How do I change my bedridden mom’s soiled adult diaper if I can not roll her?

I've had invalid clients in homecare who I could not roll and who could not remain on their side unassisted while changing a diaper. First off I'm going to let you in on a secret that's like a miracle. Line your mother's adult diapers with a trimmed down baby diaper. Baby diapers are made from a different material then the adult ones. The surface stays dry even when the diaper is heavy and saturated with urine. This will certainly help to prevent skin breakdown and she won't have to be diapered as often. What I found that works, is lay a long and heavy towel (like a beach towel) length-wise under a fabric, reusable bed pad. 1) While she's flat, unfasten the diaper. Fold as much of it as you can under her on both sides if it. You will have to do this from both sides of the bed. 2) Grasp the ends of the towel a little towards you. 3) Pull it around the clients lower back and hips. 4) Go to the opposite side of the bed and pull the towel with the pad under it, towards you. This will get the person on their side. Then return to the other side of the bed to do the changing. I'm going to assume your mom has a hospital bed. If she's able have her hold on to the bed rail. If she can't hold on you may have to repeat Step #4 a couple of times to actually get the diaper removed. Clean up of the person is basically done the same way. If there's someone to assist you then great. It's harder if there's not, but isn't impossible. To get a clean diaper back on: 1) Roll one half of the diaper. Repeat step #4. 2) Slide the rolled half of the diaper as far as you can under the person. 3) Return to opposite side of bed. Repeat step #4 then flatten the rolled side of the diaper over. It should now be in the right position and you can fasten it.
Make sure to pull the person up to the head of the bed after you have finished. This is done by raising the foot of the bed as high as it can go. Then slide the person up by pulling the long towel and bed pad under it. This step is important because the person must be properly positioned on the bed pad and long towel for changing to be possible. It sounds hard, but if these steps are done correctly, you will be able to do it successfully. The movements and positioning will seem awkward at first, but after a few times you'll get it. I used to change the diaper on a 390-pound bedbound woman daily and successfully on my own, and I don't have an Iron Man suit. At your mom's age I would not put her through invasive procedures like a colostomy bag or an ileostomy bag for urine. If you're absolutely unable to keep her in diapers because of the changing, then just use disposable bed pads that will be thrown away each time she goes.

have yoI talked to her dr Or hospice about a possible purwick? It is an external catheter that worked amazing on my mother. I know the machine is a few hundred dollars but maybe something Medicare could cover If you can’t put of pocket? I’m not sure how hospice works in your area but could you also request more help from them at no cost?

My husband has been bedridden the last 10 years. I had a hard time changing him. I spoke to his wound doctor (bed sores) about this. He made appointments for my husband to have a colostomy bag and a catheter which the tube is inserted into the bladder. So now I don't have to turn him except to change bandages on bed sores. He is 78 and I am 76 with a nurse who comes 3 times a week and an aid who bathes him 3 times a week. I have no other help. I've been his caregiver 12 years and I am really getting burned out. Prayers that I can stay strong. God Bless you!! I hope this helps.

You’ve got to get more caregiver help. Is there an Agency on Aging in your community? They’ve been extremely helpful to me. Or a visiting nurse association might be helpful as a even a resource for more assistance

First of all... I want to mention something that many don't seem to know about? Those pads that we use for our periods. Put them inside their pullup... diapers... depends... whatever you wish to call them. You can use two. Get the ones that really absorb the most and sometimes, if you check them enough, that is all you have to change most of the time! For men, I take one and wrap around more towards the END of the penis. Then take another one, so it goes UP between his legs. Many times, I have to only change my patient's pullup one time a day. I put on a fresh pullup every day.

Are you using a turn "sheet"... but instead of a sheet I need to use something of much stronger material. Right now, I am using a wet-proof pad for turning him but he is nothing but skin and bones. For bigger people, it is very difficult or depending on how much they weigh... can be impossible for one person to take care of them and NOT hurt yourself in the process.

A turn Pad ---- take some stronger material other than a sheet if you have it otherwise use a sheet..... blanket.... Fold it until it is in a rectangle and you will have several layers of "cloth" which makes it even stronger. The size does NOT have to be perfect but you will put this underneath them to help you turn them. It should reach close to the bottom of their neck...and then far enough so their buttocks are laying on it.

Also.... have several of these on hand. One is not enough. They will "jiggle" around in bed and will not stay in place so... will have to replace these from time to time. Of course, they also will get soiled and need washing.

