Excrement in Care Home sink

[paulinem]

Can anyone help please? My mother and father both share the same room a care home. My father spends most of his time in bed and nearly always asleep when I visit. (he is doubly incontinent) My mother, who has Parkinson's with related dementia was until a year ago at home with 24-hr live in carers. She is not incontinent, but obviously confused with the process of going to the toilet. A few weeks ago, I took her slippers home as they stank and on inspection at home they were covered in excrement. I reported this to the Care Home and they said my mother had used an armchair in the room as a toilet. They have now removed the armchair.

I visited yesterday only to find that there was a faece in the sink in her/Dad's room! I reported it to the nurse who again said my mother is probably trying to toilet herself and not getting things right!

My mother receives CHC funding and after being assessed at home was deemed unsafe to stay in her own home because of the risk of falls, I was told she had to go into a care home.

This situation would not have arisen at home, as the carer would have helped my mother when going to the toilet. In a care home the carers are always busy dealing with other residents.

My mother is not incontinent, just confused! The room is now obviously becoming smelly and unpleasant.

Any advice please - should I be more assertive with the care staff and ask them to routinely look in on my mother and provide more regular help for toileting. Even though there is a call bell in the room, neither of my parents ever use it - probably just can't.

 

[Butter]

Yes this is difficult. I think your approach - gently drawing staff attention to the problems as they arise - is right.

Sometimes I found it helpful to ask staff questions related to the problem - but not directly about the problem.

Like:

when is my mother taken to the toilet?

when is my father changed?

There should be a log of all these things - specifically so there is a note of pee and poo activity. Perhaps you could ask to see this?

 

[FifiMo]

I would speak to the manager and ask to see the current care plan. If not already on there, ask for your mum to be taken to the toilet at regular intervals. I would be rather cross about this because the reason she is not at home with carers is because the home would deliver the additional level of care that she needs. Just to be fair, they can't be with mum all the time and this type of fixation with excreta is quite common, so no matter how diligent they are they may occasionally fail. Another thought...are you sure it is your mum???

Fiona

 

[EllieS]

What you say is a disgrace and the care home manager would surely be worried to hear about it. A care home is only as good as the carers on duty at any one time, maybe a word in the manager's ear might help, or as your mum is receiving chc social services have to do regular assessments of the care being receive so perhaps have a word with them as we'll.
I know only too well the concern about not upsetting apple carts but there has to be a balance and you have an absolute right to voice your concerns to protect your parents.
Good luck butter.

 

[DeborahBlythe]

I would speak to the manager and ask to see the current care plan. If not already on there, ask for your mum to be taken to the toilet at regular intervals.
Fiona

I absolutely agree with this. Your mum's toiletting needs should be addressed in her care plan.

The occasional hiccup is to be expected but as it stands, it sounds as if the home more or less expect your mother to get on with things without thinking of any ways to meet her needs. Definitely not on.

 

[Nebiroth]

Not necessarily. When my dad was sectioned into a specialist ward for dementia patients (everyone had their own room, yes, this was the NHS), the ward sister told us he was using the sink as a toilet. She said the staff were all used to such things and at least it was a sink rather than anything else.

Whilst it would be nice, it is unrealistic to expect residents to be watched 24 hours every day without fail. No matter how diligent or professionally competent the staff are, there will always be distractions and things will be missed.

It may not even be a toiletting issue. It's quite possible that residents can be well toiletted and taken to the bathroom regularly. But if they no longer recognise the bathroom as such but think that something else is a toilet, well then they will not go in anything except what they think is a toilet.

How would you feel if someone kept showing you an armchair or a plantpot and telling you to go, when there was what you knew to be a toilet in another room?

Obviously it;s an issue that has to be raised, but at the same time, goals have to be realistic. I would say that the biggest issue is making sure that anything unsanitary is dealt with as quickly as possible.

Often these sorts of problems cannot be solved, all you can do is to deal with the practical problems they create as best you can.

I would not be so sure about this not happening at home with the carer. Even a live-in carer cannot keep watch 24 hours a day seven days a week, and such incidents might well have taken place at night. You can taken someone to the toilet as often as you like, you cannot make them use it; if they are so minded, they will save things up for what they think is a "toilet".

You sound as though, when you say this, you are feeling guilt. I don;t think you have anything to be guilty about.

 

[paulinem]

Thank you all for your views. I always feel TP is a good place to come when you want to discuss something sensitive that you wouldn't normally want to keep going over with your family. Also, when I read other posts I feel very humble and am always amazed at what lenghts people go through to look after members of their family.

Fiona, yes, it is my mum's poo. Last week her socks were stained with what could have only been urine or tea - the smell was the deciding factor! Also, there aren't any residents mobile in close proximity.

