Although it has changed in little details from him reading the paper and looking at the crossword puzzle while on the can, to now needing almost two people to efficiently move everything in time, this is pretty much the toileting and bathing routine we go through on a daily basis. Believe me, there is a reason for the madness....And, if you miss a step, Dad will tell you!
Toilet (Bowel Movement) Procedure (Around 4:30 - 5:00 pm Daily) Make sure he has had his warm mug of Metamucil about 1 hour prior to toileting and that he has been on the bi-pap for at least an hour so that he has enough energy to enjoy the shower procedure.
1. Recline the chair all the way down. Take shorts off by lifting knee up one leg at a time.
2. Put commode chair perpendicular to the recliner chair, leaning against bookshelf, and put the brakes on the front. Transfer him to shower commode chair.
3. Make sure his torso is straight, then recline chair back a little before you push him to the bathroom. Make sure his head is in head rest. Make sure toilet seat is lifted up.
4. If it’s hot out, set up small fan on the edge of the sink, so air is blowing on him. Otherwise, just pull away the curtain away from the window and open the window behind him.
5. Make sure he is far back on the chair, push chair back to the back of the toilet. Put brakes on.
6. Set up bi-pap machine on the stool (put stool in corner of shower wall/sink) and put it on him immediately and press white bar to turn on. You may need to hold his head back and watch/listen to the mask to make sure he is getting air efficiently.
7. Push stomach in slow, rhythmic motions with the base of two palms.
8. When finished, release brakes and pull commode away from the toilet. Wipe okole and flush toilet.
Shower Procedure (Immediately following toilet procedure)
1. Roll into shower backwards so head is near the faucet side. Make sure the right arm of the chair is about a few inches away from the shower wall.
2. Tilt back commode chair a little bit.
3. Remove feet stands of chair and place outside in the laundry basket. Feet will probably be suspended a bit from the ground.
4. Turn water on so it is warm, but not too hot. Check the water temperature first, then put on his legs to check with him. Adjust the temperature as necessary. When he okays the temperature, wet hair first. Only use water to a minimum. Try not to drown his face. Leave water on and put shower head on his lap so it is spraying on his stomach.
** IMPORTANT: Time is of the essence as he cannot be without the bi-pap for long! Use this as a rule of thumb (as a maximum!): 1) Rinse hair – 5 seconds
2) Scrub, scratch scalp and wash hair - 10 sec
3) Rinse off shampoo & wipe excess water from face – 5 seconds
4) Soap cloth and wash face and scrub behind ears – 5 seconds
5) Rinse off soap from face – 5 seconds
6) Dry face and hair and put bi-pap mask on and turn on – 10 seconds
5. Put a quarter-sized amount of Heads & Shoulders shampoo and scrub hair, massage, and scratch the sides and top of head. When he okays it, rinse off hair. Again, try not to drown face by washing the sides first, making sure you rinse ears and rinsing hair down the back.
6. Warn him when you are going to rinse his face. Only rinse for about 2 seconds! Soap the pink towel and scrub his face. Make sure to scrub behind the ears. Rub lightly over any sores on forehead and nose and eyes.
7. Warn him when you are going to rinse his face. Tell him when you are rinsing the sides first, then the front. Make sure to only rinse for 2 seconds at a time. Wipe the makapiapia from his eyes. He may want water in his mouth to drink.
8. Rinse entire body with water and then turn the water off and put shower head on the ground.
9. Soap pink towel and scrub underarms and arms and hands/fingers.
10. Lean him forward from the shoulders and scrub back and neck.
11. Scrub thighs and under each thigh.
12. Scrub between legs and okole.
13. Scrub feet and under feet.
14. Turn water back on and adjust temperature. Rinse off entire body completely. Make sure you rinse under the chair to get okole and lift each thigh to rinse underneath.
15. Shave if he wants. Use the shower gel and razor to shave cheeks, chin, and neck. Rinse as necessary.
16. Use towel from the top left rack to dry hair and face first. Dry off upper body, arms and chest, then lean body forward to dry off back and lay towel behind back, so he is sitting against it when you lean him back on the chair.
17. Use other towel from the bottom left rack to spot dry on the legs. Lay towel on his lap and pull commode chair out of the shower and onto the mat so he is facing the door. Tilt chair back as necessary for comfort.
18. Finish drying off the rest of the body. Make sure to dry off between the legs and under thighs. Dry off moustache to finish.
19. Warn him first that you are going to take off the bi-pap to clean his nose. Use rolled up toilet paper to clean inside of both ear canals and ear wax in ears. Make sure not to poke too deep inside ear.
20. Coil up toilet paper and clean inside of each nostril until clear. Promptly put mask back on and turn on bi-pap.
21. Dry off the commode chair by using rag or shirt from laundry basket.
22. Ask him if he’s ready. Remove the bi-pap, turn machine off and bring it back and set up near his recliner.
23. Tilt commode chair back and go backwards into the living room.
24. Transfer him from shower commode chair onto recliner chair. Make sure there is a pillow on the chair for neck support. Support back of neck during transferring to the chair.
25. Move shower commode chair and Recline chair all the way back. Put bi-pap on if he needs it. Otherwise, put white v-neck t-shirt on him first since he is still sitting up. Then put bi-pap mask on and turn on machine.
26. Recline him so he is laying down. Get boxer shorts and put them on him. Make sure they are up on the back by lifting one leg up and bending at the knee, then putting his same arm on his stomach and pushing his shoulder and knee over. Put lotion on his excema on the left cheek of his okole.
27. Offer a drink of water.
28. Reseat him by wiggling him back or lifting him and sitting him back all the way so he is upright in the chair.
29. Make sure chair is reclined all the way and make sure pillow behind head is comfortable.
30. Fix his arms and hands so that they are either on the arms of the chair, fingers flat, and/or arms are by his side with thumbs up. (He will tell you what he wants.)
* Around 5:30 pm daily, he takes 1 Rilutek pill with water. Make sure he is slightly sitting up when drinking water.
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