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I have been caring for my father for the last 20 years since my Mom passed away. He is 82 now. Recently he's been having "accidents" in his pants. He changes his clothes but doesn't clean himself very well and leaves the toilet seat a mess. He doesn't say anything, just leaves the clothes near the washer. Since I'm his daughter I find it hard to talk to him about things that are so personal and probably embarrassing. Looking for some advice.

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I cared for my dad as well and we also had to have some uncomfortable conversations over the years.

Now that your dad is 82 it sounds like the caregiving is changing and you're facing some situations you haven't faced in the past. The best way to deal with them is head on and as they come up.

Talk with your dad and tell him what you need from him. Be compassionate. You could say something like:

"Dad, I've noticed recently that you've been having accidents in the bathroom and it's OK, it's a normal part of aging. My concern is that you're able to clean yourself up after an accident so I've put some Depends and wipes and wash cloths in your bathroom to help you get cleaned up. I've also put a small hamper outside your bathroom in case you need it so you can throw your wash cloths in there when you're done. I've also put some paper towels and Windex under your sink so you can clean up the toilet seat. I wouldn't want you to have to sit on the commode when it's dirty."

Be matter of fact, diplomatic, and do what you can so he can hang onto some dignity. As difficult it is for you to discuss this with him I'm sure it's more difficult for him to have to discuss it with you.

I'm sure you'll be very kind when discussing this with your dad. You acknowledge the embarrassing nature of this discussion which tells me that you're a caring person and that you are concerned about your dad's feelings.
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Great answer from Eyerishlass. One additional thought, is there a reason for the incontinence? You might look at his eating patterns or if he has his own food supply whether or not it is fresh/refrigerated. Also, you might give him some active yogurts to help restore his intestine lining.
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I am going through this with my Mom right now! She says she doesn't know she is doing it. I said "Mom, do you not know you are messing yourself?" She looked at me and said "I don't know nothing"........However, my husband and I have noticed her setting up on the edge of her chair, really straight, and it's at that time she is doing her business in her depends. Because, shortly thereafter, the stench becomes known throughout the house. I used to have a strong stomach but with each new "gift" she gives me, I am becoming more "sick to my stomach". This is a 2 to 3 time a day thing and just started this past weekend. She has been incontinent for the past month and a half or so. Her food has not changed. She still eats her same menu as always. If it doesn't let up after the yogurts and probotics, guess the only solution is to head for the doctor's office. Any suggestions would be helpful. So sorry this is going on with your Dad. It makes it worse when it's your Dad. Been there and done that, too. Stay strong!
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Thank you to all who have answered my question and given advice. My brother and I were able to talk to my Dad tonight. He said that it happens when he farts and he doesn't know when its going to happen. He agreed that wearing a disposable under garment would help especially when we go out. We shall see if he keeps up his end of the bargain by telling one of us when it happens so we can help him clean up. Thanks again for the support! So glad I found this forum
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The key is communication and letting them know you are there to help them. My 80 yr old MIL tries to clean herself after she poops while in the bathroom and ends up with a bigger mess than if we help her, so we have gotten her to agree to keep her hands out of it and let one of us assist. She too goes in her depends from time to time and she too claims she does not know when she is going. We too find it hard to believe because she must feel the mushiness and the stench, but she swears she doesn't know. Same thing with urine incontinence, she claims she doesn't know. Either way, Depends are a part of her life now and have been for a long time.
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Clagraffe, I have found that the Walmart brand Assurance is more absorbent and holds more, like during the night, than the Depends and is a bit cheaper, too. We are going through twice as many in the past couple weeks as before. I have been questioning Mom as to "not knowing" and I get a dozen different answers, or maybe no answer at all. She has this look she gives me. At first a friend suggested maybe she is mad at me or pouting because I am outside or doing something else, and I thought that, too. Now, I don't think so. BUT, when she goes and she is in her chair, she will set straight up and we always know she is doing it, then she sets back and looks all innocent again. I'm like you, how do you not keep from smelling that nasty smell, even the urine smell, and the mushiness. Please keep me posted on how she is doing and any new things that you come up with to help beat this mess. I am putting sheets in the washer as I'm taking out the load I just get washed from the dryer. Really gets tiresome, especially when I know she did it and she says she doesn't know. My best to you!
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Chloesgrams - Is it possible your mom doesn't smell it? My mom has ALZ and lost her sense of smell years before the other symptoms showed up. I read recently that sense of smell is one of the earliest warning signs of ALZ because that area of the brain is one of the first affected. Doesn't explaint the "squishy-ness" you'd feel but just a thought.
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Yep. Grandma (95 years old) has this issue too. She said she doesn't even realize she goes. We keep her very stocked with pads- she hates depends as they are difficult for her. Thank god for Amazon Subscribe and Save! She likes Prevail. We got her a diaper genie and she has another trash can as well. I empty the trash a couple times a week and everytime I do, I wipe down the floor/toilet or whatever else. She is fairly good at bathing especially since we moved and she has better accomodations.
I have IBS so I found it easier talking to her about her bowels because I can sympathize with the whole running to the bathroom thing. We can relate in that way. I always tell her I understand how frustrating it is but I can't do much about it.
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I've noticed that people with dementia seems to be able to get used to almost anything.
So, I wonder if they really do have awareness that they're about to pee or poop, have extreme body odor from not bathing, are spilling food all over themselves, etc... but, they're just 'ok with it'. Particularly men, who may have had many of their personal habits and preferences accommodated all their adult lives.
The squishy, smelly depends, the shirt that hasn't been changed in a week, the food stains all over the furniture...it just doesn't bother them. But, it does bother those around them.
Dementia in so many ways makes the elderly very toddler-like, so, I wonder if nagging should be employed in the same way as one might with a 2 or 3 year-old.
Obviously, in the later stages of dementia, consciousness of all of those things starts to wane. But, I'm talking about someone who's still communicative and can respond to instructions if they're reinforced repeatedly.
I've tried it with my dad with some success on other issues. I don't nag in the same authoritative tone I would have with my kids when they were young, but I do address the same topic over and over until he starts to change an objectionable behavior. Like it was with my kids, it's sometimes a 'last man standing' situation : )
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I also think that just old age and refocusing on what are priorities during the physical and mental decline are a factor in not being bothered by things that would upset them years earlier.

