HELP, special incontinence issue Need advice.

markus8174

My beloved wife suffers primarily from urinary incontinence. Although she in in long term care they are having the same problem I often faced at home. Tab closure briefs are great for a "quick change" without the struggle of having to undress and redress completely, but to get the leg openings tight enough to prevent leaks they always cut into some very delicate areas and result in more irritation/excoriation than they prevent. Shallow cuts and subsequent fungal infections are horrible to clear up and make doing a change a battle. Any suggestions for a product that has tab closures, good absorbency but doesn't cut into the groin and thigh? I'd be happy to supply all they could use if I could find a product that worked.

LizG55

Good question, I'd like to hear the answer to that also.

Neverends

Hello  I worked in LTC as a nurse for many years. Problem I saw where I worked  was not getting changed enough. Cleaning her after every change plus protective  cream is a must. I understand  the snug fitting  brief. Maybe a female pad added with the brief might help. Fungal infections seem to be rampant in nursing  homes. If your LO's  brief  is staying  wet for long periods,problems will start. Redness,fungal infections and skin breakdowns.  Bottom line is she needs changed more often, urine cleaned from skin with wipes and cream applied religiously.  Hope that helps.

markus8174

Neverends wrote:

Hello  I worked in LTC as a nurse for many years. Problem I saw where I worked  was not getting changed enough. Cleaning her after every change plus protective  cream is a must. I understand  the snug fitting  brief. Maybe a female pad added with the brief might help. Fungal infections seem to be rampant in nursing  homes. If your LO's  brief  is staying  wet for long periods,problems will start. Redness,fungal infections and skin breakdowns.  Bottom line is she needs changed more often, urine cleaned from skin with wipes and cream applied religiously.  Hope that helps

neverends , I wish it would help but I'm worried about complaining about anything to the staff at the nursing home. Last time I expressed some concerns they tried to punitively discharge my beloved to one of the poorest rated facilities they could find.  On every visit I have to strip her bed and clean the mattress because she was incontinent at some point and the sheets & mattress are stained with old, completely dried urine. I don't think they are doing the care she should have but I have another family member in a nursing home that makes this one look like a luxury resort. That is why I was asking about a more effective incontinence product. If I supply it, it may help my DW without complaining to/about staff. I'm afraid of retaliation if I make any complaint about her care.

Neverends

I totally understand  the retaliation part but it is their job to care  for her although they don't want to hear that. They need to  be held accountable. I know its easier said than done. I'm not aware of any other incontinence products but I know other people  on this site do. If you bring in your own incontinence product just be aware that  some staff have a bad habit of  taking  things  for other residents.  I've seen them take clothes,razors,toiletries you name it unless  the person is with it enough to notice these things going on and stop them. Lock things  up that are valuable. It's disheartening  to say the least. I'm so sorry  this is happening.  I hope things turn around for your LO.

Marie58

markus8174 wrote:

 

neverends , I wish it would help but I'm worried about complaining about anything to the staff at the nursing home. Last time I expressed some concerns they tried to punitively discharge my beloved to one of the poorest rated facilities they could find.  On every visit I have to strip her bed and clean the mattress because she was incontinent at some point and the sheets & mattress are stained with old, completely dried urine. I don't think they are doing the care she should have but I have another family member in a nursing home that makes this one look like a luxury resort. That is why I was asking about a more effective incontinence product. If I supply it, it may help my DW without complaining to/about staff. I'm afraid of retaliation if I make any complaint about her care.

markus, I don't know the answer for you on this, but this is unacceptable. I'd be in the director's office in a heartbeat. Sorry you and your DW are going through this. Maybe someone else will have ideas for you as this is just plain wrong!!

Neverends

Markus 8417, Go right to the top and complain. I understand  your concerns but we are talking about basic care. Your wife is breaking down because she is not being changed  period. The urine stained sheets? Nightshift staff will change their residents right before first shift comes in, many times these residents  have been in that urine soaked  brief for.hours. If the sheet is wet here come the  bed pads to cover it up.  I worked for a five star veterans nursing  home. It was absolutely  beautiful but they had the same issues. The families that come in and  were vocal about their loved ones are the ones who got listened to. I could go on and on. Bottom line It's Their Job.  Sending strength your way.

Neverends

I meant 8174. So sorry

loveskitties

If you live in the US, each state has an agency which oversees such facilities.  You need to document your concerns/complaints to them.  That will do 2 things...get someone to check the facility and also should offer protection on retaliation.

