Fecal incontinence?

[Risa]

Not sure if Mum has fecal incontinence or is just not sure what to do when she has a bowel movement. Mum is able to take herself to the toilet and pee ok. However she is soiling herself or leaving the bathroom in a mess when she has a bowel movement. Dad does take her to the toilet during the day but unfortunately she never wants to go then and Dad is asleep when she goes at night. Sometimes she has used the toilet but appears to have walked away whilst still going or else she has gone in her pull-ups (which we started to buy because her underwear was getting in such a state). Mum also has the habit of putting her hands down her knickers and getting them covered in faeces. She is fighting Dad over being washed which doesn't help

Do you think it would be worth getting an appointment with a Continence Nurse? Dad isn't keen as he doesn't think they will be able to help (since Mum is going in the middle of the night). Apart from perhaps getting a prescription for some pads or pull-ups, I am not sure what else the nurse could offer?

This issue is getting Dad down as it causes a lot of extra work aside from being so unpleasant to deal with. We have suggested getting in a carer to wash Mum of a morning but again Dad thinks if Mum will fight him, she will fight the carer so it would be a waste of time.

Is there any way of getting Mum in the habit of opening her bowels during the day? Just stumped as to how to help Dad manage this problem?

 

[Katrine]

The Continence Nurse can suggest ways of getting the bowel habit to happen during the day when your mum can be supervised, perhaps using a mild laxative at breakfast time so that she'll be ready to go after lunch.

After a meal is usually the best time to try. It sounds as if she's losing awareness of her bowel sensations. Usually it's urinary incontinence first, followed by bowels, but there are no rules where dementia is concerned.

Your mum may need a carer in to supervise the bowel movement after breakfast, or lunch, and then wash your mum. However, it would have to be a good experienced carer, not one of these 15 minute mosquitos that would happily avoid personal care if they can

Try to keep your mum's fingernails short, for hygiene reasons. Talk to the nurse about pads and pull-ups. You are going to need them soon. It would help your dad with the cleaning up situation, being more contained. Pads aren't so good for faeces, unless they are the nappy kind. I would encourage your dad to see what the nurse has to say. There's no point in second guessing and assuming there's no help available. Why would such a job exist unless they are useful?

 

[Risa]

Many thanks Katrine, I hadn't though about giving a laxative so this will hopefully regulate her bowel so she goes during the day

I'll keep on at Dad re getting carers and seeing the nurse and hope he changes his mind.

 

[Goingitalone]

We have a similar problem

So glad I found this thread. We have a similar problem with mil.

I try to encourage her to "go" after breakfast. I never rush her and busy myself with her chores while she sits on the loo in private.

However, if she hasn't emptied her bowels at this opportunity we invariably have some sort of mess to deal with later in the day. Usually in the kitchen or living room.

Her children are at the point of putting her into a care home as they are understandably concerned about hygiene. Mil lives alone but is rarely left alone for more than 3 hours.

Knowing that the continence nurse could possibly prescribe a laxative to encourage a bowl movement at a certain time of day would possibly put off the decision re care home.

I will check out the possibility.

Many thanks.

 

[claireizz]

I give my nan 3 tinned prunes every second day alongside her breakfast which seems to have helped her, might be worth a try ...if given every day she had accidents but every second day seems to work

 

[Goingitalone]

Having done a little research on the nhs website it seems you have to be careful about laxatives. They don't recommend regular use so establishing a habit might be difficult.

However, the prunes idea sounds like a natural way to achieve it. I just have to work out when to serve them to produce a motion first thing.

It's also important that she drinks enough as laxatives redirect fluid to the large bowel. I wouldn't want to cause her to be dehydrated.

This thread has given me a lot to think about and if we can solve this problem it could literally be a life changer for poor mum in law, who seems to have her fate decided at present.

I will let you know how things go.

 

[sleepless]

My husband takes 'Movicol', (Macrogol and Macillax are equivalents) which is a stool softener, and this seems to regulate his bowel movements while making them easy to pass.
I give him one sachet every other day, but it probably varies from person to person how much is required.
I don't think these are as harsh as a general laxative.

 

[Goingitalone]

Think Mum continent, but problems anyway!