Deborah - yes I know that they cannot be "watching" Mum all of the time, but there is a marked difference in her care, obviously, from when she had a carer living with her. She was showered every day, her hair washed and always helped with going to the toilet. She was taken out to the shops and her demeanour was much better than it is now. During the night she would shout out to go to the toilet as her Parkinson's medication was at it's lowest and should could not have got out of bed by herself (one of the reasons why 24-hr care ceased, because she woke the carers up lots of times during the night). She was certainly better cared for at home and it does upset me when I leave her and she begs me to take her back home. Also, her posture is so bad she is bent over most of the time just staring at her knees. So, yes, I do feel guilty that I didn't "fight" harder for her to stay at home. It is makes me so sad when she cries most times I leave her. But "no" I could not look after my Mum nor my Dad myself and applaud those who can.

Thanks to all once again, and I shall look into whether her care plan can take into account some extra attention for toileting.

I just think they need more carers in these care homes, it is an impossible task to look after so many needy people.

 

[Witzend]

You can taken someone to the toilet as often as you like, you cannot make them use it; if they are so minded, they will save things up for what they think is a "toilet".

So true, esp. when it comes to pooh. If they don't need to go just then, then they won't. I know my mother is 'toileted' regularly but she still messes, and now and then I have found little 'nuggets' on the floor of her room or mess in her bathroom, though the CH is very good and staff zoom off to clear it up once they know. Not that I'm above clearing it up myself.

 

[virg]

I think I've realised that what I consider normal is not what counts as normal to a person with dementia. Mum manages to get poo in loads of places and it's cleared up as soon as it is noticed.

To a dementia person, what to do with poo can be completely different. Mum's care home have someone who wraps it up in newspaper plus they've found it in the sugar bowl and in mugs. Funnily enough, I don't have a drink any more!

 

[LYN T]

To a dementia person, what to do with poo can be completely different. Mum's care home have someone who wraps it up in newspaper plus they've found it in the sugar bowl and in mugs. Funnily enough, I don't have a drink any more![/QUOTE]

My OH has left in on the tv stand, the waste paper bin as well as trying to force it down the wash basin. Oh yes he also smeared it on the dog's ears.!!!!

 

[longacre]

This all sounds very familiar. Not long ago, my sister was in my mothers room in the care home, wondered what an odd smell was, feltt around in a drawer, found the usual endless loo rolls 'wraps' - except this had a different squashy feel...!

I always go into any drawers now quite gingerly. We couldn't find her hat today and there were so many loo roll sausages in the drawers as to be comical. Luckily none of them were filled with poo this time. But when I put my hand into a drawer last weekend for the hat (again) and suddenly left something extremely squishy, I feared the worst. Luckily it was just an over-soft banana.

 

[Shash7677]

I have to agree with Nebiroth. My mum was admitted to a psychiatric assessment unit (not sections but not far off) and one day I went in and her room was smelling rather rank. I looked under the sink and the smell of urine hit me, there was tissue stuffed in the little cupboard that she or another patient had been using. I dug round (don't ask me why!) to the back of the cupboard and found a tesco bag, the bag contained poo!!! I was very nearly sick I'm afraid. I spoke to one of the nurses and she said she didn't think it was mum but they would keep an eye on things. One visit when I went in her room mum was rambling on and kept sitting on the sink, 'you have to do this' she was saying 'can't go out the room' so she was obviously getting up in the night and wee'ing and whatever else in the sink. She too is not incontinent, she was just very confused.

Mums room, although self locking when she came out of it wasn't so clever as it sounds. Mum worked out how to leave the door open, goodness knows how, but other residents then has to go in and out, sleep in her bed and remove things from her room. Now on the unit there was mum and 5 other ladies and probably double the amount of staff. If this can happen with a ratio of 2:1 staff to patients then it can happen anywhere.

I agree that you should speak to the manager, maybe ask them to ask mum every so often if she needs the loo or failing that and I know some people don't like it but maybe they could put a commode on mum and dads room, then if she does need to go she has somewhere appropriate instead of having to worry about getting out to the lol. Just a thought?

Sharon

 

[Petrina]

I remember many years ago seeing a house for sale that had what on first inspection seemed an odd thing - a fully-functional, flushing WC in the bedroom. You didn't have to think for long, though, to see what a good idea it was.

I sometimes wonder whether very old people with dementia are sometimes confused by the nature of household items such as toilets, baths, showers, wash-basins etc. because of the way they were brought up. If you had a belfast in the scullery, a tin bath outside the back door and an outside lavvy with either a pan toilet emptied weekly by the nightsoil man, or an earth pit under the bench-style seat, getting old and having dementia and recognising modern conveniences isn't so easy.

I bet very old people with dementia at home are more likely to defecate in earthenware washbasins or maybe sometimes metal sinks or modern baths, but never in belfasts. If Dad ever gets to the point of using the wrong items, I'll get a good plumber and carpenter in and install belfasts instead of the kitchen sink and bathroom washbasin, and put a board with a hole type seat over the modern WC, and if he stops using lavatory paper, I'll tear up newspapers so he has something he recognises from childhood as what you clean yourself with.