Bowel and Bladder
For some people, the prospect of either giving or receiving assistance with toileting can be a source of embarrassment. A matter-of-fact approach is best. If the patient is able to get to the bathroom, consider whether the environment is helpful:
- Are there grip rails by the toilet to help return to a standing position?
- Is the toilet paper within easy reach?
- Is the toilet too low? If it is, you may be able to find a special toilet seat used to raise the level of the toilet. The seat fits onto the regular seat and can be bought at a store that sells medical aids and devices
- Is the floor in the bathroom dry?
- Is there enough light and a clear path to the bathroom?
- will they need someone to accompany them, and for part or all of the event
If the patient is unable to move to the bathroom, there are many other toileting options, including:
Commodes. These are essentially chairs on wheels with a hole cut through the centre of the seat. A collecting pan is attached to the chair and can be removed for regular emptying. Commodes can also be placed over a toilet.
Bedpans. These are plastic or metal pans that are placed under the patient’s body while the patient is in bed. Bedpans come in several different sizes. Many people find it difficult to release their bowels or bladder while lying in bed, so patients should be given lots of time to use a bedpan. Lifting the person’s head slightly with pillows or inclining the bed may help the person feel more comfortable using a bedpan.
Collection Bottles (also called urinals). These are small bottles that men can use to collect urine.
Catheters. These are tubes that health care professionals will insert into the bladder through the urethra. The tubes are attached to a drainage bag, which is strapped to the leg, or hung on the side of the bed. Washing hands before and after handling the catheter and related equipment is essential to help prevent infection. The patient’s genital area should be cleaned twice a day and the catheter itself, which exits the body and attaches to the collection bag, should be cleaned at least once a day with soap and water. The collection bag should be emptied every day and cleaned with a vinegar-water solution.
Adult diapers. These can be purchased from a health supply store. Diapers should be replaced as soon as they are wet or soiled to avoid skin breakdown and risk for bed sores. The patient’s genital area should be cleaned using soap and water, working from front to back, after a diaper is used.
Some patients may leak small amounts of urine between regular visits to the bathroom. This is called incontinence. Remedies include absorbent pads for bed linen, menstrual pads attached to undergarments, adult diapers, or, for men only, external (no tube inside the body) condom catheters. Condom catheters are latex sheaths, which are placed over the penis. The sheath has a tube, which is connected to a drainage bag. The bag can be attached to the leg if the patient is mobile or can attach to the bed if the patient is unable to move around. Condom catheters can be used occasionally to provide freedom on outings or they can be used as a regular option. Once again, absorbent pads are used to soak up urine or feces, and should be replaced as soon as they are wet or soiled.
