Do I need overnight care for mom?

Yes you do my dear especially if you work during the day. Your work and family life will suffer if you have to wake up every now and then to check on her .There is this lady that I used for my mother .if you ant to consider it. Her contact 5403948257.Good luck with your mom

I would used the barrier lotions to help keep liquid from skin. Then use the diapers with an added incontinence pad (they are wider at the back side where liquid is going to go if she lays on her back).

You can also cut the fluids off early in the evening before putting her to bed, just like you do for kids.

Is it possible mom was put into a diaper to make it easier for the nursing home? Pretty common to do that. Just wondered if she is able to move around at all. Perhaps a bed side toilet and incontinence pads if she can do this for herself.

For my mother, we have been using mostly Always Discreet Incontinence briefs, MAX strength, but at night staff adds a pad, generally used the WM Incontinence Pads for Women, Maximum, Long (the only deviation was during the time when everything was OUT OF STOCK - took what we could get!)

In general, these work. Initially when mom moved to MC, she was mobile, able to do most self-care, including toileting. The accidents she had were usually because she couldn't get her pants off fast enough. We decided eventually to take all undies and replace them with briefs. The pads came a bit later (she's 97, finishing up year 4 at MC.)

More recently they've asked me to bring in more of the pads, as she wants to change the briefs if she just dribbled a little into it during the day. I'd been buying/delivering the disposable bed pads, but they asked me to get the reusable ones.

That said, I see in your profile that one of your mother's conditions listed are UTIs. There have been times, usually when mom gets a UTI, that she will SOAK the bed at night - sheets, night garments, everything! They prep and toilet her before bed. One month there were charges for FOURTEEN extra loads of laundry. Even between UTIs, there have been 2-4 or more extra charges/month for laundry. These are charges IN ADDITION to the regular TWO loads/week included in the monthly fee. She's no longer mobile, but not bed-bound. She spends the day in a wheelchair (only about 1 year now) and is either on a schedule for toileting or she asks. It's not like she's rolling in the mud, therefore needing extra laundry done. The first UTI/bed wetting happened BEFORE she was using a wheelchair (rollator only then.)

Unless another product(s) suggested by others can handle 9 hours overnight (9-6), or you can try to change her once/night, be prepared to be doing a lot of extra laundry. I wish you all the best, but it isn't something I would take on! Even though I took early retirement after lay-off, and haven't been working, I still wouldn't take on such a huge challenge! My mother isn't even NH yet - just MC. She weighs too much for me to assist, never mind lift, can't do stairs to get in/out, can't handicap my bathrooms, so it was a no go. She's in a VERY nice place, staff is great and she is better cared for there than I could ever think of doing!

Working full time, even with someone watching over/caring for her 7 hr/day, is going to be difficult, as there will be interruptions, unplanned for. Others have pointed out the parts of the iceberg that might lurk under the surface already, so I'm not going to repeat it, but if it all works out for you, great. Better you than me!

Unless your mother is totally incontinent, it isn't likely she needs changing every 2 hours, but changing and checking are not the same. Checking maybe means checking her briefs, changing them if needed, changing her position, making sure all is well. Do they do this in the NH? Who knows. Unless you are there overnight (they could change their routine if they are aware someone is watching!) how would you know? I should think every resident should have a check multiple times/night - it might be cursory, but at least sensible. Anything can happen, so it's best they do check on everyone several times/night.

Elderly skin is quite thin and fragile. Prolonged moisture against the skin leads to skin breakdown. Thus the need for frequent checks/changes of either diapers or under-pads. Normal urine (contrary to popular belief) is essentially bacteria free. But broken skin provides an opening for any kind of harmful bacteria to enter and cause infection.

The quilted absorbent under-pad definitely (if that is the question) not "illegal" (used in Colorado). In fact, research shows this is safer than diapers that hold urine next to the skin. Of course, the oftener checks are made during the night, the better. PLASTIC lined under-pad definitely NOT as safe, since they do not allow moisture to evaporate.

