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Family Caregiver – Part 7 – Toileting the Wheelchair Patient at Home

My husband uses a catheter only on car trips, not at home. He is usually continent, in general. I keep an attentive ear to his call and I hope to lead him where he needs to be to answer the call of nature.

* A urinal is kept next to the bed on its nightstand for use during the night. He sometimes feels confident enough to use the urinal himself without waking me up. It’s good when it works. Lately he’s been using the urinal, putting it back on his nightstand without my help, then a few hours later trying to use it again when it still has urine from the previous use. You can guess what’s going on… I started placing reusable bedspreads on the floor against the bed and draping them over the side of the bed to catch accidental spills. You can never have too many bed pillows.

* I considered having him use an external catheter at bedtime. I know of a family where the husband uses a Texan catheter at night. This man is apparently not as restless as my husband. I’m afraid the way my husband tosses and turns with Parkinson’s, he’s wrapped in the tube and the collection bag is useless. So the urinal is our only choice for now. And some reusable pads on the bed. You might get lucky with the catheter or the absorbent underwear. My husband won’t wear the underwear at all.

* A urinal is in the bathroom when it can’t stand up to the toilet. One in the basement for when he’s working around the workshop, one by the kitchen table for sudden cravings that don’t make it to the bathroom. A urinal is stored in the basket of his scooter, kept safe in a discreet cloth bag. With a box of tissues packed alongside.

* Pop-up tissue boxes are everywhere to use with the urinal or to wipe the nose.

* A box of disposable latex gloves is kept in the washroom for use as needed.

* Adapting clothes helps with dressing and grooming. Try to keep the male patient in pants that are loose around the waist and hips and have a long zipper fly. Try to eliminate underwear. I changed the zipper on his pants to be extra long, extending to the crotch seam. Zippers can be added to the legs to go over the suspenders. Zippers can open a tight neckline. Velcro can be used instead of zippers. A seamstress may be able to repair/adapt garments for ease of dressing and operation. My experience is with a male patient. I can’t imagine how a woman comfortably copes with incontinence.

* To protect the wheelchair seat from wetting accidents, small absorbent seat cushions, such as a miniature bed cushion, can be used. In the absence of special pads, a layer of folded hand towels will help.

* A reusable, waterproof pad and a pad with handles can be useful to protect bedding from wetting accidents and to move the patient around the bed. If the bed cushion has handles, it is easier to grab the handles than to grab a handful of fabric to reposition the patient. A bed cushion with handles can also be used to protect a recliner and help position the patient.

* If using a bed cushion to reposition the patient, to pull them towards the head of the bed, remember that when you pull the bed cushion up, the bedding is now exposed without protection. You will want to have a second absorbent bed pad in place under the pad which will be used for repositioning so that when it is pulled towards the head of the bed there will still be protection under the patient. I use a total of 5 bed cushions in different positions on the bed, including the one with handles. Plus the one I laid on the floor.

* My husband uses a men’s split front toilet seat. This helps him position himself so he can use the toilet properly. When he sits for a while, I put a pillow or two behind him because this type of seat doesn’t have a cover to lean on. I make sure the pillows are “old” in case they get soiled or fall in the toilet.

* There are grab bars around the perimeter of the bathroom. When I wheel his wheelchair into the bathroom, he can grab the bars along the wall to help him get up and go to the bathroom. I stand behind and help him up by holding him under my arms until he is standing, or as close to standing as he can get. I then step to one side and pull the wheelchair out of the bathroom so that it is behind me, then, getting back in place behind it, I can help it to go to the bathroom or to get up if he’s willing to try. On days when he’s not as strong, he’ll use the urinal while sitting in the wheelchair, or I’ll use the walking belt to transfer him to the toilet.

* Sturdy grab bars have been installed on either side of the toilet for him to hold on to when standing on the toilet or lowering and rising from the toilet. They work very well. We had them professionally installed during other modification work. They are nearly 2″ in diameter, stick out of the wall on both sides of the toilet and swing out when not needed. VERY handy when I have to climb around it to get into the bathroom, like to do its the morning dishes. I roll him first, then I have to move to be in front of him. I have to squeeze between the sink and his wheelchair. To do this, the grab bars have to be raised to allow me to de Once I’m in front of the wheelchair, if he decides to use the toilet, I step aside as best I can and lower the bars. My husband says our bathroom is the size of a postage stamp It’s a little bigger than that, but not much – 6′ x 8′ We also had the bathroom door frame enlarged, so his wheelchair could fit through the opening.

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