Proper techniques for changing adult incontinence products are essential for maintaining the dignity, comfort, and health of the individual receiving care. Ensuring hygiene prevents skin breakdown, which can lead to complications like pressure ulcers and dermatitis. Mastering this procedure is a foundational skill for caregivers, ensuring the process is efficient and minimizes discomfort. This guide provides practical, step-by-step instructions for changing an adult diaper, whether the person is bedridden or mobile.
Essential Supplies and Preparation
Preparation increases efficiency and minimizes the time the individual spends exposed or uncomfortable. Before starting, gather all necessary supplies and place them within immediate reach.
The required items include:
- A clean, appropriately sized incontinence product.
- Disposable gloves.
- Adult-sized cleansing wipes or a no-rinse perineal cleanser with washcloths.
- A skin barrier cream or ointment.
- A disposal bag or container.
Ensure the care environment offers privacy and adequate lighting. If using a bed, raise it to a comfortable working height for the caregiver to prevent back strain. Place a disposable underpad (Chux pad) beneath the person to protect the bedding from contamination.
Step-by-Step Guide for Bedridden Individuals
The safest and most common method for changing a bedridden person involves a systematic side-lying or rolling technique. After donning disposable gloves, unfasten the tabs of the soiled product and gently fold the front panel inward to contain waste. Tuck the side of the soiled diaper farthest from the caregiver under the person’s hip.
Gently roll the individual away from the caregiver, using the hip and shoulder as guidance points to prevent twisting the spine. This movement exposes the soiled area, allowing the caregiver to pull the tucked diaper and roll it inward, containing the waste as it is removed.
Thoroughly cleanse the entire area using a front-to-back motion, which is important for females to prevent the transfer of bacteria toward the urinary tract. Carefully clean all skin folds and gently pat the skin dry, as residual moisture contributes to skin breakdown. While the individual is still on their side, perform a skin check for any signs of redness or irritation.
Place a clean, folded incontinence product beneath the person, with the tabs positioned at the back. Gently roll the individual back onto the clean product and onto their back. Pull the front panel through the legs. Secure the tabs, angling the bottom tabs slightly upward to cup the buttocks and the top tabs downward for a snug fit at the waist.
Technique for Mobile or Standing Individuals
For individuals who can stand or provide significant assistance, the process can be accomplished while they are upright, which is generally faster and promotes independence. The person should lean against a stable surface, such as a grab bar or walker, for support.
If a pull-up style product is used, the sides are torn open, and the product is slid down the legs. If a tab-style brief is worn, the tabs are unfastened while the person is standing.
The caregiver pulls the soiled product down and away. Cleaning should be performed quickly and thoroughly while the person is standing, using cleansing wipes and ensuring all areas are dry before the new product is applied. A new pull-up style product is then slid up the legs, or a tab-style brief is applied by passing the rear panel between the legs and securing the tabs.
Skin Health and Safe Disposal
Following the change, attention must turn to skin protection and proper sanitation. Apply a thin layer of a zinc oxide or petroleum-based skin barrier cream to the perineal area and buttocks, especially if redness or irritation is present. This cream creates a protective, water-repellent film over the skin, guarding it against the corrosive effects of urine and feces, which helps prevent incontinence-associated dermatitis.
Inspect the skin during every change for early signs of pressure sores, which may appear as persistent redness or discoloration on bony prominences like the tailbone or hips.
For safe disposal, roll the soiled product, used wipes, and disposable gloves tightly. Secure the bundle with the product’s tabs, if possible, and place it into a dedicated, sealed plastic bag or container to manage odor and prevent contamination. Finally, remove the disposable gloves and wash hands thoroughly with soap and water.