Toileting in the night in care homes, a query

[gondrinkin]

Hi

Just wondering if anyone knows what happens to residents who are immobile (like my mum) if they need the loo in the night in a care home? She is at home with my dad at the moment and often wakes several times a night needing a wee, she can't get out of bed/move unassisted, so he has to get up too. She does suffer with UTIs but also just seems to need to wee a lot (and always has).

Thanks

I’m assuming she is still continent? In hospital we would offer a bedpan. In most care homes the options would be either full hoist onto a commode or to the persuade her to use an incontinence pad.

I know of some care homes where they would hoist onto a commode, as the resident is still continent. And others where they really really wouldn’t. Sorry that’s unhelpful.

Just to add my Dad is 90 and is beginning to struggle with everything regarding caring for my mum, despite her having a care package already. I was looking around care homes just before coronavirus took off but I didn't think to ask about stuff like this.

Sorry - I assumed from your OP you meant your mum was a hoist transfer. Having reread I see that can’t be the case if your dad assists her currently.

How does mum transfer?

Yes it depends how she transfers. As pp poster stated she would probably be encouraged to wear a pad at night but if she's still continent then she should be encouraged to use the toilet still. Would be transferred either with 1 or 2 staff into a commode or nearest toilet.

The night staff will hoist onto a coode or help to use the onsuit toilet. 9In the care home where I worked. It kept the night staff very busy.

If she can transfer with a bit of help a commode beside the bed might suit. What social work contact do they have? - this is something an Occupational Therapist would be able to advice on. In an ideal world they would visit but even over the phone advise could be given.

My mom is in sheltered/assisted living. It's not proper residential care. She cannot walk without assistance. She had a pendant to press day or night if she needs assistance to the toilet.

Thanks Coffee

She does wear pads at night (and in the daytime too) as I think she does have some continence issues, but generally she has control. We have gently tried to discuss her wetting herself (for want of a better term) but she can't bring herself to do it. My Dad is exhausted and we know this can't continue, sometimes it is 3 or 4 times a night.

My mum was in a carehome for 6 years. She was mobile. Soon after she went into the home they informed us she was now incontinent so would be wearing pads.
On several occasions I went into her room when she was still in bed when I removed her quilt to get her up she had double pads on. It wasn't long before she had sores on her backside. Everytime we asked they couldn't tell us who had put 2 pads on her at night.
It was no surprise to find her during the day sitting with a puddle of urine at her feet. They hardly ever took their residents to the toilet. When I went in it was the first thing I would do. Staff were more than happy for families to take them to the toilet, they were a bunch of lazy arseholes.

Ah, thanks for replying everyone. It is reassuring to see that she will get help, I guess I am worrying about random stuff like this as there is not much to be done at this time. Her mobility is very poor but she can just about manage to get to the loo with my dad and a zimmer. She broke her hip at the end February and we were all amazed that she managed to become weight bearing again as she has been in a very frail state for some time now.

They will take her to the toilet or pop her on the commode. If she's incontinent though, they may just change her.

Sorry to hear that Parkhead, I hadn't seen you reply.

OP would she be able to press the call button if she needs a wee (and with time for the carers to come to her?).

If so then they`ll use a commode by the bed/ her ensuite toilet. Or use a bedpan.

I work in a care home as an activity coordinator. I have been shocked that nearly all residents wear pads. Maybe I am naive, but I know a few elderly people, all of them mobile, my mum being one of them and they have no issues. I do sometimes whether it is easier for staff if they wear pads. If your mum has to get up a few times a night, depending on staffing ratios I would not be surprised if she is in pads before you know it.

@crimsonlake
I was shocked too when my mum went in and the next thing she was wearing pads.

@beentothecoastalready

That's a good point about the call button, I'm not sure she'd have the wherewithal to press the call button (or the ability to even reach for it unless it was pretty much in her hand already). She has advanced parkinsons and the associated dementia is really beginning to show this year (especially since the latest fall).

The call button will be around her neck basically and will you be looking at a care home or a nursing home?
Depending on the stage of dementia I know nursing homes seem to have set times they change everyone's pads, for instance after lunch.
Truth be told I have been working in lounges and some resident's are yelling out to have their pads changed or go to the toilet, but as the carer's are busy elsewhere they are left.

Gondrinkin, meant to add considering your dm's condition it is a nursing home you need to be looking at and not a care home.

If there are concerns she wouldn't press a button she would be given a sensor mat beside the bed so if she got up someone would come and help.

I misunderstood and thought initially you were thinking about helping you dad at home but are you considering a permanent or respite move to care? It is incredibly hard to trust others with your precious parent but they have a lot of experience dealing with these things and may have solutions you wouldn't think of.

Thanks all for your thought replies.

It's useful to know she could have a call button around her neck. I did the visits to the homes with my sister who was brilliant and she came armed with lists of questions, but there are details like this that you just wouldn't think to ask of without the experience.

Regarding pressure sensors I don't think my mum can really move her legs at all if that makes sense. My dad has to sort of position her feet on the ground and then he has to heave her to a standing position, she then sort of shuffles along with someone's help. God knows how he manages most of this alone.

*thoughtful replies

She would also generally get checked hourly so if she was lying awaking 'needing' someone would be with her relatively quickly.