How do I manage toileting when someone can no longer get out of bed?
Toileting in bed can be managed with continence aids, equipment, careful skin care and help from the care team.
Toileting in bed can be managed with continence aids, equipment, careful skin care and help from the care team. You do not have to work it out alone.
Ask the palliative care team, nurse, GP, aged care staff or community service what equipment and support are available. The safest plan depends on the person's strength, pain, awareness, continence, skin, home setup and who is helping.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Options that may help
Depending on the situation, the team may suggest:
- continence pads or pull-up pants
- absorbent bed pads
- a commode beside the bed
- a bedpan or urinal bottle
- a catheter
- barrier cream to protect skin
- gloves, wipes and rubbish bags
- a hospital bed or slide sheet to make care easier.
Some equipment can be loaned or arranged through community palliative care, hospital services, aged care services, disability services or private suppliers.
Keep dignity central
Tell the person what you are doing before you start. Use a towel or sheet for privacy. Keep the room warm enough. Work slowly and explain each step, even if the person cannot answer.
If they are embarrassed, reassure them in plain words: "This is care. We will keep you clean and comfortable." Avoid making jokes unless you know that is what they would want.
Watch for discomfort
Toileting problems can cause agitation. A full bladder, constipation, diarrhoea, skin soreness or a blocked catheter can make a dying person restless or distressed.
Tell the care team if the person has lower belly swelling, pain, no urine with discomfort, repeated diarrhoea, hard stool, bleeding, fever, or sudden agitation.
If moving hurts
Do not keep forcing movement if it causes pain. Ask the team to show you how to turn the person, use a slide sheet, time care after pain medicine if appropriate, or reduce how often full changes are needed.
Sometimes comfort is more important than a perfect toileting routine. The team can help balance cleanliness, skin care, pain and rest.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff if toileting care is unsafe, you cannot manage physically, the person has pain, agitation, lower belly swelling, constipation, diarrhoea, bleeding, skin breakdown or a blocked catheter.
Call 000 if there is sudden severe illness or another life-threatening emergency and no end-of-life plan telling you what to do.
You may also want to read
- Why does someone who is dying become incontinent?
- How do I change sheets when someone cannot get out of bed?
- How often should I turn someone who is dying in bed?
- What equipment can I get to help care for someone dying at home?