Expanding on Isn'tEasy's theories...

I've written this before and really believe it's a factor - older folks' priorities change, and so do their sensitivities.

Maslow's heirarchy of needs is no longer multi-dimensional for them. Their focii drop down to the basic few needs and other concerns drop away.

If you think about it, they're in the last stages of their lives, have limited mobility, become dependent on others, and sometimes every day is a struggle. When you're in survival mode, a lot of things aren't important as they were when people were fully functioning.

I sometimes liken it to early humans whose focii were on food, shelter and survival. Higher level thinking processes weren't that necessary except to support the bsaics. Once their got their saber toothed tigers or mastadons, they ate, slept and then went hunting again. They all probably had horrendous body odors but I doubt if it was that important to them.
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Another issue- if a person "cleans themselves up" but doesn't properly wash their hands they or your family may end up very sick due to e coli bacteria. Not a pretty topic but something to be aware of. There is now toilet seats made that acts as a bidet which spray washes a person's bottom (and some "blow dry")- a different approach but addresses many issues including self-esteem, embarrassment, etc. I focus on bed mobility items but could dig out some contact info on those products if people are interested- I see lots of things to help people at tradeshows.
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As you grow older, you know what they say - never trust a fart. I guess it's true. My life got easier once Mom wore Depends all the time. She wore Poise before that (long, so it would catch the BM). I think older people learn to accept that kind of change - they have to! It is what it is.

Mom always sat on a pillow with a towel over it so she wouldn't ruin any chair she sat on. You can also buy disposable underpads (chux) to protect chairs or the car seat.
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I've watched dementia rob my husband of 44 years of most of the dignity he always displayed. I've cleaned up the carpet, floors and him. Sometimes I just threw away
the clothing it was so bad. He's always embarrased and my heart aches for those suffering with this lousy disease. Suppose you put yourself in their shoes and remember this is something they can't control. How about doing what you can to clean it up quickly and get on with it. I don't believe any advice you give will help the situation.
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Hard to do but you are going to have to have a conversation with him. How will you be able to initiate any interventions with him without his cooperation.
Also do not set yourself up to be a doormat. Unless I missed something than your father is nog confused. Neither am I; so would you tolerate me leaving your toilet seat a mess and just throwing my clothes full of bm next to your washer. Looks like he is going to need complete care after being incontinent. He cannot even clean himself well. I would find the words to let him know in a loving manner that changes need to be made in his toileting habits. You may put him in Depends but he is still going to need help for changes . He needs to know to call you for help with changing the Depends and getting cleaned up properly.He must have proper skin care because he is at risk for skin irritation or breakdowns. The necessity for good handwashing is a given. A call to your family MD is a good idea to make sure no other underlying medical issues are causing this. You may also want to consider the need to protect his bed also.
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I've had to help my 90 year old father start using Depends. It was an awkward conversation at the beginning but now we are okay with it. We use a diaper Gene in the bathroom for disposing of the Depends. Not aware of any smell either. Dad also uses a"guard" in the pull ups for extra protection especially when leaving the house. I put supplies in a plastic lunch bag for him to take in a public restroom in case they are needed. Hope these ideas are helpful. Take care.
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Someone mentioned the similarity to toddlers. Think about it. There are toddlers that will stay in a wet/messy diaper indefinitely and it doesn't bother them. (There are some that have a high sensitivity level and want to be changed immediately, if not sooner, at the slightest degree of wetness.) There are toddlers that delight in playing with their feces that may be floating in the toilet. The smell and feel doesn't bother them as they squish it between their fingers!