In my experience of nursing homes, I would say it's very unlikely they are changing her every two hours. These places are short on staff, constantly have staff quitting and starting, and the overnight staff are not very well supervised.

Susiq is correct. A suprapubic catheter is much safer than a regular urinary catheter, but it requires a surgical (small) incision which must be done by the physician. It requires regular simple cleansing where the tube enters the bladder. A regular urinary catheter can be inserted, or reinserted, by a nurse, but is an absolute invitation to infection, never recommended for long-term use!

The nursing home is absolutely correct. There will be a high risk, near certainty, of eventual skin issues without a regular check. There is no diaper that will substitute for it. But ask the question and you'll get misinformation all over the place like bladders can hold urine for 8 hrs, so and so gramma slept in urine and had no skin problems, 2 hrs is extreme (it isn't), limit fluids (worst idea ever), etc. We're talking old people here. Get a grip. Prevention is far easier than treatment.

Don't know if this is a complete solution to your problem, but some nursing homes do not use diapers at night, but simply a large absorbent quilted under-pad that may need to be changed perhaps once during the night. If urine is not in prolonged close contact with the skin (as with a diaper), problems with skin breakdown are less likely. Limit evening fluid intake. Toilet just before bedtime. No need to check every 2 hrs. Just check and/ or change, if wet, once midway through the night. Wash and dry skin thoroughly if wet and place a new under-pad.
I would suggest avoiding thin under-pads with a plastic lining, as they are not very absorbent and the plastic can hold moisture next to the skin.

I thought I saw something new on tv (commercial) for incontinent females, It was like an insertion item that absorbed/vacuumed urine into a container.

Imho, although every two hours seems to be bordering on the extreme, perhaps once during the night is more along the norm.

Most bladders can hold urine for 8+ hours - the amount of time most people sleep. If mom can move herself in her bed, you do not need to check her every 2 hours to turn her in her bed. Try a super absorbent diaper at bedtime and check her before you go to bed. Change her in the morning. My Gram used diapers and always soaked them overnight, but she had excellent skin care regimen so she never had breakdown.

Change her before she goes to bed and change her when she gets up in the morning. You may have to change her during the day also. Once you have cleaned her with cleansing wipes, you can treat any area with liquid resistant salve or if it looks like a rash might be developing you can treat it with A&D rash treatment cream. I've been changing my wife for 8 years and it has worked out just fine. I don't have overnight help.

I had a urinary catheter inserted for my mother. I was having to get up several times a night and it was literally driving me to a nervous breakdown due to lack of sleep. Laundry and changing sheets was a daily chore.

This has been a life saver! Home health comes out once a month to put in a new catheter and we use an overnight bag all the time (verses a leg bag) and I only have to empty it once when she gets up and again b4 bed.

Seriously consider this!

Mom has had good luck with the TENA Overnight Extra Absorbency brand. Yes, they are soaked through when Mom finally gets up each morning but, oddly enough, the wetness is not next to her skin and has all soaked through to the gel or whatever is in place in the undergarment to absorb the urine. Mom (90) says they are comfortable. They are more expensive, but worth it as far as I'm concerned.

During the daytime, I have her in Tranquility brand with the orange crotch that is in place to be extra absorbent.

Mom always applies a barrier cream each time she goes to the bathroom (after she cleans herself with disposable cleansing wipes). There is an absorbent cloth pad under her fitted sheet on her bed and a soft, disposable pad on top of the fitted sheet.

So far, she has had no skin issues (knock on wood!)

Hope this info helps.