Thanks Risa, for starting this thread.

We have tried some of the ideas on here but it doesn't seem to be solving mil's particular problem, so I'm posting this in the hope that one of you kind folks will have met (and possibly solved) the problem we have.

Mil is 92 with vascular dementia, in her own home and, with lots of support, is coping really well. We have had various little blips which we have found solutions to and so far we have managed to keep her at home. This latest one has us all scratching our heads, though!

No matter how often we visit, if she is left for more than about an hour we find soiled incontinence pants in the kitchen sink, bath or bin, the kitchen sponge has been used to try and wash them out, the kitchen bowl is soiled and there is residue of the event all over the taps, door handles and sometimes the chairs.

We have one last thing to try. We intend to make an upstairs sitting room for late afternoon/evening use as these seem to be the worst times of day for these events and she would be nearer the bathroom. She just hates the downstairs commode and won't use it unless we cajole her.

I have fought really hard to keep her in her own home but I fear we are now very close to the care home decision. Even with our band of carers we are struggling now to keep her hygienic and safe.

Any advice, please? Is it time?

 

[pahaps]

Dad visited recently. I found helping him with the toilet very challenging. He is becoming incontinent when it comes to peeing, thankfully not yet pooing. He struggles with constipation but we are supporting him with a daily addition to his breakfast porridge of dates, raisins or other dried fruit. He also drinks two glasses of fybogel a day. I think both of these things had a positive effect in terms of keeping him relatively regular. After a few enormous bowel movements during the week he was visibly more relaxed.
I don't know if that's at all useful but good luck to all out there.

 

[Katrine]

Thanks Risa, for starting this thread.

We have tried some of the ideas on here but it doesn't seem to be solving mil's particular problem, so I'm posting this in the hope that one of you kind folks will have met (and possibly solved) the problem we have.

Mil is 92 with vascular dementia, in her own home and, with lots of support, is coping really well. We have had various little blips which we have found solutions to and so far we have managed to keep her at home. This latest one has us all scratching our heads, though!

No matter how often we visit, if she is left for more than about an hour we find soiled incontinence pants in the kitchen sink, bath or bin, the kitchen sponge has been used to try and wash them out, the kitchen bowl is soiled and there is residue of the event all over the taps, door handles and sometimes the chairs.

We have one last thing to try. We intend to make an upstairs sitting room for late afternoon/evening use as these seem to be the worst times of day for these events and she would be nearer the bathroom. She just hates the downstairs commode and won't use it unless we cajole her.

I have fought really hard to keep her in her own home but I fear we are now very close to the care home decision. Even with our band of carers we are struggling now to keep her hygienic and safe.

Any advice, please? Is it time?

It sounds as if she's self conscious about toileting when people are around. Do you think she is holding on until people leave her on her own? If she's not even managing to use the toilet, but soiling her pants, then she may have faecal overflow around hard faeces, which suggests constipation. If it's diahorrea then her hand hygiene may be contributing to the problem. Keep her fingernails short and clean them regularly with a nail brush.

Ideally she needs a daily bowel movement that can be supervised. I am sure she will resist being told to go and have a poo, like a toddler, but how else can you manage the situation? I suppose you could arrange a planned total supervision day - a day where she is not left by herself at all. Then if she's trying to hold on you'll be able to tell from her behaviour, particularly if she makes excuses to get you to go away.

Have you got disposable gloves, a nappy bucket, pedal bin liners, spray disinfectant, disposable antibacterial wipes, hand sanitiser gel, and an odour neutralising air freshener? It's easier to manage incontinence if you have all the kit.

 

[Goingitalone]

It sounds as if she's self conscious about toileting when people are around. Do you think she is holding on until people leave her on her own? If she's not even managing to use the toilet, but soiling her pants, then she may have faecal overflow around hard faeces, which suggests constipation. If it's diahorrea then her hand hygiene may be contributing to the problem. Keep her fingernails short and clean them regularly with a nail brush.

Ideally she needs a daily bowel movement that can be supervised. I am sure she will resist being told to go and have a poo, like a toddler, but how else can you manage the situation? I suppose you could arrange a planned total supervision day - a day where she is not left by herself at all. Then if she's trying to hold on you'll be able to tell from her behaviour, particularly if she makes excuses to get you to go away.

