Preparing for the Change
Before beginning the process of how to change incontinence pads in bed, gathering all necessary supplies is crucial for a smooth and efficient procedure. This prevents the need to leave the individual unattended and ensures that everything is within arm's reach. Proper preparation also helps to maintain the patient's privacy and dignity throughout the process.
Gather your supplies:
- Clean incontinence pads or briefs: Have the correct size and absorbency level ready. If using a brief with tabs, ensure the new one is open and ready to be positioned.
- Disposable underpads (chucks): These are vital for protecting the bed linens and mattress from soiling.
- Disposable gloves: Always wear a clean pair of gloves for hygiene and safety.
- Warm washcloths or pre-moistened wipes: Use these for cleaning the skin. Warming the wipes can add extra comfort.
- Gentle skin cleanser (perineal wash): An optional but recommended addition, especially for bowel incontinence.
- Skin barrier cream or ointment: This protects the skin from moisture and irritation.
- Soiled pad disposal bag or trash can: Keep a bag or receptacle nearby for easy disposal.
- Clean linens: Have fresh sheets or blankets ready for after the change.
Step-by-Step Procedure for a Safe and Respectful Change
Following a systematic process ensures the individual is comfortable and the change is hygienic.
Step 1: Ensure Comfort and Privacy
Always start by communicating with the individual about what you are going to do. Close the door or draw curtains to ensure privacy. If the bed is adjustable, raise it to a comfortable working height to protect your back from strain.
Step 2: Remove the Soiled Pad
With the individual lying on their back, undo the tabs or fasteners on the soiled pad. Place a disposable underpad underneath them if one is not already in place. Gently roll the individual to their side, facing away from you. Bend their knees to help stabilize them. As they are on their side, roll the soiled pad inward, tucking it snugly between their legs to contain any waste. Push the soiled pad and underpad bundle towards their back.
Step 3: Clean the Skin
Using warm, pre-moistened wipes, thoroughly clean the individual's perineal area. Always wipe from front to back to prevent the spread of bacteria. Use fresh wipes as needed until the area is completely clean. Pay close attention to skin folds and creases. After cleaning, pat the skin dry with a clean cloth. Inspect the skin for any signs of redness, rash, or irritation.
Step 4: Position the New Pad
While the individual is still on their side, fold the new pad or brief lengthwise (like a hot dog bun) and place it on the bed, tucking one half under their buttocks. The tabs should be on the side closest to you. With one side of the clean pad in position, apply a thin layer of barrier cream to the skin to protect it from moisture and irritation.
Step 5: Roll and Secure
Gently roll the individual back onto their back, over the new pad. This will allow the new pad to flatten out beneath them while the old, soiled pad is easily accessible on the other side. Reach across, remove the soiled pad and dispose of it in the trash bag. Pull the new pad through the legs and up over the groin. Fasten the tabs snugly but not too tightly to ensure a secure but comfortable fit. Adjust the individual's position to ensure they are comfortable.
Step 6: Post-Change Hygiene
Remove and dispose of your soiled gloves properly. Wash your hands thoroughly with soap and water to prevent cross-contamination. Ensure the bed is clean and dry and the individual is covered with clean linens for warmth and privacy.
Comparison of Incontinence Products
Selecting the right product is essential for both comfort and leakage protection. The choice often depends on the level of incontinence and the individual's mobility.
| Feature | Adult Briefs (Diapers) | Pull-Up Underwear | Disposable Underpads (Chucks) |
|---|---|---|---|
| Best For | Heavy to severe incontinence, bedridden individuals | Moderate incontinence, more mobile individuals | Protecting bed linens, additional security for any user |
| Fastening | Refastenable tabs on the sides | Worn like regular underwear, no tabs | No fasteners, relies on placement |
| Ease of Changing | Can be changed in bed without having to fully move the person | May require the individual to be able to stand or lift their hips | Quick and easy to replace, especially when used with other products |
| Discreetness | Bulkier than other options | More discreet under clothing | Not worn on the body, used on the bed |
| Leakage Protection | Excellent, especially when fit correctly | Good for moderate leaks, riskier for heavy incontinence | Provides an extra layer of defense against leaks |
Common Challenges and Troubleshooting
Even with the right technique, challenges can arise. Addressing these issues proactively can improve the caregiving experience.
Skin Irritation
- Cause: Prolonged exposure to moisture, friction, or infrequent changes.
- Solution: Ensure the skin is always clean and dry after each change. Use a high-quality skin barrier cream. Inspect the skin for any redness and report any signs of breakdown to a healthcare professional.
Leaking Pads
- Cause: Incorrect size, improper placement, or worn-out elasticity.
- Solution: Measure the individual's waist and hips to find the correct size. Ensure the pad is centered and secured properly without wrinkles. Check for signs that the pad's absorbency capacity is being exceeded and consider a more absorbent product if necessary.
Back Strain for Caregiver
- Cause: Bending or twisting in an uncomfortable position while changing the pad.
- Solution: Always raise the bed to a comfortable height, use a proper rolling technique, and maintain a good posture. Consider using assistive devices like a draw sheet to help roll the individual.
Conclusion
Changing incontinence pads for a bedridden individual is a routine task that requires patience, respect, and proper technique. By following a detailed, step-by-step process—from gathering supplies to performing the change and ensuring post-care hygiene—you can provide dignified and comfortable care. Paying attention to potential issues like skin irritation and using the right products will contribute to the individual's overall health and well-being. Ultimately, informed and compassionate caregiving can make a significant positive difference in the lives of those managing incontinence.
Best Practices for Dignified Care
- Communicate Clearly: Explain every step of the process to the individual, even if they are non-verbal. This helps them feel informed and respected.
- Maintain Privacy: Always provide privacy during the change. Closing doors and pulling curtains ensures a sense of security.
- Handle with Care: Always be gentle when rolling or positioning the person. Use pillows for support to make them more comfortable during the process.
- Prioritize Skin Health: Consistent cleaning and the use of barrier creams prevent painful skin issues like rashes and sores, which are common with incontinence.
- Be Patient: Take your time. Rushing the process can cause discomfort or lead to mistakes. A calm, reassuring demeanor benefits everyone involved.
For more information on skin care for individuals with incontinence, see the National Institute on Aging's guide to caring for a bedridden person [https://www.nia.nih.gov/health/alzheimers-and-dementia/caring-person-bedridden-alzheimers-disease].
