How to make a bed for an incontinent person for maximum protection and comfort

According to one study, up to 41% of adults in long-term care settings experience skin irritation related to incontinence. Proper bed-making is a critical skill for caregivers to prevent complications and maintain hygiene. Mastering how to make a bed for an incontinent person with protective layers provides essential comfort and preserves expensive mattresses and linens.

Quick Summary

Managing incontinence requires a strategic bedding approach to protect mattresses and maintain hygiene. This guide details a multi-layered system using waterproof and absorbent products, provides step-by-step instructions for occupied and unoccupied beds, and offers essential tips for skin care and laundry management.

Key Points

• Layer for Protection: Use a multi-layer system, starting with a zippered waterproof mattress encasement, followed by absorbent pads and standard linens, to contain leaks and simplify cleanup.

• Change an Occupied Bed Safely: Utilize a turn-and-roll technique with the person's back toward you to change linens without them needing to get out of bed.

• Prevent Skin Irritation: Apply barrier creams and change soiled products promptly to protect the skin from moisture and irritants.

• Select the Right Products: Choose between reusable and disposable underpads based on the level of incontinence, laundry capabilities, and desired convenience.

• Manage Laundry Effectively: Treat soiled items by rinsing in cold water and using enzyme-based detergents and vinegar to eliminate stubborn odors.

• Reduce Nighttime Accidents: Limit fluids in the evening, avoid bladder irritants, and ensure easy access to the bathroom to help minimize overnight leakage.

• Keep Bedding Smooth: Ensure all layers, especially the underpads, are smooth and free of wrinkles to prevent pressure points and discomfort.

The Multi-Layer Bedding Strategy

The most effective method for managing incontinence in bed is to use a multi-layered system that combines waterproof and absorbent materials. This approach creates a simple, highly protective setup that simplifies cleanup and reduces the risk of moisture reaching the mattress or irritating the skin. A good layering system allows caregivers to quickly remove and replace only the top soiled layers, minimizing disturbance to the individual.

Building Your Protective Layers

1. Mattress Encasement: This is the foundational layer. A zippered, fully waterproof mattress encasement covers all six sides of the mattress, providing the ultimate barrier against liquid spills, stains, and even dust mites. Choose a quiet, non-crinkly material for comfort. Opting for a breathable fabric can also help reduce heat buildup.
2. Fitted Sheet: A standard fitted sheet goes over the mattress encasement. If you are layering multiple sets for a quicker nighttime change, each layer would include a fitted sheet with a pad on top.
3. Washable Underpad (Chux): Placed over the fitted sheet in the high-risk area (typically from the person's shoulders to thighs), this layer provides high absorbency. Washable underpads are a durable and cost-effective option for long-term use. Look for options with non-slip backing or tuck-ins to prevent bunching.
4. Disposable Underpad (Optional): For heavy incontinence or for ease of nighttime changes, a disposable underpad can be placed on top of the washable pad. This allows for the quickest possible cleanup, as the disposable pad can simply be removed and discarded.
5. Top Sheet and Blanket: Finish the bed with the standard top sheets and blankets. Keeping extra sets nearby can facilitate quick changes.

Essential Incontinence Products

Choosing the right products is key to a successful incontinence care routine. It's important to select products that match the individual's needs, activity level, and level of incontinence.

Comparison of Incontinence Products

Feature	Waterproof Mattress Encasement	Washable Underpads	Disposable Underpads
Primary Function	Complete mattress protection from liquids and pests.	Absorbent layer to catch leaks; can be reused.	Quick, easy absorbent layer for immediate cleanup.
Placement	Covers the entire mattress, under all other layers.	Placed over the fitted sheet in the middle of the bed.	Placed on top of the fitted sheet or washable pad.
Convenience	Low maintenance; protects long-term.	Washable and reusable; saves money over time.	Disposable; allows for very fast cleanup.
Cost	Initial investment, but durable.	Higher upfront cost than disposables, but lower long-term cost.	Lower cost per item, but higher long-term cost.
Eco-Friendliness	Long-lasting, reducing waste.	Reusable, generating less waste.	Disposable, creating more landfill waste.
Best For	All levels of incontinence; mattress longevity.	Moderate to heavy incontinence; cost-conscious users.	Heavy nighttime incontinence; extremely fast changes.

How to Prepare an Unoccupied Bed

1. Gather Your Supplies: Before starting, collect all the necessary clean items: mattress encasement, fitted sheet, washable pad, disposable pad (if using), top sheet, and pillowcase. Keep soiled linens in a laundry hamper, not on the floor.
2. Protect the Mattress: If you do not have an encasement on already, start by putting a zippered waterproof mattress encasement over the bare mattress.
3. Place the Fitted Sheet: Lay the fitted sheet smoothly over the mattress encasement, ensuring there are no wrinkles.
4. Add Absorbent Pads: Place the washable underpad in the center of the bed, positioning it to cover the areas most prone to leaks. If using disposable pads for an extra layer, place it on top of the washable pad.
5. Finish the Bed: Add the top sheet and any blankets. Remember to change the pillowcase with a fresh one.

How to Change an Occupied Bed

Changing linens with a person in bed is a common task for caregivers and requires a specific technique to ensure comfort and safety. This can be done alone, but it is easier with two people.

