How to deal with adult nappy changing - bed bound

I am new to the forum and need advice. Sorry, but I don’t know a nice way to put this question so will try and spare too many details. I have been caring for my mother (now 85) who has been bed bound for over 2 years and I have been coping quite well with the personal care up until recently. She now pees throughout the change and I don’t know how to handle this as I am trying to clean and dry her and apply the barrier cream but as she is peeing throughout and I don’t know how effective any of this is. Should I carry on as normal or is there a better way of doing it? Thanks for any advice offered.

Hi ER1, welcome to the forum, it a hard one to workout. Ring the doctors and ask for a home visit for your mum, explain the situation. It could be a simple water infection or bladder issues. They should be able to help. Do the doctors know she is bed bound? If not tell them as there could be more to the problem.

Hi @ER1 and welcome.

My husband has continence problems which probably stem from Prostate Cancer. This morning was the first day I have not had to change the bed in months, so I can partly empathise. It is humiliating for him and he gets quite upset. I am sure it is the same and probably even worse for your Mum so you have my deepest sympathy.

I would echo Michael’s comment about calling the GP. They can get the District Nurse involved who should refer to the Bladder and Bowel Team to get you help. They should be checking for UTIs and what is causing the continence problems as it may be possible to medicate to help prevent some of the urgent need. They are the experts so they will be best to advise.

Please don’t be embarrassed at discussing things like this - most of us have experience of it and worse (like poonamis!!!) You will find we have no qualms about discussing topics which many find distasteful or embarrassing as - to us - it’s simply another Fact of Life of Caring.

Please let us know how you get one and ask as many questions as you want and think we can help with. Almost certainly someone will have “been there” and still have the t-shirt :rofl:

:people_hugging: :people_hugging: to you.

When did mum last have a Needs Assessment, and you, a Carers Assessment?
It’s OK to as for help, that’s not an admission of defeat but awareness of mum’s increasing needs.
You are not getting any younger either! It’s so important to look after your own health too.
hen did you last have a proper holiday?

Thanks for the replies, mum is in her last stage of dementia and she is well known to the GP, nurses, social services, bladder and bowel, palliative care etc, etc. She does not have any infections and is regularly checked and this is purely down to complete loss of control. The only thing she is able to do is eat and drink at one end and let it all come out at the other end. Nothing going on in between. She lost control years ago but we were able to sneak in a change between one pee and another but its just gone past that point now. So now it’s just a case of getting it done as best as we can. I had a long break recently. She is fairly easy to care for as she isn’t doing anything and just lies there and to be honest it was much harder through the other dementia stages. The only thing that is becoming a pain is trying to get her changed before she pees in the middle of the cleaning and barrier creaming.


Thanks for the additional info.

As GP and the rest of the Health Care Team know Mum, I think your best course of action is to get more help from them - do you have any help in your Caring role? Clearly if you managed to get a break, there was some provision, so perhaps it’s time to expand that to get you more help and fill in the gaps and difficulties you are experiencing.

If Nurses are aware of the difficulties you are experiencing with cleaning etc they should be able to guide and provide the additional support you need, before it becomes even more of a problem for you.

You seem to be holding things together very well, but it can so easily become overwhelming so don’t be backward at asking for more support.


Hi @ER1
Welcome to the forum…gosh you’ve been through the wringer over the last few years. BIG empathy and hugs.
My dad had vascular dementia with a load of other issues including bladder cancer so peeing blood, and incontinence became bad in the last 6mths-year of his life.
Given what you’re already doing it sounds like you’ve probably found the approach that works best for you and your mother to change her safely, and when its easiest or best for her.

I asked the hospice at home nurses for tips, they had a few I used. They’re probably different tips between changing a man and a woman though…
I used to pre-prepare the new ‘nappy’ with barrier cream on the seams and a bit on the sides - as these were the worse places to ‘rub’
I’d hold the old, unfastened pad in place whilst wiping around, slowly rolling to one side to dislodge it from the back, on both sides and then replacing old pad with a flannel…some people put a towel or low pillow under the person to raise their hips for easier changing. Dad was quite light and with his arthritis rolling was better.
It wasn’t often that he peed into the flannel but on occasion, sometimes, it was more poop - which was why I always had large bed pads under him…he didn’t like the feel of those, even thro PJs so I’d layer sheets with pads…the ultimate incontinence lasagne…The bigger poonamis happened in the last months PJ bottoms, pad and ‘nappy’, in those instances I’d roll the under-large-pad towards him bed edge in…before undoing anything…or the whole under layer of sheet and pad made it easier…and in one case safer, to remove it in one go and have dad on a new pad first.
If I remember right I think I had the back of the new pad-pre-creamed lying on the new pad which was vertically semi-rolled so when I rolled dad towards me, I held him, …then unrolled the other side of the pad with the new pad, and rolled him back onto his back, removing the flannel once I’d threaded the new pad up between his legs…removed flannel and fastened the sides, then pulled up the PJ bottoms…

Graphic details & not sure I explained that well… I hope this isn’t TMI for you, but there’s very few videos and advice on the in between movements…people just say change them, not realising how tricking moving, rolling, safety


Thank you so much @Victoria_1806, this is really helpful and some very good tips which I will definitely give a go today.

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You’re welcome @ER1
I know how little tips and tricks can help a lot…just be careful of your lower back and go slow for her and yourself…by the time we were in that place I was numb to mess and hypersensitive to our safety.
Much easier if there is 2 of you doing it but I managed on my own