American Medical Association Family Medical Guide - American Medical Association [140]
Using a Commode
If the person is able to get out of bed for brief periods, using a bedside commode may be easiest. Assist the person out of bed and onto the commode. If necessary, help the person wipe himself or herself, and then help him or her back into bed. Empty the removable pan into the toilet. Rinse the pan out, clean it thoroughly with a household disinfectant diluted with water, and return it to the commode.
Using a Bedpan
A person who is confined to bed will need to use a bedpan, which can be awkward. In addition to giving the person privacy, be sure to give him or her plenty of time. A person who is embarrassed about using a bedpan or who feels pressured while using one may be reluctant to ask for it when he or she needs it. Resisting the urge to have a bowel movement can lead to constipation and fecal impaction. Remember to ask the person frequently if he or she needs to use the bedpan—and keep it within easy reach and in the same place so it can be found quickly when needed.
Before giving the person a bedpan, sprinkle a small amount of body powder on the rim of the bedpan to make it easier to slip under the buttocks. The open end of the bedpan should always be toward the person’s feet. Keep toilet paper and moist towelettes within easy reach and help the person with cleanup if necessary. After use, empty the contents of the bedpan into a toilet and rinse and wash the bedpan with a household disinfectant diluted with water.
A person who cannot lift himself or herself up may be able to use a bedpan with assistance. If possible, have someone help you. Lift the person’s hips while the other caregiver places the bedpan beneath the person’s buttocks. If another caregiver is not available, roll the immobile person away from you onto his or her side. Gently position the bedpan against his or her buttocks and press the bedpan firmly into the mattress while rolling the person back on top of it. To remove the bedpan without spilling its contents, hold it firmly in place and gently roll the person away from you, and off the bedpan. Thoroughly clean and dry the genital and anal areas.
Using a Handheld Urinal
Always keep a handheld urinal in the same place and within the man’s easy reach. Have him put the urinal in a large bowl or bucket to prevent and contain spills until you can empty it. Empty the urinal into a toilet after each use, rinse the urinal, and wash it thoroughly with a household disinfectant diluted with water.
Monitoring Symptoms
As a person’s main caregiver, you are in the best position to observe any changes in his or her condition that may indicate an improvement or decline in health. What you need to watch for depends on the person’s illness or injury. In general, it is important to closely watch his or her alertness, memory, mobility, vision, hearing, emotions, sleep patterns, eating habits, personal interactions, and sensory responses such as touch. Even small, seemingly insignificant changes can indicate a serious underlying health problem and should be reported to the doctor or nurse as soon as possible. Common signs to watch for include:
• Changes in breathing patterns, including shallow breathing, hyperventilation (abnormally deep, rapid, or prolonged breathing), raspy breathing, gurgling noises in the throat, temporary cessation of breathing (including during sleep), difficulty breathing, or wheezing
• Changes in mobility such as limping, problems maintaining balance, restricted use of arms or legs, or paralysis
• Tremors, shaking, facial tics, twitching, drooping eyelids or mouth, or facial paralysis
• Unusual sneezing or coughing
• Discharge, such as through a bandage; a bloody nose or leaking eye; or pus oozing from an open sore
• Fever, chills, or sweating
• Insomnia (difficulty