Dad is refusing to change his soaked pad (guard) in his moisture-wicking briefs. Any ideas?

It certainly is nice to see people are in the same boat. I have a 98-YEAR-OLD father-in-law that I live with, along with my husband (his son). We were married just about 2 years ago. I would have been gone a long time ago if it wasn't for my moral convictions. The FIL wears adult diapers but still wets through them into his pants and then onto his reclining chair that he sits in. When he does change the diapers, he gets poop all over the toilet seat, on the floor, on the walls, etc. His bed is wet every night. The bathroom should be cleaned every day. I used to clean it but then it became "my job", so I won't do it any longer. He's not my father and "if you want it clean do it yourself" argument is just a selfish way to get out of something you don't want to do. Another sibling lives separately at the other end of the 10 acres but does very little but knows it all. From the living room and down the hall to his bedroom and bathroom, smells like pee. The guy cusses and uses foul language constantly. I hate going home anymore.

Start a toileting schedule - get him to sit on the commode every 2 hours when he is awake. It might help to get a bidet attachment to the toilet so he can "get cleaned" every time he uses the toilet. In addition, switch to disposable underwear - incontinence briefs - so you don't have to deal with the "tear out the used pad and insert a new pad" since those tasks are probably beyond him. If he soils or saturates a brief, just tear it off at the sides and put on a new one when his bottom is clean.

Tracie: Perhaps your father requires managed care facility living as this is going to be beyond TOUGH for your mother to manage. Also perchance he needs to see his specialists, i.e. neurologist, gastroenterologist and urologist.

Get some help from his primary care doctor. He may benefit from some medication for his dementia. Sores and rashes can become infected, septic and life threatening.

He probably needs to be admitted to the ER for admission and an evaluation.

Sounds like home caregiver is needed. . An aide can be sent to shower him several times a week.

So sorry Tracie, this is extremely difficult. You and mom need help with dad.

The situation really does pretty much rely on how long your mother remains determined to stay ahead on the clean up and ongoing sores, which will inevitably become infected and grow larger.

In dementia, it may not be reasonable to expect Dad to take directions, or appreciate odors, or feel concern for the needs of others who love him.

If your mother refuses to provide NECESSARY HELP that she feels will distress him, the inevitable future won’t be good to her, and won’t make matters better for him.

Many situations in the course of this illness have no good solutions and no happy outcomes for the original victim or for those who love and attempt to care for them.

While brutal honesty can be too cruel, to continue to look for “good” solutions can in a different way be just as unkind to your mother.

Reality is that the best thing for Mom is to attempt to impress upon her the DEEP CONCERN you feel for HER, and HER WELFARE. Nothing will change your father, but you may be able to open a conversation with her about the need for “a few” changes that may become imperative sooner or later, rather than choices.

Sending hugs and hopes that something can move in a positive direction for some aspect of his care.

I wonder if it would help if you set a timer and just say. “Oh Time for a shower” without any reference to his incontinence which he is denying. Also, if that doesn’t work, you either need a big forceful aide to help. If that isn’t possible, he needs to be placed. This is too much for you to handle.

Consult immediately with his PCP, get updated " level of care needs assessment" for your father and, care options going forward. It may be time to consider some form of facility placement or other in home care options .
Get support for yourself by getting support with him.

You cannot lead a horse ... as the saying goes. And dementia isn't funny or a phrase. It is serious and sad.

You will not be able to TALK logic to him.
He will either / and not listen or not be able to comprehend.
He will continue to BELIEVE he is right and will do what he wants.

It might be time for your dad to be in a facility.
If not, someone may need to be with him 24/7 re hygience/bowels needs.

I sense he has a level of dementia that requires medication and caregiver support.

That he is stubborn or 'refusing' / unable to care for himself is a red flag that he needs more / other support.

If he is not diagnosed with dementia, he may be able to do what he wants when he wants.

A huge difference: is he living in YOUR home? or HIS?
You do not want 'this' behavior in your home.
You need to consider making other housing/living arrangements for him.

Gena / Touch Matters

My mother cared for my father during his final illness until he became too sick for her. It really drained her and she was a very active 70 year old. I can't imagine how hard this must be on your mother's physical health. Also she is not being successful in getting him to take care of basic needs or doing it for him. Some of this does sound like my MIL with moderate vascular dementia, except she is mostly continent. She just refuses to bathe. She battles me on everything as if it is her goal to oppose everything I try to help her do. Except weed or bring her food. She likes me to weed her flower beds and put ready to eat things in her fridge....

