How to Change a Bedridden Patient's Adult Diapers

If you are caring for a loved one at home who is bedridden and incontinent, you may find yourself tasked with having to change adult diapers. Changing diapers properly is important as it helps keep the skin clean and free from infection and perianal/perineal dermatitis (a.k.a., diaper rash).

Prolonged exposure to urine and feces can be damaging to the skin, causing tissue breakdown and promoting the formation of decubitus ulcers (bedsores). Beyond keeping the skin clean and infection-free, a properly fitted adult diaper helps minimize abrasion that contributes to the onset of these difficult-to-treat sores.

Changing an adult diaper for the first time may seem awkward and intimidating, but there are steps that can make the process easier for you and your loved one.

What You Will Need

If you are the one responsible for changing a loved one's diapers, it is a good idea to store all of the needed supplies near the bed so that you are not scrambling for things when there is an accident. These include:

• Disposable medical gloves
• A clean adult diaper
• A plastic grocery bag (which you can collect every time you're at the grocery store)
• Pre-moistened wipes, such as baby wipes or wet wipes (or, alternatively, a skin cleanser with disposable cloths)
• Skin protection barrier cream

Make sure these supplies are dedicated to diaper changing only. It is important, for example, not to share barrier cream. Moreover, if you store all of your supplies in one place, you are less likely to accidentally run out of wipes or skin cream.

Step-by-Step Instructions

In order to maintain the integrity of the skin, you need to change the adult diapers as soon they are soiled. Every effort should be made to check the diapers regularly. It helps to recruit other family members to do so when you are out shopping or doing chores and to teach them how to change diapers if they are capable of doing so.

Changing adult diapers can be done by a single individual, but it makes it much easier if there is someone to assist you (particularly if the loved one is large or you are small). With that said, it usually only takes a little practice to do so yourself.

To change an adult diaper:

1. Wash your hands thoroughly with soap and warm water.
2. Put on a pair of medical gloves.
3. Place your loved one comfortably on their back if they are not already.
4. If the bed is adjustable, raise the entire bed to a comfortable height, slightly lower than your hips. Lower the head as far down to horizontal as your loved one can tolerate.
5. Unfasten the tabs on the soiled diaper, tucking the side farthest from you under their hip.
6. With one hand on the hip and the other on the shoulder, roll your loved one away from you onto their side.
7. If you tucked the diaper far enough under the hip, you should be able to pull the diaper out from under them.
8. Roll the soiled diaper inward as you remove it to contain any mess.
9. Place the soiled diaper into a plastic grocery bag (but do not seal the bag quite yet).
10. Using the moistened wipes, thoroughly clean the diaper area, both the front and the back. Avoid pressing or rubbing the skin too hard. You may need to roll your loved one onto their back or side to clean the areas you cannot reach.
11. Place the used wipes in the grocery bag.
12. With your loved still on their side, check for bedsores. It is important to do so daily and to treat them appropriately when early sign develops.
13. Apply barrier cream to the perineum to moisturize and protect the skin.
14. When your loved one's skin is dry, open a fresh diaper, and tuck the side farthest from you under the hip. Flatten and position the rest of the diaper on the bed, smoothing the sheets underneath as well.
15. Roll your loved one back toward you onto the diaper.
16. Pull the diaper between their legs.
17. Remove any wrinkles and fasten the tabs. For a snug fit, stick the top tabs facing downward and the bottom tabs facing upward.
18. Remove the disposable gloves and place them in the grocery bag. Knot the opening and discard.
19. Wash and dry your hands thoroughly.
20. Return bed to the desired height and position.

Before leaving, check that your loved one is properly positioned in bed. This includes moving them regularly so that pressure is not placed on a hip or other part of the body for too long.