NOT that this makes it any easier when dealing with clean up, but it may help to explain why your loved one doesn't seem to notice or respond or be bothered when they have a bm in their clothing or on toilet seats, etc. There's the additional factor of possible embarassment, like we see in toddlers, who will deny it when you confront them about a wet or feces filled diaper/pullup out of embarrassment or simply having something they are engaged in at the moment that they don't want to stop doing. As others mentioned, also, the sense of smell is often very compromised for elderly people. That's sometimes why they have a poor appetite...can't smell...can't taste...boring! As much as we take our toileting habits as a "given", there's actually a lot of social/cultural/learned factors influencing it. (Look at many animals....like dogs...who check each other other by smelling each others anuses when first meeting!)
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This is very hard for a daughter to approach her father my friend had same problem SO she got the nurse to have a word and her brother in law told him discreetly that he smells a bit! hes in good health but just smelt of pee.

Expect them to get angry though this is thier didnity and still my mum will tear my head off if i mention anything about her mess. I dont bother anymore just clean up like a robot.

You dont say if dad has dementia? as this is harder to deal with. my mum throws her dirty clothes on the kitchen floo?
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There are surely various reasons some people have bathroom problems where they are unaware of their need to use the toilet, or may have gone in their pants or diaper and don't know they are soiled. It is true - is does happen, as I can personally attest. For me the doctors have told me a disease involving the signals from the nerves don't work (the nerves may be dead) and I don't feel anything. Plus I don't have a sense of small. I am embarrassed about the fact that I am offending, but can do nothing about it. I read some very good suggestions about helping with clean-up supplies, communicating, etc. Most of all, just be understanding that this is difficult for them as well as you.
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It all depends what is condition your loved one has.
I remember one "son" confronting me on hording his mother's diapers because she does not remember having any accidents. Guess what? He did it on front his mother and I still remember how painful it was for her to hear me saying that, indeed, she has accidents every day when in my care (respite/day care). Maybe because she is confused and not sure where the bathroom is, maybe because she does not feel it coming and, by the time she makes it to the bathroom, it's too late and we need to change all her clothes, not only diaper.... I refused to continue discussion on front of her. He called me very next morning and said: "I apologize! My mother just pooped her pants and it was awful! I do not know how you can handle it every day...." and I did hear his mother crying next to him..... What was really awful that he was very open about discussing it on front of her and I knew how heart broken she was to hear that.
So, be considerate! Do not humiliate your patents! Just clean it up or learn how to avoid mess by simply preventing it: trip to the bathroom right after meal, reminding them to use bathroom more often before it's too late, "offering" (insisting!) on helping them to clean up butt, etc.... That's what I do every day.
Besides, keeping that but clean and applying lotions all the time you might prevent "bad sores" which happen not only in the bed. Easier to prevent than heal!
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Ugh, us too with this problem. FIL claims he does not know if it happens (!!!!!!! How can that be?!!!!) I usually notice the stain on his outer clothing and then he argues with me about changing into clean ones. We did go to a gastro doc two years ago and he took him off milk products and gave him a high fiber diet, no sugar but he does not keep up with it unless I am standing right there watching. Also just found 10 ---TEN bags of candy in his room So glad we have all gone on a diabetic diet to compensate for HIS needs, UGH!
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lot of good answers here so I'll be brief.
Depends are great. I make sure mom puts on a new pair everyday
As far as accidents...one day she vomited AND had a chocolate mess all over the toilet. She was picking up vomit with her bare hands while smearing a big mess on the toilet. Talk about a.cleanup.
Anyway...I bought a BIO-Bidet toilet seat. With a remote control.
look it up. It washes, rinses, and dries, my mom's rear and other.
Get the remote control because your dementia parent will have no idea how to operate.
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This is so sad and bringo back memories from when my dad was adjusting to wearing protection. He was mortified and hated it. His Alzheimers kicked in and he cared less and less about sitting in it. I tried so hard to help him maintain his dignity. Until the very end, I never even saw him in his underwear. Just saying, the aging process can be cruel. Now I'm praying that my momma can pee with assistance.
