Post by norbert1 on Jun 26, 2006 8:10:51 GMT -5
Andrea writes---
{{{My husband, 65 was diagnosed with AD 18 months ago, later on, neurologist said it was fronto temporal dementia. 6 months ago he started getting his underwear dirty, so I assumed it was fecal incontinence and bought diapers that he now wears day and night.
He goes to the bathroom when he has the urge. He also goes to the br when he wants to urinate. My question is, if he is getting the diapers dirty in spite of all these, what is happening? Can it be that he forgets he has to clean himself? Every time it happens I help him take a shower, but I have to clean him very thoroughly.
He has many sympotoms of Ad , but he walks, drives his golf cart around, he still can carry simple conversations. I do not understand this and never have read about it anywhere.}}}
Andrea,
I cannot tell you definitely what is going on. When you said he was getting his underwear dirty, are you talking minor soiling (vs volume)?
Consider that no one knows exactly what causes incontinence in Dementia in the later stages. Do they not receive the signal that they need to go to the bathroom, or do they not know to respond to the sensation properly.
But earlier, incontinence issues are all about confusion and faulty response. Before incontinence even occurs, the person with dementia becomes confused by the sequence of bathroom procedures. They will need cueing (verbal instructions to help them with the steps of the procedure). I remember one set of posts where caregivers were describing the confusion their LOs had, getting the TP, and knowing what to do with it after they were done with it. (or using other things instead of TP)
In my case - I was shocked one day to peek into the bathroom and see my mom wiping first front, then back, then front again (same piece of TP).
I believe your hunch is right. You need to find out what is going on in the bathroom. And remember, the procedures for #2 are more involved than for #1 (for a man). Also, BM is most likely to occur 20 minutes after a meal, usually breakfast, so that is a time to begin routine toileting.
I remember one poster here a while back, that the LO had fallen against the door, and they could not get into the bathroom to assist - so they took off the door and replaced with a tension rod and a shower curtain. The benefit was that they could peek in and enter when cueing or assistance was needed. Many families are shocked when they discover how much confusion their LO is experiencing during bathroom procedures - (this also includes use of TP, bathing and brushing teeth)
I believe I heard, that when there is confusion during dressing, there is likely to be confusion in the bathroom.
Norbert
Alice adds ---
He might not be cleaning himself or completing the job while on the commode. Sometimes I feel they think they are going but they are not. His brain may be giving him the message that he needs to go but the muscles are not getting the same messsage. Maybe just suggest he sit a little longer and be sure and clean himself good. If you are around give him the wipes to use they do a better job.
Sometimes we just have to step in and do the cleaning for them. Sorry but its time to get the platex gloves and lots of wipes.It could be also he is late getting there and then has an accident and just pulls his diaper back up or he is not getting there at all..Are you seeing him actually go or is he just saying “yes I go”? It gets to a point we have to supervise these things.It is embarrassing for them..sadly another part of their dignity being taken away by this cruel disease.
Sometimes they are no longer able to do simple task.
Are you using the pullups or diapers. The pull ups are more like his shorts and easier for him to pull up and down. It makes them feel a little more like them selves.
I found the Wallgreen brand the best in absorbing and all..cheaper too.
My prayers
alice
See also, an extensive discussion on this board titled "peeing everywhere". alzheimers.proboards32.com/index.cgi?board=ADgen&action=display&thread=1189249126
{{{My husband, 65 was diagnosed with AD 18 months ago, later on, neurologist said it was fronto temporal dementia. 6 months ago he started getting his underwear dirty, so I assumed it was fecal incontinence and bought diapers that he now wears day and night.
He goes to the bathroom when he has the urge. He also goes to the br when he wants to urinate. My question is, if he is getting the diapers dirty in spite of all these, what is happening? Can it be that he forgets he has to clean himself? Every time it happens I help him take a shower, but I have to clean him very thoroughly.
He has many sympotoms of Ad , but he walks, drives his golf cart around, he still can carry simple conversations. I do not understand this and never have read about it anywhere.}}}
Andrea,
I cannot tell you definitely what is going on. When you said he was getting his underwear dirty, are you talking minor soiling (vs volume)?
Consider that no one knows exactly what causes incontinence in Dementia in the later stages. Do they not receive the signal that they need to go to the bathroom, or do they not know to respond to the sensation properly.
But earlier, incontinence issues are all about confusion and faulty response. Before incontinence even occurs, the person with dementia becomes confused by the sequence of bathroom procedures. They will need cueing (verbal instructions to help them with the steps of the procedure). I remember one set of posts where caregivers were describing the confusion their LOs had, getting the TP, and knowing what to do with it after they were done with it. (or using other things instead of TP)
In my case - I was shocked one day to peek into the bathroom and see my mom wiping first front, then back, then front again (same piece of TP).
I believe your hunch is right. You need to find out what is going on in the bathroom. And remember, the procedures for #2 are more involved than for #1 (for a man). Also, BM is most likely to occur 20 minutes after a meal, usually breakfast, so that is a time to begin routine toileting.
I remember one poster here a while back, that the LO had fallen against the door, and they could not get into the bathroom to assist - so they took off the door and replaced with a tension rod and a shower curtain. The benefit was that they could peek in and enter when cueing or assistance was needed. Many families are shocked when they discover how much confusion their LO is experiencing during bathroom procedures - (this also includes use of TP, bathing and brushing teeth)
I believe I heard, that when there is confusion during dressing, there is likely to be confusion in the bathroom.
Norbert
Alice adds ---
He might not be cleaning himself or completing the job while on the commode. Sometimes I feel they think they are going but they are not. His brain may be giving him the message that he needs to go but the muscles are not getting the same messsage. Maybe just suggest he sit a little longer and be sure and clean himself good. If you are around give him the wipes to use they do a better job.
Sometimes we just have to step in and do the cleaning for them. Sorry but its time to get the platex gloves and lots of wipes.It could be also he is late getting there and then has an accident and just pulls his diaper back up or he is not getting there at all..Are you seeing him actually go or is he just saying “yes I go”? It gets to a point we have to supervise these things.It is embarrassing for them..sadly another part of their dignity being taken away by this cruel disease.
Sometimes they are no longer able to do simple task.
Are you using the pullups or diapers. The pull ups are more like his shorts and easier for him to pull up and down. It makes them feel a little more like them selves.
I found the Wallgreen brand the best in absorbing and all..cheaper too.
My prayers
alice
See also, an extensive discussion on this board titled "peeing everywhere". alzheimers.proboards32.com/index.cgi?board=ADgen&action=display&thread=1189249126