Have you got disposable gloves, a nappy bucket, pedal bin liners, spray disinfectant, disposable antibacterial wipes, hand sanitiser gel, and an odour neutralising air freshener? It's easier to manage incontinence if you have all the kit.

Hi, Katrine,

Yes, I agree that she may be hanging on when certain people are there. That's quite reassuring in a way, as it shows a measure of control so is not incontinence. Quite the opposite.

I have started giving her a small bowl of prepared fruit to graze on during the afternoon. That way she is occupied so less likely to "go messing" and hopefully it will produce a bowel movement in the morning when I am there. She usually doesn't mind that I am around, I leave the bathroom door ajar for her as she hates being shut in anywhere. I usually go downstairs and busy myself with her housework and wait till I hear the boiler fire as I know then that she is washing her hands.

She does need some help with cleaning herself afterwards and that could be a problem but she does seem genuinely ok with me.

Yes, we do have all the kit. The other carers are great, too. None of them at all worried by the issue. I have a lot to be thankful for.

Just want to keep her safe at home for as long as possible.

 

[mancmum]

Little value in tinned prunes

My mil thought that tinned prunes kept her regular...they did not ..If I remember correctly there is actually very little fibre in them. I did manage to get her to eat some soft ones that had not been tinned. Dr recommended Hob nobs to replace other biscuits. Also she did start eating porridge again and even the instant packet porridge is better than white bread.

 

[WORRIER123]

My dad has a sachet of movicol and a senakot each night and not been for a week now. He hadn't been for a week prior but hallelujah he did but not back to square one
He's obviously in pain as he said it's like a tight belt being pulled
Going to call doc tomorrow for some lactose.
Tried prunes they didn't work but believe me sugar free sweets do !!

 

[Goingitalone]

Yes, the artificial sweetener in those sweets do make you "go" they give me tummy ache.

We have bought some sugar free squash with the same intention.

 

[WORRIER123]

Yes, the artificial sweetener in those sweets do make you "go" they give me tummy ache.

We have bought some sugar free squash with the same intention.

I bought a tiny and I mean tiny pack of sherbet lemons in m&s sugar free. Each one was the size of a finger nail no bigger. I ate maybe 6 one after the another.....
My goodness did I have to run and yes a tummy ache too
Maybe I get dad a bag as nothing else is working
He now says its like someone tightening a belt around him and making him so moody

 

[Aisling]

Not sure if Mum has fecal incontinence or is just not sure what to do when she has a bowel movement. Mum is able to take herself to the toilet and pee ok. However she is soiling herself or leaving the bathroom in a mess when she has a bowel movement. Dad does take her to the toilet during the day but unfortunately she never wants to go then and Dad is asleep when she goes at night. Sometimes she has used the toilet but appears to have walked away whilst still going or else she has gone in her pull-ups (which we started to buy because her underwear was getting in such a state). Mum also has the habit of putting her hands down her knickers and getting them covered in faeces. She is fighting Dad over being washed which doesn't help

Do you think it would be worth getting an appointment with a Continence Nurse? Dad isn't keen as he doesn't think they will be able to help (since Mum is going in the middle of the night). Apart from perhaps getting a prescription for some pads or pull-ups, I am not sure what else the nurse could offer?

This issue is getting Dad down as it causes a lot of extra work aside from being so unpleasant to deal with. We have suggested getting in a carer to wash Mum of a morning but again Dad thinks if Mum will fight him, she will fight the carer so it would be a waste of time.

Is there any way of getting Mum in the habit of opening her bowels during the day? Just stumped as to how to help Dad manage this problem?

Rosa, you need to contact the Nurse. Get as much help and advice as you can from Professionals. I wouldn't risk giving laxatives etc without input from doctor.

Sending support,

Aisling xx

 

[Beckam]

Forgot how to push !!!

Hi, My husband has Frontal Temporal Dementia, not sure whether latter middle stage or early third stage. he has forgotten how to push when opening his bowels !! he also can`t clean himself, at present I am trying suppositories and Senna tablets and trying to maintain a bowel routine. With no mental capactity he is becoming hard work, any idea`s