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Buttwiping 101 and Other Lessons


srademacher

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I thought all caregivers knew and understood the importance of keeping the skin clean and free of sores, scrapes, scratches, etc., but apparently it's not as important to some as to others. I have had to repeatedly remind the caregiver to make sure Gary gets wiped clean after having a BM on her shift. There is nothing worse than putting him to bed at night and smelling leftover mess in that area and then trying to clean it after it's dried and fermented all day while he sat in it. I had to give a lesson in buttwiping 101 again this week. I am tired of hearing "I wiped him good" and then finding leftover mess hours later - it's not acceptable when I am paying $22/hr. for his care. It's time for another lesson this week, and this time I will ask to check the cellphone at the door, as I fear she is afraid it will fall out of her pocket if she bends over too far to wipe him properly.

 

Another lesson I learned this week while shopping at Walmart, is that here in AZ you can't take a short-cut through the Depends aisle as the wheelchairs and walkers are lined up worse than the pre-boarding lines for a Southwest Airlines flight heading to Phoenix. And, look out if someone has a cane - DO NOT get in their way! :)

 

After Gary's incident in WA, I decided it was time to get on the ball and get a new DNR for AZ, since the Colorado one is not valid here and we've been here over two years already (wow, times flies when you're having fun)! I downloaded the form from the AZ website, copied it onto orange paper (as stated to make it a "legal" document), and got all the signatures except for the Dr. I called on Friday and they said the physician's assistant who did his last two physicals wouldn't be in the Scottsdale office until Tues. of this week, so I stopped by and dropped it off at the office that morning before heading to my 90 min. massage. I checked back later and she hadn't signed it yet, so I had to wait until the next morning to pick it up. Gary now has a legal DNR hanging on the refrigerator in case something should happen at home. He is determined that he will never go through another trip to hospital, tubes, machines, and all that he went through after the massive stroke in 2004 if he has to continue to live like this, and I have to respect his wishes.

 

We got an email this week from another stroke buddy's wife - Dennis had his stroke a year before Gary and we met him and his wife after I spent a night in ICU with chest pains while Gary was in rehab. All the stress had thrown my body out of whack and it ended up being a thyroid problem, but they were running all the heart tests because of the stress I was experiencing at the time. I was given their number by one of the nurses in the ICU, who told me we had similar situations and I should contact her for support. Dennis had a massive brainstem stroke in 2003 and has pretty much been homebound since that first couple of years, as she found it too difficult to travel or go anywhere with him. He was recently diagnosed with blood cancer, so they've taken him off all meds and have hospice coming in now. He is about a year older than Gary - but has been through 11 years of Hell since his stroke, not to mention the toll it has taken on his wife. She will keep me updated on his condition.

 

We only have about 1.5 weeks before we head out to San Diego for a beach weekend. I'm hoping it all goes smoothly as Gary's caregiver will be going with us to help with driving and his care.........but I think I'll be doing the buttwiping! lol

 

 

Sarah

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LOL.  Butt Wiping 101.  I hear you loud and clear.  One thing I do that helps keep that area clean and helps make the cleaning easier....I bought a sitz bath pan from the drug store.  It fits perfectly on the toilet bowl with the seat up.  I fill it with warm water and have mom sit on this after her bm. When mom was using the bed side commode at the hospital I asked for an extra bowl and did the same thing. The nurses were impressed. :-) This might be considered Butt Wiping Advance Class but it can make the wiping a lot easier.

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Sarah: boy, I hear you. And the few times Bruce has had to have a hospital stay or procedure, you can be sure I tell the admitting nurse "His skin is intact. It better still be that way when I pick him up." I keep gloves and wipes for the caregivers, of course. But I am a washcloth and soap girl. I am always on the alert for washcloths on sale and about twice a week, I do the good hot water machine wash with bleach. Just growing up pre-disposable diapers - not that Mom and Dad could have afforded them anyway - and six younger sibs - LOL.

 

Good news on the DNR. I have to update Bruce's Lifeline for the same reason. One of those things that is the most important, but something I just keep putting off. I am so sorry for your friends. I do pray they find peace and comfort.

 

Pix will be needed from San Diego! Have a wonderful time and I am hoping you have some time for yourself. Debbie

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I wipe Bob with tp till he seems clean (I flush every couple of wipes), then I use a wet wipe,  until those look clean.   Usually 1, but I have had 3  - fold in half, wipe, fold again, wipe x 3 cloths.   THEN I wipe with dry again, which finishes any wet wipe leftovers - never miss the end dry tp.  

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Buttwiping 101!  Leave it to Sarah to tell it like it is.  lol  As a caregiver, I have learned and done many things I never dreamed of having to do.  This board and friends on here, like my nurse friend Debbie, have walked me through many health issues with Larry.  

 

Larry is somewhat embarrassed when our home helper has to help him at certain times.  One product I use is the Assurance Premium Washcloths from Walmart. They are not flushable, so I use toilet paper in addition if I have to.  I keep disposable gloves in the bathrooms also.

 

Julie

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Hygiene is always important but is doubly so when dealing with people who are ill and unable to care for themselves. Flushable wet wipes are very useful. You can buy them on Amazon. Keeping a patient clean helps prevent infection plus it makes them and everyone around them feel better.

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I want to mention that the reason I start with dry toilet paper (tp) is because it's like dirt, if you add water to it, you have mud!   I get as much off as the paper will take (flushing every 2 wipes) and THEN use the wet one for any dried on the skin.    Then, that will just liquefy anything there, so I follow with dry to make sure it is absorbed by the dry tp, and not left behind.   Try wiping mud or dog doodoo off your shoe, only using wet, and you'll find it just keeps smearing around - dry finishes the job (and starts it).

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From time to time, these blogs contain references to DNR (do not rescuscitate) directives. Allow me to share something about those advanced orders that I learned back when my mother was quite ill. We were wisely advised to be sure my mother's DNR was very specific because otherwise hospital caregivers might not follow it for fear of misinterpreting. So if the patient is fine with somewhat mild efforts to save and/or sustain life but doesn't want extraordinary measures such as a ventilator or chest compressions, the DNR should make that clear. Usually folks who issue DNRs are merely trying to avoid being kept alive artificially while in great pain. But not all life-sustaining measures extend to that level. Also, if the patient has someone he or she trusts fully, a medical power of attorney is a good idea. That way, if the patient is not able to make decisions about care, the person with the power of attorney can do so. Finally, it is a very good idea to discuss the specifics of all of this with the physician and then be sure the directive and power of attorney are attached to the patient's record. In my mom's case, I had power of attorney and she was no longer conscious and I was trying to decide if her DNR needed changes as her condition grew steadily worse. I asked the doctor what lifesaving measures he would advise against. He suggested only one--chest compressions. He said that chest compressions, which are performed in an effort to restart the heart, would be more than my mother could bear at her age (90 and frail) and that they would crush her bones. So I amended the DNR to say "no chest compressions". I assume none of this is news to most of the people who read these blogs but I thought it was worth mentioning just in case.

Ron

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Only let the caregiver take butwiping 101 class twice. If they fail after that get rid of them as they are not worth the effort to teach a 3rd time. Just from my experience the really good ones don't even need to be shown this as they are suppose to be the professional! Hugs and Love to you guys and I hope your friend finds peace through these hard times she is going through.

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