Several thing to help when turning them also:
1. When they are ready to be turned...... put their head down.... and put their legs up. Hopefully, you have a bed where you have controls to put their head up/down and legs up/down. If you don't please check and see if you can get a motorized Hospital bed. This would greatly help.

2. Also.... about the bed.... get a bed that also has a control where you are able to bring the whole bed up. Like me, I am tall so this keeps me from having to bend over so far to take care of my patient. Saves my back.

Sometimes they can lay on their back, bend their legs and push up to get their buttocks off the bed long enough for you to push a menstrual pad underneath them. Or.... a menstrual pad sitting on a diaper... .depend.

3. When you are ready to turn....does she have one side that she can turn to better than the other?
a. Put the head of the bed down.
b. Put the bottom of the bed up.....legs up, if you can.
c. Also... have them bend their legs at the knee as much as possible.
Also, they may be able to help by crossing one ankle over the other: if they
are turning to the left, cross the right leg over the left leg as much as they
can. Ankle crossed over other ankle.
d. Some people can help while others cannot.
Some people can help a little. Allow them to help as much as possible.

If you are turning her to the left.... stand on her right side.... grab that turn sheet with both hands... on hand up even with her right shoulder... and the other, somewhere across her buttocks. ...... pull up on it while turning her to the left.
e. If she is able... and you may have to do this part----grab their hand and
help them grab the bar (in this case, the bar would be on her left) to help
them turn themselves or at least keep her from turning back the other way.
over once you have turned them.

Of course, if you have 2 people, it is much easier to do this. When you have her start to turn to the left, the other person is to be standing on her left and is to grab that turn sheet from you when you start the turn; they can grab that turn sheet at some point from you.... and hold her over while you position the pillow behind her.... behind that turn sheet... blanket..... pad....whatever.

I hope this helps.
I feel for you. Been doing this for 30 plus years. It is NOT easy.

As someone else suggested, use the adult diapers that are more like "baby diapers" that completely open up on each side and then tape shut.

This will enable you to change her diaper without having to roll her. Most babies are changed while lying on their backs with their knees bent. You can use the same method with a 98-year-old person.

If push comes to shove, buy the Depends-type diaper and cut a slit on both sides from waist to hip. Once you change the diaper, you can tape the slits shut in a few places with packing tape; just overlap the slits a tiny bit so the tape does not touch her skin.

My 95 year old mother with dementia has been on hospice and bedridden for a year and four months. I know your struggles. Changing briefs on an adult is hard to do. I am lost without a turning sheet which allows me to do the brief changes easier and pull her up in the bed. I use a really long one so it lasts longer because they eventually work their way out the end. My mother rolls best to the left and you may find there is a certain side that works best too. Her left knee is frozen but the right one still bends ok. Before rolling I gently bend the right knee up which seems to help. Also I make sure to lay her flat and cross her arms over her chest which is something the CNA showed me. I then grab the sheet at the shoulders and hips and roll her towards me. I have a pillow handy to put behind her back so she will stay in place till I can get back around to the other side. My mother is amazingly strong and pushes back against me so I have had to learn how to hold her with one hand and clean with the other. (She was prescribed a small dose of lorazepam to help her relax more during brief changes and I think it does help.) Very difficult at times especially with a soiled brief. I also have everything ...wipes, creams, etc already within reach. One trick the CNA taught me early on in this process is to layer briefs. I put two briefs down and also insert a large liner. I only fasten one brief though and leave the other laying flat underneath her as to not make her hot. This has really been a timesaver for me. One other thing I have faithfully used is a back brace for support. This really has helped to protect my back from injury, as I already had some back issues anyway. One other thing, not sure if you have problems with this too but when you use the turning sheet or draw sheet as some call it to pull your loved one up in the bed raise the bed up at the foot some, assuming you have a hospital bed. This eases the load tremendously and helps saves your back, etc. Best of luck to you. Someone suggested lifting weights which is a good idea. Our CNA says she goes to the gym for that purpose. You will develop strength over time if you have to turn your loved one everyday...I know I have.

Someone has already posted an air mattress above and that worked when I worked at the bedside successfully. But I wanted to add a video from Youtube. I also wanted to suggest that you reach out to her insurance covered Case Manager and get more help with a team of care givers as well as additional equipment to help. God Bless you and your family. https://youtu.be/cbT18UtpGJQ

I found the pros who know best how to safely move a bed bound patient are the bathers who come. I learned a lot from them.

