A big problem in the smallest room in the house. Help please!

[4boding]

I could definitely use some guidance on how I might tackle an especially awkward problem, concerning toilet etiquette. The 70-year-old woman I care for (and live with) has an ongoing problem remembering how to manage No2. At first it was not remembering to flush, but frequently she manages to get exrement on the hand towel and often puts the used toilet tissue into the bin instead of down the loo. What exactly is going on I can't say, but knowing her failure to use dish soap when washing up cups or plates, I imagine she is wiping with difficulty and failing to wash her hands properly, getting poo on the towel, or on one occasion using the towel as if it were toilet paper.

What have I tried to do? I've installed a new toilet roll holder and a new towel ring, as far apart as possible; I bought one of those bathroom etiquette plaques and put it in the bathroom, and I've finally drawn her attention to the mess and tried to remind her of the proper sequence, the latter humiliating for both of us. But what can be done? It is unacceptable behaviour. Any guidance, please?

4boding

 

[jaymor]

Hi,

The behaviour is unacceptable unless you are dealing with dementia then it can almost be classed as normal behaviour. The person you care for is losing her brain pattern and what is a normal sequence is no longer there for them. It is like asking a nine month old to go to the toilet, wipe themselves and make sure they flush the toilet. It can't be done, the child's understanding has not developed that far. As a child gains understanding a dementia sufferer looses understanding and nothing can be done.

Explaining to them is not going to help, it will agitate them and cause anxiety and then things become difficult for the career and the cared for. It is best to help and support allowing them as much dignity as you can. It is not easy and all we can do is our very best.

Jay

 

[Cloverland]

Jaymor has explained it very well. If the person you care for has dementia then you need to contact the district nurse for incontinence pads assessment.

Just out of interest are you a live in Carer and has the person you care for had a formal diagnosis and claiming attendance allowance or DLA/PIP, if so they are entitled to council tax rebate or exemption.

http://www.nhs.uk/CarersDirect/moneyandlegal/finance/Pages/council-tax-discounts.aspx

 

[4boding]

Hi,

The behaviour is unacceptable unless you are dealing with dementia then it can almost be classed as normal behaviour. The person you care for is losing her brain pattern and what is a normal sequence is no longer there for them. It is like asking a nine month old to go to the toilet, wipe themselves and make sure they flush the toilet. It can't be done, the child's understanding has not developed that far. As a child gains understanding a dementia sufferer looses understanding and nothing can be done.

Explaining to them is not going to help, it will agitate them and cause anxiety and then things become difficult for the career and the cared for. It is best to help and support allowing them as much dignity as you can. It is not easy and all we can do is our very best.

Jay

I take your point, but that doesn't help me. How am I supposed to get her to wash her hands - I can't wash them for her - without embarrassing anyone? I was hoping for some practical tips, canny suggestions, to get round the prooblem without confronting it directly.

 

[Spamar]

OH was doing similar. Tissues would go into the loo and toilet tissue into the bin. Fortunately we have a big enough shower room that I could put the bin in the opposite corner, up high. This has worked. Washing, w.e.l.l, in the mornings I am there supervising, so he does wash properly at least once a day. The rest of the day is pot luck!
By the way, someone mentioned a denture dislike. Me too ! But it's the only way to get them done, and his breath smells disgusting in the morning. I insist on daily mouthwash as well!

 

[jaymor]

I take your point, but that doesn't help me. How am I supposed to get her to wash her hands - I can't wash them for her - without embarrassing anyone? I was hoping for some practical tips, canny suggestions, to get round the prooblem without confronting it directly.

You are going to find it very difficult to get someone who has lost an ability to do something so really all you can do is your best, and if that means you washing her hands then do so as long as there is no aggression from her towards you when you do it. You are caring for the lady so hopefully there should be no embarrassment, there is lot worse to come and be overcome. Non of it is easy and sometimes there are no answers.

We all like to think that be can preserve dignity for as long as we can but there comes a time when we just have to dive on in there and help. It is important that her hands are clean so please don't worry about her embarrassment of having her hands washed.

would your caree enjoy her hands creamed and massaged after them being washed? Maybe she would allow you to clean her hands prior to the massage.

 

[Jess26]

Would she allow you to use antiseptic wipes on her hands ? I don't mean to sound rude but have you actually tried washing her hands for her ? I'd say that was one of the least embarrassing things carers (paid or otherwise) have to deal with.