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I think this has to be the worst thing for them to suffer. i feel guilty now as a few years ago i would really snap at mum as i couldnt understand why she was flinging her colostomy bags out the bedroom window and it just made me so angry and then if friends called id die with embarrassment as shed leave one in the toilet and my friends would see it but now i tell them, well one friend as she looked after her mum and had to clean her up alot so she understands. Theres days when i dont want anyone to call as the stress and cleanup is too much. this morning i had to pick up about 6 diapers in the bathroom as she was hiding them in her room then just dumped them in the bathroom but i know she probably intended to bring them down to the rubbish but then forgot. I dont know sometimes she thinks nothing of what shes done then she will clean up like she knows its so sad but you just dont go there with them anymore as they dont know what they are doing and when you point it out they get angry it must be awful for them. yep i hate this disease!
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I have recently had the same problem with my father in law who is 82. I had to remove all of this regular underwear and replace it with depends. It was an adjustment at first, but now he doesn't know the difference.
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My mother is 86 with an intestinal disease, and I'm just so glad I found this site! It's so great to read advice from others who are going thru the same thing. My mom's on Depends, has been for a few years. Thank you for the suggestion of the Diaper Genie. That is going to make her feel better, and do wonders for the smell. She's been putting her used ones in plastic shopping bags and leaving them in her room. Cleaned them out and had to use a double trash bag. Now she's on a clear liquid diet and I hope that will help. Today was the most I've cleaned up the bathroom and I was feeling down. When I saw the topic and read the various answers, it made me feel so much better and we've had frank discussions. I've brought up the toddler comparison as well. Luckily she's got a great sense of humor and only a bit of vascular dementia, which we're dealing with via medications. So again, thank you for the advice and suggestions!
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These are all great responses. However, am I the only one who feels as if I would not be able to handle this stage of aging ... at all? There is no way I could even imagine dealing with this sort of thing on an indefinite basis.
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Drummergirl, if it's coming your way, you had better make well laid plans, and have the finances to do so, if you are dead set that you feel you "would not be able to handle this stage of aging...". My own sister tells me, "I don't know how you do it. How much longer are you going to do this?" I suppose I will until she starts throwing crap at me!
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One of the things I do is purchase wipes for my father to use. This helps with clean up. I always check the toilet and use a Lysol wipe for clean up if needed, and with soiled underwear I spray with Oxy-Laundry solution and add some bleach to my water and they clean up fine. My father is not as flexible as he used to be and he has had some shoulder issues so he has some difficulty with cleaning himself-the wipes really help so there is less mess for me to clean. When my father had surgery on his shoulder and couldn't take care of himself, I just did it without talking about it. I don't hesitate to speak of any issues I'm seeing for I feel it's best to just get it out there, discuss it then leave it alone. It saves embarrassment and the issues has been discussed with solutions.
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I am assuming your dad has some form of dementia or alz too and unfortunately with those diseases it is only going to get worse. When my grandfather started with these issues my mom got a portable toilet for is bedroom so if he had to go it wasn't a long trip to the bathroom if they "forgot" they had to go. I was a teen then and all I can remember is it too was a mess to clean up. I remember my mom and dad going to him when he had an accident and telling him if he had an accident that he needed to shower every time it happens. Of course he denied he had the accident and tried to blame the dog for going on the floor. (dog was trained). The best thing my parents did was realize that the best thing for him was to go to a nursing home where he could get the care he deserved to get. It was a very hard decision for them as they wanted to keep him home but I the end they knew the care that they were giving just wasn't enough and as his mental issues got worse they knew they just couldn't do it. Now I have my Mother In Law at home she too has Dementia and Psychosis along with some other minor mental issues and has just been diagnosed with CHF. Every day I get the "Oh I forgot" excuse. Right now she isn't having accidents but my husband and I have had that discussion and we both know that once that starts happening I just can continue to care for her the way she deserves to be cared for and still care for my own family and have a life of my own too (which we all deserve too). With the Dementia getting worse I will predict maybe a max of 3 years more here at my home before she will need nursing home care.

Just remember its ok to put yourself and your family first too and realize when no matter how much we want to care for our aging parents sometimes that isn't the best choice.
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Thanks for your reply, dirtydimensia01. I am not equipped emotionally *or* financially for that kind of arrangement. That's where practical caveats of Dad living with us would arise.

He covers his own (occasional) non-VA care expenses, and where that ends, I would summon the counsel of his VA doc and related resources. This is not for lack of love, but more an acceptance of personal limitations.
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