Try arm lifts with 2-5 lb. weights to help strengthen your arms muscles. Is there a close neighbor, family member, or friend that came come over just to help turn her? Definitely use a draw sheet to help turn her no matter how many people you have to help. Ask the home health nurse about a specialty bed that can be ordered that helps shift under the patient & makes it easier to help turn her. One of the nurses should be able to help you problem solve this issue. Good luck!

As an RN, I will share my tricks - and I have had to take care of super heavy people who are hard to move:

Place a folded sheet that will span the width of her bed and reaches from hips to shoulders.

Place absorbent pads - like large puppy floor pads (cheapest) or bed pads that have plastic in one side - under her bottom area.

She doesn't need adult diapers that pull up like underwear. She will need adult diapers that remind you of baby diapers with tape on the sides.

Changing diaper:
1 - Loosen diaper tabs on both sides. Clean the area in front as best you can. Disposable wipes or warm, wet paper towels work well for this.

2 - I turn my patients by first crossing one leg over the other and the same arm over the body. Then, I stand on the side the hands and feet are on and use the sheet to roll the person onto his/her side. If you don't have a sheet try holding onto hip and shoulder to roll her onto her side.

3 - Move to other side of the bed and loosen diaper from backside, Clean bottom using disposable wipes or more warm, wet paper towels. Try to roll diaper to cover as much "dirt" to avoid more getting onto bottom.

4 - Place new, clean, open diaper along side of butt cheek that is clean. Do all steps 1-2 to roll her onto other side of body.

5 - Finish cleaning skin as needed. Then move clean diaper over this butt cheek. Part legs gently to bring front part between legs.

6 - Roll onto back to secure tapes on sides of diaper.

When a person has diarrhea, my colleagues and I find it easier to not use a diaper and just drape a large towel through the legs and try to allow as much air as possible to the bottom areas. We pad the bed generously with absorbent pads to avoid having to change the bed often.

Imho, isthisrealyreal has posted some great tips. Thank you, isthisrealyreal. Prayers sent to the OP.

One thing I had started doing with Richard was using an inflatable air mattress under his sheet. If you place it so it is only under one side of their body, and inflate slowly using a tank of compressed air or a pump, the filling mattress will slowly tip the person onto their side. Then you change the undergarments, making sure the high side is all properly pulled up and taped, then let the air out, reposition on the other side, repeat.

Ask your hospice nurse how to make a turning sheet. Fold a sheet in half lengthwise. Then depending on the size of the bed fold the long side of the sheet so that about 4 inches hangs over on each side. When you put the sheet under your mother the first time someone will have to help .but after that you can turn her by rollong her with the sheet.

I have some amazing absorbent pads that are washable. I got them online and they hold an amazing amount of urine without getting any on the bedclothes. They are about 3 ft square and plastic on one side. I started using them when I was taking care of an autistic teen who was incontinent overnight. Saved his mattress and sheets. I started using them for Mom when she started having bowel incontinence since they were washable. I also recommend Dude Wipes for wiping her up as they are bigger and stronger. I am 65 and was also able to use a sheet to roll Mom over.

A Hoyer lift with a "Turn Sling" may help your situation. Although I do not have the turn sling yet, that is next on my list. It works the same way as a slide sheet or turn sheet except you connect one side to the bed rain and the other the lift. Then the lift does the work.

This may take longer and not be worth the trouble as you have to disconnect from
the bedrail and lift and then reconnect the opposite sides to the lift and bedrail. (The lift does NOT need to be moved around the bed)

I am blessed as my wife's insurance has approved 56 hours a week of help. Although it is very difficult to fill that many hours with willing help. We do have one aide that comes for 2 hours daily, 7 days a week from about 7 to 9 to help transfer her from her wheelchair to the bed. change her, and clean her up . The other aides all work mornings till early afternoon.

This may not help your situation, but when my dad became bedridden, I couldn’t roll him either. I was lucky and found an aide who was able to do a split shift - she came 2 hours in the morning and two hours in the evening before bedtime. Hospice folks worked with me and came around mid-day....so this schedule worked well. My dad slept most of the day at that point. Wouldn’t know what to do without new immigrants willing to pitch in and help out in the healthcare field. Very grateful!

Yes, I agree. It works best as a two-person job. However, as a family carer for my wife 10 years into Alzheimer's and in bed for the last two years, it can be done by one person. I assume you have a good hospital bed at home. Here in England we have the Dyna-Form Air-Pro Plus bed which has rails. Take down the rail on your side; keep the rail up on the other side; and (hopefully) get the person whose pads need to be changed to hold on to that other rail. It works quite well, with a minimum of anxiety both for the person whose incontinence pads are being changed and for the caregiver. Also, ask nurses and other caregivers for their suggestions.

