A Complete Guide on How to change pad in care home with Dignity

According to research, a significant percentage of care home residents experience some form of incontinence. For caregivers, mastering the respectful and hygienic procedure for how to change pad in care home is a critical skill that directly impacts resident comfort, dignity, and skin health. This authoritative guide details the proper steps and best practices.

Quick Summary

Changing an incontinence pad in a care home is a multi-step process prioritizing resident privacy and safety. This involves gathering supplies, proper positioning, gentle removal and cleaning, and applying a new pad correctly to prevent leaks and skin irritation. Communication and respect are paramount throughout the procedure.

Key Points

• Prioritize Dignity: Always communicate clearly, ensure privacy, and handle the task with respect to maintain the resident's dignity.

• Gather All Supplies: Prepare all necessary items beforehand to ensure a smooth, uninterrupted pad change and prevent leaving the resident unattended.

• Use Proper Positioning: The side-lying technique is standard and effective for safely removing and applying pads while minimizing strain on both the caregiver and resident.

• Focus on Skin Care: Thoroughly clean and dry the skin, especially in folds, and apply a barrier cream to prevent rashes and skin breakdown associated with incontinence.

• Ensure Correct Pad Fit: Selecting and fitting the correct pad size is crucial for preventing leaks and skin irritation. A snug but not-too-tight fit is ideal.

Prioritizing Dignity and Respect in Care

Caring for residents with incontinence requires empathy and professionalism. The way a caregiver handles this task has a profound effect on a resident's sense of dignity and well-being. Before starting, always explain what you are going to do in a calm, matter-of-fact tone. This maintains respect and helps alleviate any potential anxiety or embarrassment.

Communicating with Residents

For residents who can communicate, use clear and simple language. For those with cognitive impairment, communication is just as important. A calm voice and gentle touch can be very reassuring. Treat the individual with the respect you would offer anyone, regardless of their condition.

Ensuring Privacy

Privacy is a fundamental right. Always close doors and curtains before beginning the procedure. Consider using a privacy screen if the resident is in a shared room. Ensuring the resident feels secure and unexposed is a cornerstone of compassionate care.

The Step-by-Step Pad Changing Procedure

Following a consistent and correct procedure for how to change pad in care home settings is essential for efficiency, hygiene, and comfort. The following steps detail a standard side-lying technique.

Step 1: Gather Your Supplies

Prepare everything you need beforehand to avoid leaving the resident unattended. This includes:

• Fresh incontinence pad/brief
• Disposable gloves (at least two pairs)
• Protective underpad (chux)
• Wipes or a washcloth with warm, soapy water
• Barrier cream or skin protectant
• Waste bag or receptacle

Step 2: Prepare the Resident and Bed

1. Wash your hands and put on a pair of disposable gloves.
2. Explain the process to the resident to prepare them.
3. Lower the head of the bed until it is flat and raise the bed to a comfortable working height for you, protecting your back from strain.
4. Cover the resident with a sheet to maintain their modesty, exposing only the area you are working on.
5. Roll the resident to one side and place a fresh protective underpad on the bed.

Step 3: Position the Resident and Remove the Soiled Pad

1. With the resident lying on their side, undo the tabs on the soiled brief.
2. Gently bend the resident’s knees towards their chest. This makes it easier to clean and position the new pad.
3. Roll the soiled pad inwards, away from the resident's body, trapping any mess inside. Place it in the waste bag.

Step 4: Cleansing and Skin Care

1. Using a clean wipe or washcloth, clean the perineal area from front to back to prevent the spread of bacteria. Change wipes as needed.
2. Pay special attention to all skin folds and creases, as moisture can accumulate there.
3. Use a dry wipe or towel to gently pat the skin dry completely. Moisture can cause skin breakdown.
4. Allow the skin to air dry briefly.
5. Apply a thin layer of barrier cream to protect the skin from further moisture and irritation. Be sure to check for any redness or sores.

Step 5: Applying the New Pad

1. Fold the clean pad in half lengthwise, creating a taco shape, and place it between the resident’s legs.
2. Push the folded portion beneath the resident's hips, ensuring it is flat and centered.
3. Roll the resident gently onto their back, then pull the folded pad through to the other side.
4. Flatten the pad and secure the tabs. For a tab brief, ensure the top tabs are pointed down and the bottom tabs up for a snug fit. The fit should be firm but not too tight.