I wonder if convincing your mother that getting him more care is best for her and you would do any good? Your father has passed the point of rational thought. he can't make the decision. Do find someone who knows elder law to help with planning finances. You might not be able to place him in a care facility if he doesn't want to be places UNLESS it is medically necessary. That's a discussion to have with the lawyer and his PCP. Finding good help at home might be hard, especially since it seems he needs it not just for a few hours, but for bits of time throughout the day.

He's past the point of being able to manage himself. Someone needs to mange his needs.

This thing I wonder is if he ends up in the hospital for an infected sore, will APS come after you for neglect? (I’m legit asking because I don’t know). Any possibility of that?

Are his sores healing?

It sounds to me like your mom isn’t really understanding that his health and safety are more important than staying home.

Try the adult pulls ups and get rid of the moisture holding briefs. They clearly aren’t working for his issue.

If he still has this problem after you make the change, then to me it sounds like he needs to move where he can get a higher level of care.

Believe me, I understand when you have one difficult and uncooperative LO. I can only imagine how emotionally difficult it is to have two uncooperative LOs.

"He completely dislikes any care brought into the home".

May as well stop at "He completely dislikes any care."

So he is going to dislike being changed no matter if he is prompted, family help him or an Aide helps him 😶

Tracie, is may be worth talking to Mom (in a quiet moment).

Tell her this is hard but she is doing a fantastic job caring for Dad. But you want her to look after her needs too. The situation has to work for BOTH of them.

She may want very much to keep him home. I get that. Home care IS the way to extend this.

If a person is sitting in wet trousers collecting sores due to their own stubborness it's just too hard on one main caregiver. A team of caregivers is needed. Enter Home Care Aides.

Trial it. Keep trialling it as Plan A.
Eventually a move into care may become Plan B.

Tracie,

You may have to completely remove yourself from helping your dad in order to convince your mom to get outside help or place him in a facility.

I know that it may be hard for you to do, but as long as they know that you are going to help, then they don’t have any incentive to move forward.

Transitional times are always the hardest.

Explain to your mom that your dad will adjust to his new surroundings and then you and she can visit him on a regular basis.

Tell her that she will be involved in his care by being his strongest advocate.

It's probably time for your father to be in memory care. If he's in a care facility they will handle toileting him and changing his pants.

He should also be using diapers now, not pads and briefs. When the pants pooping starts, that's when it's time for diapers and usually time for placement.

If they can afford 24 hour homecare, it's worth a shot but I'd advise you to consider placement.

You cannot provide the care he needs and neither can your mother.

Its time for Dad to have help in the bathroom. Maybe use men's disposable briefs. They rip down the side for easy getting off. There's a way to get then on without taking off his pants.

I would think caring for him is a lot for your Mom. She is with him 24/7. Maybe time to place him. If money is no object, maybe a nice AL where they can live together. Then she can enjoy all the activities and outings knowing he is being watched. If they need Medicaid to pay for care, then a nice LTC facility near by. But if Mom goes this way, she needs to see an elder lawyer well versed in Medicaid. She needs to have their assets split. His split going to his care and when gone, Medicaid is applied for. As a Community Spouse, she stays in the home, has a car and enough or all of their monthly income to live on.

I know this will be a hard decision but the stress on Mom could kill her before he goes.

Routine & assistance.
When *asking* no longer works, move to *saying* "It's time to.." or "Follow me..". After than comes *doing* the task WITH them, then eventually FOR them.

In aged care group living, staff have a toileting schedule for residents no longer fully independant in this area. Eg wash up & dress start of day. Maybe quick check mid morning. Walk to toilet & sit awhile after lunch. Brief change as required. Afternoon resttime. Brief check. Toileting again after dinner &/or before bed.

This may become very burdonsome for your Mother. Even more so if he requires a lot of hands on help to walk there & manage clothing. Even more again if he lacks understanding so refuses checks & changes. This resulting in wetter pants & sores as you already know.

I wish I had better advice for you.

I have 2 LOs that wish to still be independant (good) so often refuse help (not good). Cognitive decline appears to reduce ability to see/feel/smell problem. Lack of reasoning to connect clean & dry with preventing sores.

Your profile says that you’re helping your mom out two days a week, spending the night at their home.

Your father has vascular dementia and it will only become more difficult to care for him. He isn’t able to reason with you.

Why not speak to mom about placing your father in a facility? Then you and she can visit as family members.

He needs to seek medical attention for the sores.

Best wishes to you and your family.

As sad as it is, it may be time to consider memory care.