontinence pad or brief: Ensure you have the correct size and absorbency level for the individual's needs.
• Disposable underpad (chux): These protect the bed linens from soiling.
• Personal protective equipment (PPE): Disposable gloves are essential for hygiene.
• Cleansing wipes or washcloths: Choose gentle, unscented wipes designed for sensitive skin, or use warm water and mild soap with a soft washcloth.
• Protective skin barrier cream: This helps prevent skin irritation and rashes.
• Trash bag or diaper pail: For sanitary disposal of the used pad.
• Fresh clothing or gown (if needed): A change of clothing may be necessary if a leak occurred.

The Step-by-Step Process for Changing a Pad

Ensuring dignity and comfort is paramount when providing intimate care. Communicate each step to the elderly person to help them feel more in control and less vulnerable.

Step 1: Set the Stage

• Wash your hands thoroughly and put on disposable gloves.
• Explain what you are about to do in a calm, reassuring voice.
• Raise the bed to a comfortable height to avoid straining your back.
• Gently position the individual on their back and lay a disposable underpad beneath them to protect the bedsheets.

Step 2: Remove the Soiled Pad

• Unfasten the tabs of the soiled brief or pad.
• Using a hand on the individual’s hip and another on their shoulder, gently roll them onto their side, facing away from you. Bend their knees slightly for stability.
• Roll the soiled pad inward, tucking the soiled part underneath them to contain any waste. Do not pull the pad straight out, as this can cause spillage.
• Use a fresh cleansing wipe to clean the front of the individual, wiping from front to back to prevent the spread of bacteria. Place the used wipe inside the soiled pad.

Step 3: Clean and Protect the Skin

• With the individual still on their side, complete the cleaning process. Wipe the back and buttocks, ensuring all areas, including skin folds, are clean. Continue to wipe from front to back.
• Gently pat the skin dry with a clean cloth or towel. It is crucial that the skin is completely dry before applying a new pad.
• Apply a thin, even layer of protective skin barrier cream to the buttocks and perineal area. This provides a protective layer against moisture.

Step 4: Apply the New Pad

• Roll the new pad or brief lengthwise and place it between the individual’s legs, tucking it under their hips from behind while they are still on their side.
• Gently roll the individual back onto their back, over the new pad.
• Position the pad so that the front panel can be pulled up between their legs.
• Smooth out any wrinkles in the pad to ensure a comfortable fit and to prevent leaks.
• Fasten the tabs securely. For most briefs, the bottom tabs should be angled slightly upward, and the top tabs angled slightly downward for a snug, contoured fit.

Step 5: Finalize and Clean Up

• Assist the individual in getting comfortable again.
• Ensure their clothing is adjusted and they are warm and covered.
• Remove your gloves and dispose of them, along with the soiled pad, in a sealed trash bag or diaper pail.
• Wash your hands again thoroughly.

Comparison of Incontinence Products

Selecting the right product is a key part of effective incontinence care. Here is a comparison of different types of pads and briefs.

Feature	Tab-Style Briefs	Pull-Up Underwear	Bladder Pads
Best For	Bedridden or less mobile individuals. Heavier incontinence.	Active or mobile individuals. Moderate to heavy incontinence.	Light to moderate incontinence. Can be worn with regular underwear.
Ease of Use	Can be difficult to put on alone but easier to change for bedridden individuals.	Put on like regular underwear. Easier for independent changing.	Simple to use, but requires careful positioning.
Security/Fit	Highly adjustable tabs provide a secure, leak-proof fit.	Offers a close, comfortable fit similar to underwear.	Can shift and may not offer full protection for heavier leaks.
Dignity	May feel more like a diaper, potentially affecting dignity.	Discreet and resembles regular underwear, preserving dignity.	Most discreet option, allowing continued use of personal clothing.

Advanced Tips for Skin Health and Comfort

• Regular Skin Checks: Inspect the skin during every pad change for redness, chafing, or bedsores, especially on bony areas. Report any concerns to a healthcare professional immediately.
• Encourage Independence: When possible, involve the individual in the process. Ask them to help with small tasks, like lifting a leg, to maintain their independence and sense of control.
• Use Proper Hygiene Products: A gentle, no-rinse skin cleanser can be effective and less irritating than harsh soaps and water.
• Maintain a Schedule: Regular changes, even when the pad is not full, prevent prolonged exposure to moisture and reduce the risk of skin breakdown and infections.

Conclusion

Mastering how to change a pad on an elderly person is a fundamental skill for any caregiver. By approaching the task with empathy, preparation, and a methodical process, you can ensure the individual's comfort, maintain their hygiene, and preserve their dignity. Staying informed about the best products and skin care practices will lead to a better quality of life for those in your care. For more resources on safe caregiving techniques, consider consulting reputable sources like the Family Caregiver Alliance: Family Caregiver Alliance.

Key Caregiving Takeaways

Prepare Thoroughly: Gather all supplies, including a new pad, cleansing wipes, barrier cream, and gloves, before beginning the change to ensure a smooth, uninterrupted process. Prioritize Dignity: Communicate clearly with the elderly person about each step, providing a calm and reassuring presence to help them feel comfortable and respected. Clean and Protect Skin: Ensure the skin is meticulously cleaned and dried, and apply a skin barrier cream to prevent rashes and irritation, especially in sensitive areas. Master the Rolling Technique: Learn the proper method of rolling the individual gently onto their side, tucking the soiled pad, and positioning the new one to prevent messes and ensure proper placement. Check for Skin Issues: Regularly inspect the skin for any signs of redness, sores, or other issues, and consult a healthcare provider for any concerns to maintain optimal skin health.

Frequently Asked Questions

How often should you change a pad on an elderly person?

This depends on the individual's level of incontinence and the type of pad used. For urinary incontinence, it is often necessary to change the pad several times a day. For bowel incontinence, the pad should be changed immediately to prevent skin irritation and infection.

What supplies do you need to change a pad on an elderly person?

You will need a new incontinence pad, disposable gloves, cleansing wipes or washcloths, a protective skin barrier cream, a disposable underpad (chux), and a trash bag for disposal.

How do you change a pad on a bedridden elderly person?

You can change the pad while they are lying down by gently rolling them onto their side. This allows you to remove the soiled pad and replace it with a clean one from behind, minimizing movement and maintaining comfort.

How can I prevent skin irritation from a pad change?

To prevent skin irritation, ensure the skin is thoroughly cleaned and dried after removing the soiled pad. Use a pH-balanced, gentle cleanser and apply a protective skin barrier cream before putting on the new pad.

Is it better to use pull-up style underwear or tab-style briefs?

The choice depends on the individual's mobility. Pull-up style underwear is better for more active individuals, as they can pull them up and down like regular underwear. Tab-style briefs are often easier for bedridden or less mobile individuals to change.

How do you discreetly dispose of a used pad?

To dispose of a used pad discreetly, roll it tightly to contain waste and odors. Place it inside a sealed plastic bag or a designated diaper pail before putting it in the trash. This helps minimize odors and is more hygienic.

How do I make the pad change more comfortable for an elderly person?

Communicate openly, ensure privacy, use warm water and gentle wipes, and work efficiently. Using a bed that can be raised and lowered can also reduce discomfort for both the caregiver and the individual.