Step 6: Final Adjustments and Tidy Up

1. Adjust the resident’s clothing and position them comfortably.
2. Remove your soiled gloves and dispose of them in the waste bag along with the old pad.
3. Place all waste in the appropriate receptacle.
4. Wash your hands thoroughly.

Comparison of Incontinence Pad Types

To effectively manage incontinence in a care home, it is crucial to understand the different products available. Choosing the right pad depends on the resident's mobility, level of incontinence, and comfort needs.

Feature	All-in-One Briefs (Adult Diapers)	Pull-up Pants	Booster Pads (Liners)
Best For	Heavy to severe incontinence, bed-bound residents, fecal incontinence	Moderate to heavy incontinence, mobile or semi-mobile residents	Mild to moderate incontinence, used to boost absorbency in other products
Key Benefit	High absorbency, secure fit with tapes, good for immobile residents	Easy to pull up and down, promotes independence and dignity	Increases product lifespan, cost-effective for managing surges in leakage
Downside	Can be less discreet, requires rolling/side-lying for changes	Less effective for bed-bound residents, not ideal for fecal incontinence	Not for standalone use, can shift out of place
Change Method	Requires side-lying or log-roll technique	Can be changed standing or sitting; tearable sides for messy changes	Removed and replaced within the main product

Best Practices for Preventing Skin Breakdown

Preventing incontinence-associated dermatitis (IAD) and pressure sores is a key responsibility for caregivers. Following these best practices can significantly reduce the risk.

• Frequent Checks and Changes: Never leave a resident in a wet or soiled pad. Frequent checks, especially after meals or at night, are crucial.
• Gentle Cleansing: Avoid scrubbing the skin. Instead, use soft cloths or no-rinse cleansers designed for sensitive skin. The Association of Professionals in Infection Control and Epidemiology offers best practices for preventing pressure injuries, which are often related to skin breakdown from moisture.
• Proper Use of Barrier Creams: Apply a thin layer of a zinc-based or petrolatum-based barrier cream to protect the skin. Using too much can reduce the pad's absorbency.
• Ensure Correct Fit: A poorly fitting pad can cause leaks and friction, leading to skin irritation. Ensure the leg openings are snug and the pad is centered correctly.

Conclusion

Mastering the skill of how to change pad in care home is about more than just a task—it's about providing compassionate and dignified care. By following a standardized, respectful procedure, using the right products, and prioritizing skin health, caregivers can ensure residents remain comfortable, healthy, and respected. Consistent training and adherence to best practices are essential for delivering high-quality senior care.

Frequently Asked Questions

How often should an incontinence pad be changed in a care home?

Pads should be checked frequently and changed immediately upon becoming wet or soiled. Regular checks, especially after meals and before and after bedtime, are vital for maintaining hygiene and skin integrity.

What is the best technique for changing a pad for a non-mobile resident?

The side-lying, or log-roll, technique is the safest and most effective method for changing a pad for non-mobile or bed-bound residents. It minimizes movement and risk of injury while ensuring a thorough cleaning.

How can I prevent leakage when changing an incontinence pad?

To prevent leakage, ensure the new pad is the correct size and absorbency level for the resident. Make sure the pad is centered and the elastic leg guards are properly positioned and not folded over. Secure all tabs firmly.

What should I do if I notice a rash on a resident's skin?

If a rash or any skin irritation is noticed, report it immediately to the supervising nurse or medical staff. Continue with gentle, thorough cleansing and ensure a barrier cream is applied to the affected area to protect the skin.

Are there different types of incontinence pads for different needs?

Yes, products vary based on a resident's needs. Briefs with tabs are best for immobile residents and heavy incontinence, while pull-up pants are more suitable for mobile individuals. Booster pads can be used to increase absorbency.

How do I maintain a resident's privacy and dignity during the process?

Always inform the resident of the procedure, close doors and curtains, and expose only the area being attended to. Use calm, respectful language and maintain a professional, empathetic demeanor throughout the process.

What supplies are absolutely essential for a pad change?

The essential supplies include a new incontinence pad, disposable gloves, wipes or cleanser, a protective underpad (chux), and a waste receptacle. Barrier cream is also highly recommended to protect the skin.