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Organizing  the  Bedroom  for Incontinence  Care

The Supervision Stage of Care

Basics to consider in the early stage

The Taking Charge Stage of Care

The In-Charge Stage of Care

 

THE SUPERVISION STAGE:

It is important to maintain normalcy as much as possible in the beginning stages of this illness.   Their things are important to them and moving them may challenge their sense of who they are and their history.  However, this may be the time to begin considering the changes that will come.   

 

The key is to simplify the environment but at this stage you can still involve them in the decision making.  You don't have to go into great detail about why changes are being made.    In other words, don't focus your explanations on their deficits, instead speak in terms of decorating, sprucing up the room, making life easier for yourself in terms of cleaning, clutter, etc.   The last thing they need is to have their fears of becoming a burden constantly reinforced.  

 

Basics to consider:

Clutter adds to their confusion.   Leave only those items that are necessary for grooming out and clear the tops of dressers, shelves etc., as much as possible without dramatically altering your person's sense of how they want their space.    

Highly patterned wall paper may ultimately add to confusion and disorientation.   Consider painting the room a soft soothing color or re-papering in a more nondescript pattern. 

Organize closets and drawers so that their clothing is easily accessible to them.  

  • Keep only items that are seasonal in the closet and drawers.

  • Organize items (shirts, skirts, dresses, shoes etc.,)   

  • Store other seasonal clothing elsewhere.   

  • Keep choices of what to wear to a minimum.   

Put highly patterned sheets, pillow cases, bedspreads and coverlets away and replace them with solid colors.    As the illness progresses, floral and geometric shapes, wild color combinations on sheets and bedspreads tend to add to confusion.   For example, it becomes difficult for them to distinguish between what is just a print and what is real.   They can mistake that floral print for actual flowers.   Something as simple as that can account for problems when getting them ready for bed during the mid-stage.  This is a rather innocuous change to make at the early stage.

If you don't already have 100% cotton sheets and you can afford to buy them do so now.    Get as high a thread count as you can afford.   The higher the thread count the silkier the fabric, the less wear and tear on the skin.   Do not iron after washing during the late stages of care.   This hardens the surface of the fabric.   I recommend 100% Cotton for the following reasons:  

  • Cotton is a natural fiber that allows the skin to breath  better than polyester or polyester blends.    Contrary to belief, cotton doesn't stain any more than polyester does and for what it is worth, stains are harder to get out of polyester than cotton.   With the advances in finishes you really don't even have to iron cotton anymore, (not that I ever did anyway).   Considering the skin problems that develop during the mid and late stages of this disease, you want to give your person every chance at comfort that is possible.   100% cotton is more comfortable and softer on the skin.

  • Polyester is plastic.   Using polyester/blends is tantamount to wrapping your person in a plastic bag as far as I'm concerned.   No matter how the fiber is crimped, wound, woven or treated chemically to make it more breathable, it is still plastic.   It is cold and clammy on the skin in the winter and it is hot and sticky in humidity and heat.   It can make the skin itch and it can be very abrasive.  To put it in its most graphic terms, and being in danger of offending the entire polyester industry, sleeping in polyester sheets or bed clothes is like going to bed in a knitted polyester suit.   NO THANK YOU!  

  • 100% cotton flannel bedding is best kept for the late stages.   The natural warmth of flannel is important because our people tend to loose body temperature as they loose weight and because the body's ability to self regulate temperature becomes impaired.   In the early and mid-stages however, flannel can be another sort of booby-trap and finding solid colored, unprinted sheets, is a bit of a challenge.  However, if you are planning their use during the late stages of this disease, the print probably won't be a problem.   Also note, pajamas and nightgowns tend to stick to these sheets and your person is liable to become so entangled they either can't move at all or they can fall out of bed trapped in their draperies.

  • The new cotton jersey knit sheets may be the way to go and might be  preferable even to percale, particularly in the late stages of care.  Where jersey is warm in the winter it has the added appeal of also being cooler in summer.   Much like sleeping in a huge tee shirt.  However, knowing the nature of knit fabric, this also tends to stick to bed clothes although they are advertised as being silkier than percale.  The beauty of them is that they stretch on to the mattress and leave a smooth finish without ironing.   Where you want your person to be able to slide out of bed without falling in the mid stages, your want them safe and warm and snug in the late stages.   These knit sheets may provide both.

I also recommend that light weight down/fiber filled  comforters are preferable to blankets.    If your person is allergic to down there are some light weight fiber fill alternatives that serve the same purpose.    These fiber fills are a derivative of polyester, but the loft nature of the padding and the new resiliency now built into these battings make them just as light and airy and resilient as down.   The plus of synthetic fiber filling is that the loft allows air to circulate which allows for breathability whereas woven products made with plastic based yarns do not.    

  • Buy one size larger than your mattress.   If you use a double, buy a queen.   If you use a queen, buy a king.  The reason for this is that you will want to tuck one side under the mattress so that your person can slide out of bed without getting themselves tangled in the covers and fall.   

  • A top sheet really isn't necessary in the mid-stages but wear and tear on the comforter can be, so purchase duvet covers, in 100% cotton.    The duvet takes the place of a sheet which is just another thing to tangle around the legs.   By using a duvet, the comforter and the duvet/sheet function as one unit.   I recommend solid colors for duvets and sheets for mid-stage use.

  • Blankets, and bedspreads, can be used during the Supervision Stage without problems but I believe it is a good idea to make as many changes as you can as early as possible.   The layering of blankets etc., adds weight to your person at night.    This may not seem like an important point, but as their own weight diminishes that weight can be oppressive.   It is important to keep them warm and down/fiber fill is the best way to accomplish this in my opinion.   

Introducing new things at a pace is less invasive that confronting them all at once after a crises has hit.   

 

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