Is there no other option available for her care?  Another facility?  More daily oversight by paid care giver, family or friends?  The more visible you are the more service she might get.

[Deleted User]

The user and all related content has been deleted.

markus8174

Thanks for the welcome back all.

This has been a chorus of "They are bad and must be told to do better!" responses. Perhaps I wasn't clear. The administration of this facility tried to discharge my beloved against my will when I insisted she have her own clothes and glasses on. We(I) do her laundry so lack of labeling wasn't a problem. Much of the stuff was labeled- with other people's names!

I won't make any significant complaint to anyone. I can't be there 24/7 and my beloved cannot defend herself. Someone in staff, most likely here, stole thousands of dollars of my wife's possessions that I couldn't come in and secure due to Covid restrictions. The medical director has made sure she is blackballed for admission to any other decent facility in the state.  The place is already short-staffed and I don't want them to lose any more bedside caregivers or they will have to use extensive agency help. Agency staff have a place, but they are not known to be the most cost-effective care or to provide the most "above expectations" care long term. I doubt they would use agency much anyway. They would just make the current staff do twice the work- not a good outcome for my DW since I can't move her.

All this is why I was hoping to find some solution I can provide. One of the staff let it slip that my DW was complaining of peri-area pain/inflammation when they tried to clean for a urine specimen. If it wasn't for that I wouldn't know there ever was a problem. Their "quarterly updates" are nothing more than a 10 minute phone conference telling me what a great job they are doing. Her caregivers don't even participate in the conferences.  If they use my provided incontinence products on other patients, I'll live with that and just bring in more. What else can I do? Her care is beyond me at home and I cannot get her into any other place. I have to find a way to facilitate her care there if I want her to get better care.

As to bed changes, it is 2 hours away from my home. No visiting with meals and traffic to get there is a nightmare. I have taken the trouble of bringing home a few of their bed pads and bottom sheets so I can launder them and bring them back without the staff knowing.  I'm afraid of asking for clean linen for fear a caregiver will know I had to change the bed. If I visit every other day, at least one day out of 2 her bed will be clean. I just can't be there to change her incontinence wear 24/7. When I have asked for help with this from the staff I've gotten heavy sighs, stomped sullen action, and wordless aggressive intervention for my beloved-WHILE I'M SITTING THERE! What are they going to be like when I'm not there if I annoy them?

Even if I didn't get a solution for better incontinence protection, I can hear and feel your support and I appreciate it. It's just like asking for directions to the highway and having someone tell you the recipe for great fudge brownies. Both useful information, but not equally effective in solving the immediate problem. Still, thanks for the recipe- they sound great!

Twin Mom

We use... Medline FitRight Disposable Underwear for Men and Women in the Brief version which are excellent.  Have never had any breakdown...and I don't change during the night which is usually about a 10 hour night.   I use these for our son who is a quadraplegic and has significant skin issues due to the use of steroids...so thin skin etc.  Of course he doesn't move so I don't know how the leak protection is. I would think the underwear version would be just as good.  They have been excellent for us...they really do breathe.  I also use Medline Ultrasorb pads for the bed which have no plastic in them so everything "breathes" and he is on a low air loss mattress.

Hope this helps.

Ed1937

Markus, do you have an attorney you could talk to about this? That seems to me to be a good first step because they will make a record of the potential problem, then if there is any retaliation against you/her, it should be a problem that will be handled in short order. Just my opinion, but she needs proper care. I'm sorry you feel you are in such a tight spot.

markus8174

Ed1937 wrote:

Markus, do you have an attorney you could talk to about this? That seems to me to be a good first step because they will make a record of the potential problem, then if there is any retaliation against you/her, it should be a problem that will be handled in short order. Just my opinion, but she needs proper care. I'm sorry you feel you are in such a tight spot.