 

[Owly]

4boding, I see from your previous posts that this is your Mum you are looking after, but it isn't clear what gender you are, as that makes a difference regarding how 'acceptable' it might be for you to be in the bathroom while your Mum is using the toilet, both to help with the toileting and the hand-washing afterwards.

My Mum was never bothered by me coming into the bathroom, but I'm female, and she was always OK with a female helping her when she knew that any kind of mess had been created.

Sadly, this is a phase that comes to many sufferers of dementia, that they need to be supervised or prompted to carry out the right 'procedures' when needing the toilet.

You said on a previous post that she was in denial about her dementia, and that evidently won't help, as any intrusion into what she would see as her private business might be strongly rejected.

 

[sunny beach hut]

I hope I'm replying in the correct way to this post. Have you thought about getting a disposable plastic apron when dealing with 'toilet matters'. Some people associate them with nurses and if you have to then wash the lady's hands it could be seen as professional care.... just a thought
Good luck and it sounds as if you are a lovely carer

 

[Jessbow]

Flushable wet wipe might do for both functions, or a box of tissues to fullfil both functions of loo roll and hand dry/wipe

 

[keywest67]

Hi
I am sorry to say this but this problem will get worse and there really isn't anything you can do to ensure this lady uses the toilet and washes her hands........as dementia progresses she will forget where the toilet is and become incontinent, as others have said she needs a district nurse to assess the situation and she will need some sort of carers help with many of her day to day tasks eventually (if she doesn't already) such as washing and dressing...........I wish it was as easy as giving some practical tips to help but I'm afraid I have been in this situation with my Dad who eventually forgot how to use the toilet and went just about in every room in the house and even in the back garden.........he eventually went into a care home because we couldn't cope.......but please remember she can't help it, it's a terrible illness which you never get better from, wish I could give more positive news.

 

[4boding]

4boding, I see from your previous posts that this is your Mum you are looking after, but it isn't clear what gender you are, as that makes a difference regarding how 'acceptable' it might be for you to be in the bathroom while your Mum is using the toilet, both to help with the toileting and the hand-washing afterwards.

My Mum was never bothered by me coming into the bathroom, but I'm female, and she was always OK with a female helping her when she knew that any kind of mess had been created.

Sadly, this is a phase that comes to many sufferers of dementia, that they need to be supervised or prompted to carry out the right 'procedures' when needing the toilet.

You said on a previous post that she was in denial about her dementia, and that evidently won't help, as any intrusion into what she would see as her private business might be strongly rejected.[/QUOTE

Yes, you're right, it is my mum - I wasn't sure about mentioning it - and I am male, and she is in denial of the problems we're experiencing. It would be easier if we weren't related and if I was only visiting. But there it is.

 

[4boding]

I hope I'm replying in the correct way to this post. Have you thought about getting a disposable plastic apron when dealing with 'toilet matters'. Some people associate them with nurses and if you have to then wash the lady's hands it could be seen as professional care.... just a thought
Good luck and it sounds as if you are a lovely carer

Thank you for your support.

 

[4boding]

Hi
I am sorry to say this but this problem will get worse and there really isn't anything you can do to ensure this lady uses the toilet and washes her hands........as dementia progresses she will forget where the toilet is and become incontinent, as others have said she needs a district nurse to assess the situation and she will need some sort of carers help with many of her day to day tasks eventually (if she doesn't already) such as washing and dressing...........I wish it was as easy as giving some practical tips to help but I'm afraid I have been in this situation with my Dad who eventually forgot how to use the toilet and went just about in every room in the house and even in the back garden.........he eventually went into a care home because we couldn't cope.......but please remember she can't help it, it's a terrible illness which you never get better from, wish I could give more positive news.

I appreciate the reality check.

 

[AlsoConfused]

A lot depends on how aware your Mum now is of gender issues ... they may already be so fuzzy to her that she simply doesn't care which sex you are. If that's the case, then all you have to deal (all!) are your own feelings.

My Mum has to be supervised while she's in the loo and cleaned up after she's "been". She doesn't like it. I don't like it either ... but if the supervision wasn't there she'd block the loo, spread dirt everywhere (I mean everywhere!) and put herself at even higher risk of developing UTIs. So I steel myself, deal with things in as matter of factl way as I can and pretend this is the usual pattern of assistance an offspring gives to a parent. I think you'll have to do the same.

It's worth talking to the Incontinence Nurse - they help your morale as well as providing practical help.