My mom broke her back and had to spend a great deal of time in bed for a few weeks. She was used to sleeping long hours through the nite but would get up to void herself as needed. We were warned to change her position and brief (which she ended up wearing) to avoid skin breakdown and sores. We opted to use heavier briefs and a waterproof pad under her to allow her to sleep more. Thought it’d make dealing with back pain better if she was more rested... Turned out to be a bad choice! She developed skin breakdown and several sores. Although small, they were incredibly painful. Wound care people became involved-it was a mess. We healed her sores and got help to reposition her and change her briefs regularly. It was a painful learning experience for Mom especially, but for us as well. This is our story, I hope yours is much better! Good luck.

so after reading everyones answers and I guess some helped you and some didn't.  So I am going to provide another answer.  IF you are not sure of the answers given here........take some time and google about adult diapers and what are rated the "top notch" for wetness retention so that you and your mother can sleep the full 9 to 6 each and every day.  And if you have a good support system, maybe you can all come up with a routine schedule where you take turns getting up every 2 hours IF you can't find a great adult diaper product.  wishing you luck in this big adventure.  I hope no one hurt your feelings and none were intended I am sure.

In my experience, Poise pads are better than any overnight "pull-ups" I've used. Which I believe were the Walmart overnight absorbency; cheap. I think just trial and error; process of elimination. Good luck.

I doubt very seriously anyone at any facility would be changing your mom during the night.

Im sure your can get night time pullups or thicker diapers for Adults just like ones for children.

I doubt your mom wants to be woke up during the night anymore than you do.

Besudes the overnight diapers. Always use a thick babycream to help her not get a diaper rash.

You can also set up a Baby Monitor or a Nest Camera where you can check on her at any time 24 7 by using your computer or cell phone.

You're fortunate she sleeps thru the night unlike my 96 yr old Dad who won'ts a snack at 2 or 4 AM

Not sure of the whole situation, but I would assume it would be just like a baby in some ways.  Even if she sleeps thru the night, you could still change/clean her.  I am not sure if NH check all their residents every 2 hours for that but maybe there is something out there (desitin) to be used on her skin to help seal out water (even vasoline) that way you wouldn't need to change as often.  So if you hire an aide to change her every 2 hours and she is sleeping, you can do it also, with the help with above mentioned items.  wishing you luck.

For Five years my mom was changed each night before bed. Then first thing in the morning. I used Sam’s club depends with one Sam’s club pad inside. Mom’s crack on her bottom was coated each evening/ morning with Desitin. I bought the adult wipes from Sam’s club and used these to keep her bottom area clean and wiped down prior to using the Desitin, I also reapplied the Desitin when ever she used the bathroom or once she was bed ridden when I changed her. Every few days I applied the Desitin under mom’s breast and if needed in leg joint or anywhere else I thought might need it.

I borrowed a hospital bed from the Lion’s Club and I purchased a pressure mattress.
From Amazon I purchased washable bed pads, One was placed under the Sheet and one on top. I also purchased disposable pads to have as back up. Most nights mom did not leak. I used a washable pad on moms recliner and later on the wheelchair.

I never had to roll or reposition mom, mom never got bed sores. Desitin was my mom’s best friend along with the alternating air pressure pan. Later on when mom was having trouble standing I was able to get a Hoyer lift. This became my favorite device and my mom loved it. I used the split leg harness sometimes and other times a short full harness I purchased from Amazon. Mom was in a seated position in these harnesses vs the V position. I was able to move her. easily from bed to recliner or wheelchair very easily. We never used overnight care. I used a small camera that if I woke in the night I could check on mom easily.

Make sure mom is kept clean down there and use barrier cream. Try and get and alternating air bed pad for your mom to sleep on. Get her out of bed during the day. Wishing you the best. Get help for a few hours each week to give yourself a break, if mom is not ok the be left alone. My mom passed away at home in August.

Now my dad 97 needs a little help here and there bad knees. He is incontinent sometimes but not always. He keeps a urinal near him. He uses the Desitin also. More places on him for protection day and night. Mostly he coats himself. On bad days I do, we joke about greasing him down. Dad’s of sound mind which makes it easy. He is able to still live on his own. We live across the street. I go over a few times daily and always at night to make sure he is safe on stair lift transfers, because of his bad knees.

I wish you the best ask your doctor what durable medical equipment you may qualify for through medicare. If the nursing home has physical therapy they can possibly order a wheelchair if needed before she leaves. If you are in the US check with the Lion’s or Rotary club to see if they have a lending program. My mom had her hospital bed for 5 years from the Lion’s club.

