Wash support (bottom region)

All about caring
1

I have a client who has a severe intellectual disability ,is elderly, is obese (Lymphedema, cellulitis, lipodema) and has bad arthritis. she can put on clothes on, walk around (with difficulty but fine around the flat), make basic sandwiches, make tea, operate the shower, she needs support with putting cream on legs, stockings, and putting a pad on (although sometimes she does this herself). Amongst the more obvious: cooking, cleaning, medication , personal safety etc.

The problem I am having is supporting her with washing, she can have a shower herself, but she finds washing her bottom difficult, so I support her with this…

she is obese so a lot of poo gets deeply lodged in the bottom and it’s quite difficult to get in there to clean

It’s apparent she doesn’t wipe her bottom at all (I am not sure if it’s because she doesn’t know to do it, can’t physically do it, or doesn’t care).

She only wants me to use her special flannel she uses for the rest of her body (she’s very stubborn, won’t even let me launder it) and afterwards it’s covered in poo and she then takes it off me, rinses it and then proceeds to use it to clean the rest of her, I try to tell her not to, it’s dirty etc, but she shouts and gets mad, even violent.

I have minimised this by only supporting her after she’s done most of the cleaning she can do… but sometimes she’ll still use it again (even on her face).

I’m not really sure what the best thing to clean her with is… even if I she agreed to me using something else. I do try sort of ‘jet washing’ her with the shower down there first, but because it’s so deep, it doesnt work unless you pull apart her buttcheeks and spray , and often the water bounces back and sometimes has hits me in the eyes, I already wear so much PPE (gloves, sleeves, apron, shoe covers).

It’s a pretty unpleasant job for me and for her, and I would like to make it easier and safer, for us both.

I wonder if there is equipment available that could help …maybe a special wiping contraption for her to use after toiletting or maybe a special cleaning contraption for me that would make it easier… maybe a portable bday or something.

Anyone got any tips or advice?

2

There are wiping devices but I have no idea if they work. Here at the Complete Care Shop (I have no connection to them) under Toileting Aids there is a bottom wiper.

It might be too much bother for her to use.

3

Not recommending but may give you some ideas. How about a long handle sponged shower/bath brush.

should you not speak with your agency for best way forward.

4

Hi Panda, I have read your post and am thinking …

Melly1

5

Have you ever heard of the DLF (disability living foundation) or not? They can offer advice and stock lots of disability aids and equipment as well. If you need further information/help/advice, call their helpline on 0300 999 0004.

https://www.dlf.org.uk/content/our-services

You can find a full list of information/fact sheets here https://www.dlf.org.uk/content/full-list-factsheets

6

My wife’s carers insisted right from the start that two face flannels were necessary, (one dark coloured and one light coloured for easy identification) the dark one is only used for the nether regions.

I can see that your client won’t like the idea, so you either persuade her or just let her get on with it.

I’m not suggesting by any means that it’s a good idea to be smearing remnants of faecal matter around your body, but at the same time we do get a bit precious about hygiene in the 21st century. I’m sure mine was pretty poor at times sixty plus years ago (although not with poo) and I’m still here and as healthy as anyone my age.

7

On the odd occasion when my 93 year old mother had had an "accident " resulting in her needing to be thoroughly cleaned down below I used to get her to sit on the toilet (lots of towels down to protect the floor ) and then proceed to wash her. (She was not able to get into the shower cubicle because of her frailty).

To clean her I used a soft wash sponge rather than a flannel. I soaked the sponge with lots of water from the bathroom sink and it was then fairly easy to get between her buttocks and also her front area. Saying that my mum isn’t obese so not sure if this would work with your patient. But a sponge is certainly easier than a flannel and much softer to use on those nether regions.

Perhaps you could get some baby wipes to wipe away the excess/place them in a happy sack before you got down to the nitty gritty of the actual procedure of washing.
…
I know it must be very difficult (and unpleasant) for you. I wonder if you could somehow use the wipes without her actually noticing them or if she does tell her that they are ‘extra special’ wipes and that you even use them on yourself and find them very soft and nice to use!!!

It’s like I tell my mum,who is in a nursing home and refuses to wear one of their beige horrible looking ‘bibs’ , that in five star hotels the waiter comes and places a lovely white napkin tucked into a person’s neckline to protect their clothing. As I’m saying all this I make a show of placing the napkin in situ and mum laughs and goes along with it all. (The napkin is actually a soft paper towel and I’ve even got the staff doing this for her now!!!) A form of flattery goes a long way!!!.

Anyway good luck. Let us know how you go on.

On a lighter note it also sounds as though you could do with a pair of goggles when carrying out all this spraying! :grinning:

Joan x

8

I found the Tena 3 in 1 wet wipes to be large, strong and useful. Weldrick’s Pharmacy used to have the best prices and our carers liked them.

The carers also recommended Lidls baby wet wipes, but they were smaller as I recall.

9

Yes Rosemary,

I’d forgotten about those Tena wipes, they are much better then the baby wipes!

Joan x

10

Has she got a bath? if she has then she could sit in that for a while and it would soften the poo then she could just shower her bottom. It sounds very unpleasant for you.

11

Glad I jogged your memory then! Carers were so impressed they told other clients too. Good for cleaning, refreshing/‘rinsing’ and left skin soft and moisturized too, smelled ok too. Sort of texturized too and thick enough for the job! Just don’t allow anyone to flush them down the loo!

Prices really do vary a lot for the very same package so please do shop around. I think the link given previously is still excellent value. Usually I found one did the whole job without grabbing a whole bunch of the smaller baby wipes.

Btw, there aren’t many places to discuss bottom cleaning online. Thanks, Carers UK!!!

12

I worked in a silc school we had an amazing toilet the seat would heat up you pushed a button and jets of water would wash down below then would air dry it was really good and we had a few large pupils who used it don’t know if they would fit one in someone’s home though

13

Yes, search for ‘Japanese style toilet’ - probably expensive though, and installation needs electricity.