Ed,

I plan to give what concerns I have had to the owner(one of them) who has been very personable and accommodating in our interactions, once my beloved is no longer using the facilities. Unfortunately, because she is black balled from any move to a different facility, I want to keep the staff happy, and on my side as much as possible. Even if I wanted to move her elsewhere for only convenience sake, that is no longer possible. The attempt to punitively discharge her didn't come from a nursing assistant, it had to have gone through management at a fairly high level. I know for a fact, at least the Director of Nursing, the Social Service Director, and the Charge Nurse for her floor were involved. "Discharged due to behaviors unmanageable by our facility" is a very real possibility. There isn't "nowhere" that would accept her. There is just no decent place that will consider her admission. There will always be snake pits that can't fill their beds without taking patients no one else will consider.  I have to accept the fact that I cannot be there 24/7 to ensure her safety and must depend on their caregivers to provide for her needs as well as they are willing to do. Having the facility angry and resentful towards me and my spouse is not going to facilitate that care. In all honesty there are some very good staff there that have been very responsive to my beloved's needs. The fact that there others who do only a marginal job at best, and have few scruples about their interaction with residents(as evidenced by thousands of dollars of missing jewelry), only means I have to put out an extra effort to ensure my DW is a beloved resident that never gives them much trouble. Contacting an attorney to harass the nursing home would not serve that goal. I just want better diapers.

markus8174

Neverends wrote:

Markus 8417, Go right to the top and complain. I understand  your concerns but we are talking about basic care. Your wife is breaking down because she is not being changed  period. The urine stained sheets? Nightshift staff will change their residents right before first shift comes in, many times these residents  have been in that urine soaked  brief for.hours. If the sheet is wet here come the  bed pads to cover it up.  I worked for a five star veterans nursing  home. It was absolutely  beautiful but they had the same issues. The families that come in and  were vocal about their loved ones are the ones who got listened to. I could go on and on. Bottom line It's Their Job.  Sending strength your way.

Neverends, 

The nursing home won't use overnight incontinence wear. The say it is against regulations and must depend on a single bed pad to provide for overnight incontinence. Of course, the urine soaks into the mattress, and the comforters & sheets I provide to make the room more home-like. I strip the bed, wash off the mattress, and exchange her personal bedding almost every visit. I'll need to buy a few more comforters soon. They run about $100., but they aren't made to be laundered 2-3 times a month. I have four I rotate and a back-up one that doesn't fit the decor if I get behind. As I have said, I have no other options but this place for her care. I cannot p-ss them off or my DW will pay for my actions. I just want a better diaper.

Neverends

I'm sorry if I upset you, it was not my intent. I'm not knowledgeable  about better incontinent products.  I know other people on this forum  have listed websites  where you can purchase a better  product.

markus8174

Neverends

I'm not upset with you or anyone on this forum. I was just trying to vehemently express how my back is against the wall in this. I have to be the solution if there is going to be one. Nothing good will come of insisting the staff do their jobs more to my satisfaction. Any outrage you heard was an echo of all the posters when care of our loved ones is not done properly. 

Ed1937

Markus, if you're looking for a "step up" from what they are probably using, follow the link I'll provide. This link goes directly to the best I've found for my wife, although people are different, so if you want, you can order samples. They usually come two to a pack, and the price just rose to $2.99. If I were you, I'd try several different products to see which one works best for you. The site also has a lot of information on different things, including incontinence. You can also call them to speak with someone who is knowledgeable about their products. I think the company is top notch. https://www.parentgiving.com/shop/dry-direct-ultimate-protective-underwear-9310/p/  Samples usually take 7 - 10 days for delivery, but when you make an order for other than samples, they are exceptionally quick.

markus8174

Twin Mom

Thanks for the tip about Medline FitRight. I haven't seen much about that brand before, but a web search shows it to be way less expensive than most.  I'll give them a try when I can find some in the right size. The couple places I've looked have been out of stock.

Buggsroo

Markus, 

Just a suggestion here. When my dad was in a home, my mom still had to provide clothing and such for him. She decided to buy his clothing and bedding from the Sally Ann or Value Village, because it all got washed in an industrial setting, so anything that didn’t wear like iron gave up the ghost pretty quick. Also my father was past caring what he wore or used. 

Now with my husband, I do the same because he always needs fresh sheets etc. I also buy him second hand clothing for the same reason. After all you aren’t made of money, and you can afford better incontinent products. 

This is also good because, yes the staff are paid such low wages they resort to stealing. 

Good luck.

Twin Mom

The Medline Ultrasorbs  will last all night without using any brief.  If we have a risk of skin issues we don't use the briefs at all and just use the Ultrasorbs....I have never had one leak through....and you could use 2 if you wanted to.  They totally breathe...they are about $2 each or a little more but worth every penny...they are also great for using while positioning.

extex

I’d like to know that answer also.