I hope this works. Life is challenging.

Take care . . . and prayers

You are strong enough to roll her if when you make the bed up you use a sheet folded in half on the top of the sleep sheet and use it to roll your mom. Im almost 70 and I can do it. It's a trick taught to CNA's, Nurses, ect.
You might try pulling it up on line.

My sister could not be rolled because her back would spontaneously break, so she was just layed on washable chux that got changed as needed. They are stronger than the disposable ones and could be pulled up under her behind. If your mom urinates large amounts you could tuck absorbent pads to help catch some of it. This was the best solution that was worked out for my sisters situation. She eventually could not even physically deal with the pain and she had a catheter. It is just a difficult situation that changes day to day.

I am so sorry that you are losing your mom and she is suffering from a painful knee, hopefully hospice is keeping her comfortable. Please use the services they offer for you as well. May God grant you strength and wisdom during this difficult time. Great big warm hug!

The CNA from Hospice SHOULD show you how to roll her and she should have you do it several times so you know what you are doing.
I used a sheet to help me roll my Husband. No pressure on the shoulder or his hips that way.
You can also ask that they get you a Hoyer Lift that way it would be VERY easy to change her as well as the sheets when they need to be changed.
But using a sheet is a very easy way to not just roll someone but to help when you have to change their position. You place an extra sheet on top of the sheet (or just do away with a fitted sheet and just use a "draw sheet") and you gather that up and while you are on one side of the bed you roll the person towards you. It does take practice and it will not be perfect but the object is not perfection it is getting her changed, the sheets changed or her re positioned.
Trust me there were plenty of times when the tab brief I put on my husband looked like a 2 year old could have done better BUT it did the job. My object was to do it without causing injury to either of us.
The more you do it the better you will be and the more you do it the more you will realize you are your own worst critic. No one is going to complain that the brief is not on perfectly, that the tabs are a little off center, that it is a bit higher in back than the front. All that does not matter because in about 2 hours you have to do it all again!

It sounds like either when you need to change her to have someone that is going to be available to help you, meaning they would be on call 24/7 if needed, OR you might have to get someone to come be a "live-in" to care for her hygiene.  I personally don't have any experience with that.  I do know that sometimes the NH have a special pad that they put under the patient that they can grab from the other side to help pull her over but IF you still don't have the strength then you need one of the other options I suggested. hope someone else can offer more advice.  wishing you luck.

The caregivers have told you all they know I assume. You have watched videos? I have to guess that you have all the tricks such as the sheet roll where you pull her toward you using the sheet on the other side of her body, then secure that sheet to the rails; I am assuming you have a hospital bed so that you can raise the bed to a proper height? Pillows between her legs? Is she overweight? This makes me wish I could show you all the tricks I had as a nurse, but you have caregivers and I hope they shared all knowand you are still having trouble. We old nurses have the backs to prove that in the end, almost nothing works, and you are in trouble when there's only one of you.
My first inclination was to tell you that when you have tried everything it has to be recognized that there is nothing you can do but go to placement ultimately. I understand you feel this is not an option with Covid-19 afoot and upsurging again. You may feel "responsible" if she gets it? I can only say that I am assuming you are now in a hospice posture; pneumonia was once known as "the old person's friend" because it took them to final rest after many trials. If hospice is there she will be medicated beyond pain and air hunger, and pneumonia of one kind or other will almost certainly happen. There is even pneumonia caused by bedrest alone.
I am so sorry, and wish there was something I could tell you to help. Please try to use good body mechanics as much as you are able.

Tell your hospice nurse about this problem. They are obligated to instruct you. Generally, bend her right knee keeping the left straight. Stand on her left and reach across her to pull the tug sheet toward you. This will start turning her hips, and the weight of her bent right leg will add momentum. Reverse to do the other direction. When her parttime caregivers are there, tell them you want to help with changing her brief and do it with them. You will get the tricks down.

Have you had an OT assessment? Have you thought about a lift? Otherwise I think having a hospital bed that is accessible on both sides, height adjustable and has rails she can reach to assist you as much as possible is going to help, and slide sheet or pads are absolutely necessary.

(I have to add that even though my mom wasn't that heavy it was all still difficult and I spent time lifting weights to ensure I had the strength needed for her care)