The answer to your question is “YES.” You should be following these instructions as an older persons skin becomes very thin and prone to infection. It’s best to be overly cautious so that any issues don’t develop and you keep things under control.
You seem very defensive when some responders offer you constructive advice. Removing someone from skilled nursing is a major undertaking and will require You to provide full time, around the clock care.

I cannot see why she would need to be changed at all during the night. If she goes just before bed and you put a Maxi (8 drop) incontinence pad on, then it will last till morning. There cannot be anything more disruptive than having to get up and change someone during the night. It will shorten your life and destroy your sleep pattern. That's what we do with my 94 year old heavily incontinent mom and it works fine. I don't know if 8 drop is available in America. Take a look on Amazon. I found these there
TENA Intimates Overnight Absorbency Incontinence/Bladder Control Pad with Lie Down Protection.
Oh and I meant to add also that you will need to put down incontinence mats on the bed just in case of leakage. I seldom have a problem.

I would change my Husband before he went to bed and I would change him at least 2 times during the night. Actually once was before I went to bed then the other was about 3 am.
You can get mattresses that are alternating pressure mattresses that reduce the need to change position as often but she should be repositioned fairly often (every 2 hours is standard)

Changing her every morning is obvious but bathing her every morning is not necessary and can sometimes lead to skin issues as well. Cleaning the areas that become soiled, wet is important but a bath or shower is not necessary.

You might want to contact Hospice and see if she would qualify for Hospice services. You would have a Nurse that would come see her weekly and a CNA that would come in 2 maybe 3 times a week to bathe her, order supplies and help you out for an hour or two. you would also get the proper equipment that you will need. A good Hospital bed, a Sit to Stand or Hoyer Lift if either are needed, or you will get them when they are necessary.

You should also start looking for caregivers, either an agency or if you are going to hire privately. Even if you do not need one over night having someone come in a few hours during the day several days a week can be a lifesaver (and sanity saver)

I posted on LoopyLoo's answer up above. She mentioned a lot of things I'm dealing with, in trying to take care of my wife at home. But in reading all of the answers I can see that no one answered your question. So I hope this helps. I use "always discreet underwear" overnight maximum on my wife. I buy them thru Amazon. I also put 2 "certainty under pads" down on the bed, one half way over the other. Then I put a heavy pliant plastic barrier cross ways over those and top that with 2 more pads. Otherwise I'm up to my ears in laundry. Even though the diaper manufacturers say they don't leak. Some do. You can get these items at Walgreens.

As to the incontinence, you might consider the Pure Wick system.   It has one end that you place between her legs, and it draws urine away.   They used it at the hospital the last time my mom was there.  It will cut down on pads getting overwhelmed

Every 2 hours sounds excessive but maybe once or twice would be helpful and keep her from having issues. Many people have issues with adult diapers, etc. not really doing the job and having accidents in bed. Waterproof sheets, chux, etc.

Good luck.

Keep your mom dry by applying a barrier cream such as Cavilon. It can be purchased at Walmart.

I think it might be instructive for the OP to spend 48 continuous hours in the NH to see what her mom's care needs are. And if she sleeps through the night. And what her level of "need" is over the course of those hours.

Look, I'm all for home care if it is the best thing for everyone involved. I just want the OP to be fully informed about what the issues that come up might be.

The great thing about having my mom in a NH was that the care came to her.

There was a geriatrician, Advanced practise nurses, medtech nurses, podiatrist, audiologist, dentist, psychiatrist, dermatologist and eye doctor. All of those services were available "in house". No need to shlep mom out to have her seen.

Our only foray into the medical community was for a biopsy of what we all thought might be a new melanoma (it wasn't). But it was a heavy lift to get mom to and from the dermatologist's office, up on the table, etc for the procedure. I can't imagine having had to take her out for ALL of her medical care.

To my knowledge there is no incontinence product that will keep her dry all night so that you don’t have to get up.