What steps would you take to assist a resident to change their incontinence pad?

Over half of all nursing facility residents experience urinary incontinence. Providing compassionate and efficient care is critical to their well-being. Knowing exactly what steps would you take to assist a resident to change their incontinence pad is essential for maintaining their dignity and health.

Quick Summary

A systematic procedure for assisting a resident with an incontinence pad change involves preparing supplies, ensuring privacy, positioning the resident for comfort, cleaning and drying the skin thoroughly, and applying a new pad while maintaining dignity and proper hygiene.

Key Points

• Prepare all supplies in advance: Gathering everything needed beforehand minimizes interruptions and ensures a quick, smooth process.

• Prioritize privacy and dignity: Always close doors and curtains, and explain each step to the resident to maintain respect and comfort.

• Clean and dry thoroughly: Use a front-to-back wiping motion and ensure the skin is completely dry before applying a new pad and barrier cream to prevent irritation.

• Adapt the technique for mobility: Adjust the changing procedure based on the resident's mobility level, from a bedridden side-roll to a standing quick change.

• Document and monitor skin health: After each change, note any signs of skin irritation and properly dispose of soiled materials to maintain a clean and safe environment.

Preparation for a Dignified Change

Before beginning the process, meticulous preparation is key to ensuring a smooth and dignified experience for the resident. Gather all necessary supplies and ensure the environment is comfortable and private.

Gathering Your Supplies

Having everything within arm's reach prevents interruptions and minimizes the time the resident is exposed. This is crucial for both their comfort and dignity. A complete set of supplies typically includes:

• New incontinence pad or brief of the correct size and absorbency
• Disposable gloves (consider having extra on hand)
• Disposable underpads or 'chucks' to protect bedding
• Pre-moistened cleansing wipes or washcloths and a basin with warm water
• Gentle, pH-balanced soap if using a washcloth
• Barrier cream or ointment to protect the skin
• A plastic-lined trash bag for soiled items

Creating a Safe and Private Environment

Respecting the resident's privacy is paramount. Close the door and any curtains to the room. If possible, ensure the temperature of the room is comfortable. Explain each step of the process to the resident clearly and calmly, even if they have cognitive impairment, to maintain their respect and cooperation.

The Step-by-Step Procedure for a Resident Who Can Lie Down

For residents who are bedridden or have limited mobility, a careful, sequential approach is necessary to ensure safety and hygiene.

1. Initial Positioning and Removing the Soiled Pad:

   • Wash your hands thoroughly and put on a pair of disposable gloves.
   • Place a disposable underpad beneath the resident to protect the bedding.
   • Gently assist the resident to turn onto their side, positioning them away from you.
   • Unfasten the tapes or tabs on the old pad and fold the soiled portion inward to contain any waste.
   • Tuck the folded, soiled pad toward the resident's back.

2. Cleaning the Area:

   • Using moist wipes or a warm, damp cloth, clean the perineal area thoroughly. Always wipe from front to back to prevent the spread of bacteria.
   • Pay special attention to all skin folds and creases, as these areas can harbor moisture and bacteria.
   • Use multiple wipes or washcloths as needed until the area is completely clean.
   • Gently pat the skin dry with a clean, dry cloth. Allowing the skin to air-dry completely is also a good practice.

3. Applying a New Pad and Barrier Cream:

   • Apply a barrier cream sparingly to protect the skin from further moisture exposure.
   • Take the new incontinence pad, fold it lengthwise, and tuck it between the resident's legs. Ensure the back portion is fanned out and tucked under the resident's hips.
   • Gently roll the resident onto their back over the new pad, and pull the front portion up through their legs.
   • Fasten the new pad securely, ensuring it's not too tight or too loose, and smooth out any wrinkles to prevent chafing.

Adapting the Process for Mobile Residents

For residents who have greater mobility, you may be able to perform the change while they are standing, leaning, or sitting on the edge of the bed. This preserves more of their independence and dignity.