1. Prepare: Put on gloves and gather clean linens. If using a hospital bed, raise it to a comfortable working height and lock the wheels. Explain the process to the person to minimize anxiety.
2. Move the Person: Help the person roll onto their side, facing away from you, and have them hold onto the side rail if they can. Place a pillow behind them for support if necessary.
3. Remove Soiled Linens: On your side of the bed, loosen all the bottom linens and roll them tightly toward the person's back, tucking them snugly against their body. If the mattress is wet, clean and dry it before placing new linens.
4. Add Clean Linens: Place the new fitted sheet and absorbent pad on the exposed side of the bed. Fan-fold the remaining clean linens into the middle, tucking them against the rolled-up soiled linens.
5. Roll the Person Back: Gently help the person roll over the ridge of linens onto the clean side of the bed. Raise the side rail on the clean side before moving to the other side of the bed.
6. Complete the Change: Lower the opposite side rail, remove the soiled linens, and place them in the laundry bag. Pull the clean linens across the bed, smooth out any wrinkles, and tuck everything in tightly.
7. Final Touches: Help the person lie back down comfortably. Replace the top sheet, change the pillowcase, and ensure the call light is within reach. Lower the bed to a safe height and unlock the wheels if applicable.

Preventing Skin Irritation

Maintaining skin integrity is a primary goal when caring for an incontinent individual. Prolonged exposure to moisture can cause rashes and skin breakdown.

• Change Products Promptly: Change soiled bed pads and other incontinence products as soon as possible to keep skin dry.
• Clean Gently: After each episode, clean the skin gently with a mild, fragrance-free cleanser. Pat the skin dry instead of rubbing.
• Use Barrier Creams: Apply a protective barrier cream containing zinc oxide or petrolatum to shield the skin from excess moisture and irritants.
• Inspect Daily: Perform a daily skin check, paying close attention to areas that have been in contact with soiled linens.
• Reposition Regularly: For bedridden individuals, repositioning every two hours helps improve circulation and prevents pressure sores.

Handling Incontinence Laundry

Effective laundry management is key to controlling odors and bacteria.

• Rinse and Soak: For heavily soiled items, rinse them in cold water first to prevent stains from setting. Soaking in a solution of cold water and a splash of vinegar can also help neutralize odors.
• Use the Right Detergent: Use an enzyme-based or heavy-duty detergent formulated to break down bio-stains and odors.
• Add Deodorizers: For stubborn odors, add white vinegar or baking soda to the wash cycle. Do not mix vinegar and baking soda together, as they cancel each other out.
• Sanitize the Washer: Run an empty, hot wash cycle with bleach or a washing machine cleaner periodically to sanitize the machine.
• Separate Loads: Wash incontinence-affected items separately from regular laundry to avoid cross-contamination and ensure a thorough clean.
• Sunlight is Best: Whenever possible, dry items outside in the sun. The sun's UV rays are a natural sanitizer and deodorizer.

Conclusion

Managing incontinence in bed is a manageable task for caregivers with the right approach. By employing a multi-layered bedding strategy using waterproof mattress encasements, absorbent pads, and quick-change techniques, you can ensure the bed stays clean and dry with minimal disruption. Prioritizing skin health, using appropriate products, and implementing an effective laundry routine are all crucial components of a successful care plan. This thoughtful and methodical process helps to preserve the dignity and comfort of the individual while simplifying caregiving tasks significantly.

Frequently Asked Questions

What is the best way to layer bedding for an incontinent person?

The best layering method involves starting with a zippered waterproof mattress encasement. On top of that, place a fitted sheet, followed by a washable underpad in the area where leaks are most likely. For extra protection, a disposable underpad can be added on top of the washable one.

How do you get urine smell out of bed sheets and clothes?

To remove urine odor, start by rinsing items in cold water. Then, wash them with an enzyme-based detergent. You can also add a cup of white distilled vinegar to the rinse cycle to help neutralize the odor. Avoid using fabric softeners, as they can lock in smells.

What is the difference between a mattress encasement and a mattress pad?

A mattress encasement is a zippered cover that fully encloses the mattress, offering 360-degree protection from liquids, stains, and allergens. A mattress pad, or underpad, is a layer placed on top of the bed that provides a localized absorbent or waterproof barrier, but does not offer full coverage.

How often should incontinence pads be changed?

Bed pads and other incontinence products should be changed promptly after they are soiled to prevent moisture buildup against the skin. For overnight protection, use high-absorbency products and change them as soon as possible in the morning.

How can I prevent a bed pad from bunching up during the night?

To prevent bed pads from slipping, ensure they are securely placed underneath the fitted sheet. Alternatively, use pads with adhesive strips or tuck-in flaps, which are designed to stay in place, even with a restless sleeper.

What is the safest way to turn a bedridden person to change the sheets?

To safely turn a bedridden person, roll them gently to their side, positioning them toward a raised side rail if available. Use a 'log roll' technique, ensuring their head, back, and legs move as one unit. This prevents twisting and is essential for changing occupied bedding.

What are the best products for heavy nighttime incontinence?

For heavy nighttime incontinence, use a layered system. Start with a waterproof encasement for the mattress, then a high-absorbency washable underpad, and top it with a disposable pad for easy changes during the night. Use an overnight brief with high absorbency as well for maximum protection.