I've posted about most of this before but it may be helpful to someone.
Urinary incontinence usually strikes first and those who believe in 'the stages of dementia' put it in the later stages and remark that late stage dementia often involves double incontinence.
I've always thought it odd that for S things developed the other way round. Like so many people, Sue had a longstanding tendency towards constipation. So when, over four years ago, she started to have soiling problems (mostly 'overflow' to start with), we used any number of laxatives and other drugs which various medics swore by. They turned out to be worse than useless. They simply complicated the issue and, whatever dose of whatever drug you used, you never really knew if there was any progress. Sometimes there seemed to be, but then you were suddenly back to square one.
Fast forward. For ages now, there has hardly been a problem. Sue has usually emptied her bowels every day and is almost completely clean all the time, i.e. 99% goes down the pan. This hasn't been achieved suddenly of course. There have been false hopes in the past but overall things have gradually improved over time.
How has this been achieved? I expect that this is what some carers reading this will want to know. So these are my tips, mostly discovered by trial and error:
1) Regular exercise, e.g. we aim to walk at least 5 miles a week whatever the weather.
2) Vegetables are very important. We tend to eat a lot (we don't eat meat). Some vegetables are extremely effective - carrots, sweet potatoes, squash, onions all work well for S so I concentrate on these but not exclusively.
3) Insoluble fibre, particularly wheat bran and anything that contains it, has to be treated with caution as it can have exactly the same unwanted effect as the drugs.
4) Soluble fibre, in particular oat bran, is great and much of the improvement can be traced back to when we started to have porridge for breakfast - real porridge not instant refined muck.
5) We discovered that immediately after the evening meal was the optimum time for a successful visit to the loo.
6) Before every meal I give Sue fruit finger foods - mango, melon, apple, pears. I've always understood the importance of fruit but this fairly recently introduced tactic means that S eats way more fruit than she did before.
7) Obviously, it's also important to keep hydrated and this is sometimes difficult - S has to be watched to avoid spills and she sometimes drinks very slowly.
We can go for months with absolutely no problems. Then we might have a few weeks when, a few times, there'll be a small amount of faeces on her pad in the morning (never any other time for years). Then things sort themselves out again.
I'm sure none of the above is particularly novel. And what has worked for Sue may not work for others but I hope that they may be of some use to someone.
As I've said before on TP, I can't help wondering how many people who are labelled faecally incontinent are actually people who have always had a tendency towards constipation - a situation that has never been resolved.