Quick Change Technique for Mobile Residents

This method is particularly useful for pull-up style products.

1. Have the resident stand and hold onto a sturdy surface.
2. Tear the side seams of the pull-up product.
3. Pull the soiled product down and away.
4. Using wipes, clean the area from front to back.
5. Step into a fresh pull-up product and pull it up like regular underwear.

Comparison of Incontinence Pad Changing Methods

Feature	Bedridden Resident Change	Mobile Resident Quick Change
Resident Position	Lying on side and back	Standing, leaning, or sitting
Tools Needed	Underpad, multiple wipes, gloves	Wipes, new product, gloves
Time Commitment	Longer, more involved process	Quicker, more efficient
Level of Dignity	High, when done respectfully	Very high, maintains independence
Hygiene	Exceptional, thorough cleaning	Sufficient for light-to-moderate changes
Best For	Immobile or low-mobility residents	Mobile residents needing a faster change

Post-Procedure Best Practices and Ongoing Care

After a successful pad change, your role isn't quite finished. Completing a few final steps ensures a high standard of care.

1. Ensuring Resident Comfort: Adjust the resident's clothing and bedding, ensuring they are positioned comfortably. Check for any sign of skin irritation or discomfort.
2. Disposal and Cleanup: Roll up the soiled pad and any gloves and place them in the plastic-lined trash bag. Tie the bag securely and dispose of it properly. Clean up any spills immediately to maintain a safe environment.
3. Documenting the Event: As a caregiver, noting the time and details of the pad change is important, especially if you observe any skin issues or changes in the resident's condition.
4. Maintaining Good Skin Health: Regularly changing pads, cleaning the skin, and using barrier creams are critical for preventing skin breakdown. Consistent care is the best defense against skin irritation.

For additional resources on elder care, the National Institute on Aging offers a wealth of information and support. [www.nia.nih.gov]

Conclusion

Assisting a resident with an incontinence pad change is a fundamental aspect of compassionate senior care. By approaching the task with preparation, respect, and a clear, step-by-step process, caregivers can ensure the resident's comfort, hygiene, and dignity are maintained. Whether the resident is bedridden or more mobile, adapting the method to their needs allows for an efficient and respectful experience. Following post-procedure best practices ensures ongoing skin health and a positive, caring relationship.

Frequently Asked Questions

How often should an incontinence pad be changed for a resident?

Ideally, incontinence pads should be changed as soon as they are soiled to prevent skin irritation and infection. For regular care, check on the resident every two to three hours during the day and at least once during the night.

What is the best way to clean a resident's skin during a pad change?

Always wipe from front to back to prevent the spread of bacteria. Use moist, disposable wipes or a soft washcloth with mild soap and water. Pay close attention to skin folds and creases, and gently pat the skin completely dry afterward.

Should barrier cream be used every time an incontinence pad is changed?

Yes, applying a thin, protective layer of barrier cream is highly recommended with each pad change. This creates a seal that protects the skin from moisture and helps prevent rashes and skin breakdown.

How do you manage incontinence pad changes for residents with cognitive issues?

Approach the task calmly and respectfully. Explain each step in simple, reassuring language. Maintaining a predictable routine can also help reduce confusion and agitation for residents with cognitive impairments.

What if a resident is uncooperative during an incontinence pad change?

Remain patient and non-confrontational. Try to identify the source of their distress. Sometimes, waiting a few minutes or enlisting the help of a second caregiver can make the process easier. Ensure all communication is respectful.

Can I reuse incontinence pads if they aren't very wet?

No, disposable incontinence pads should never be reused, regardless of how wet they are. Even lightly used pads can harbor bacteria and compromise skin health. Always use a fresh pad with each change.

How should soiled incontinence pads be disposed of?

Roll the soiled pad up tightly to contain any waste. Place it in a plastic-lined trash bag, tie the bag securely, and dispose of it in an appropriate waste container. Never flush pads down the toilet.