When I was in school learning to be an occupational therapist no one mentioned that part of my job would require helping people in the bathroom. By helping I mean hands-on wiping butt, applying cream, changing diapers, and more. In my young, innocent mind everybody did that for themselves. Incontinence was a vague concept that I did not understand and was happy to remain ignorant about. Many caregivers have had this same awakening.
My Awakening
Then the unavoidable happened. I HAD to get involved. No one else was around. Compassion took over. My reluctance went out the window and I became a bathroom therapist. As a mother of four kids I had my share of experience with potty training so I was pretty sure these were issues I could manage with adults too. I’ve come up with a few pearls of wisdom worthy of sharing with reluctant caregivers.
- 1. Always wear protection.
- Disposable protection products are game changers for your social life and laundry pile. Bring extra products with you wherever you go. Ladies are used to that from menstruation but guys usually need teaching about that. Always is a favorite brand of many women. Buy in bulk at a warehouse store for maximum savings.
- 2. Layer the protection
- Layer protection especially if you’ll be out for a few hours. Wear a “pull up” undergarment PLUS a liner inside. The liner can be easily disposed of and replaced. Always have extra products handy. There’s a men’s product on the market called the Quick Change Wrap (athome.medline.com)which wraps around the penis so it’s easy to get on and off. No such luck for ladies.
- 3. Get up and go frequently
- If you have urge or stress incontinence, get to the toilet every two hours whether it’s needed or not. Don’t rely on sensations to cue you to go because sensation may be diminished. You probably find yourself rushing to the toilet with not enough time to get there.
- Avoid rushing to the bathroom which is a recipe for a fall. Getting to the bathroom every two hours helps people to mobilize more frequently and prevent accidents. Set a timer as a reminder, if needed.
- 4. Bidets are game changers. Look into bidets at bidets.com. In my experience they are an ordinary and well accepted part of life in other parts of the world such as Asia, Europe and Mexico.
- In Bali, every bathroom, public or private has a “bum gun” which is a water sprayer available next to the every toilet. It’s not the same thing as a bidet but is a convenient way to clean up. Those countries have older plumbing than the US and do not allow toilet paper to be flushed away.
5. Many folks have “short arm syndrome” meaning they can’t reach their behind properly for wiping. Whatever the reason is for that, a bidet will help with that problem. Check out the Tushy bidet at hellotushy.com. There are many, many others with wide ranging price points and features but Tushy has a fun video on their website to entertain you. There’s also a portable bidet on the market called “Clear Rear” which is worth knowing about.
6. Special Advice for Men
- Guys…if you pee while standing up make sure your stream gets to its’ proper destination. Some men have an enlarged prostate and are no longer “straight shooters”. Try standing at the toilet while holding a urinal in place, then dump it right in when you’re done.
6a. About Urinals
Guys….if you are enlarged down there find yourself a urinal with a wide opening. Or customize one by enlarging the opening of a thin plastic urinal to create a wider opening for your junk. Be sure to leave the handle intact. Tape over the rough cut edges. See the photos below for more info.
Guys…if you’re on a diuretic you might need to have more than one urinal handy especially overnight. Find a sturdy plastic container to store them in so they won’t spill.
- 7. If your balance is off
- If your balance is off, or you can’t stand steadily for very long, pull your pants up and over your knees before standing up. Keep your knees apart so the pants won’t fall down. If the pants always fall down get some claw clips (like what the dentist uses for bibs) to clip the pants to your shirt. That way the pants won’t hit the floor unexpectedly while standing.
- 8. Never Let Go Jack
- If you can’t stand without holding onto something, plan ahead and pre-pull several sections of toilet paper before standing so you can keep one hand on a steadying surface, like a grab bar, at all times. Tuck your shirt or dress into it’s neckline before standing so you can see what’s going on down there. Having TP ready in advance means you can wipe with one hand and steady yourself with the other hand. Always hold onto a steadying surface with one hand.
- 9. Simplify
- Choose simple clothing styles such as pants with elastic waistbands. The more fasteners to handle the longer and more complicated the toileting routine becomes. Avoid fasteners likes belts, buckles, zippers and buttons to simplify things. All those fasteners usually require two hands to manage.
- If someone is continent but has pain or obesity or a fracture I often give them permission to go “commando” and eliminate underwear, for simplification. A belt looped through a pain of jeans is heavy and more likely to end up on the floor that a pair of pajama pants, or shorts
10. Unfortunately…
…in my experience, toileting trouble is the tipping point that often determines if a caregiver can manage at home or if the person goes to assisted living or a nursing home.