I'm sorry, this is a delicate subject, but I'm the daughter of a 90 year-old, ALZ father. His bathroom aim has noticeably been off for the past week or so. It's noticeable he's rushing faster to the bathroom, too. The shower door is now getting wet and the toilet lid, the under side, is splatter painted. His medications tend to make him loose, but he's getting spots now on his shorts and socks. I am wondering if incontinence is far behind. I try to pick my fights carefully with him, as I know this is one that will embarrass him and cause immediate denial, if I suggest Depends, which will also cause a problem to his skin with his loose movements.
Any suggestions? Thanks so much!
I knew my mother wouldn't even want to discuss this or acknowledge she had a problem, much less agree to using them. She isn't really incontinent, but does sometimes have trouble getting clothes off in time. In her case, the staff and I removed ALL her underwear and left the disposables in various places (two drawers in her room, one drawer in bathroom.) Never brought it up, never discussed it, never heard a word or complaint about it!
With any kind of cognitive issue, just telling him how to do it, what to wear, to sit (even if it is his doctor) isn't going to stick with him. He will likely need some gentle guidance when he goes.
It might be wise to have a doctor and/or urologist exam, just to rule out any potential medical issues that might be contributing to the issue. It could be balance, eyesight, prostate, or just absent-mindedness (little boys will tend to not pay attention and sometimes 'miss', and with various types of dementia, they are becoming more and more like little boys or girls again!)
Meanwhile, suggesting bathroom breaks on a regular basis might help with the "rushing" and/or dribbling before he "shoots." For instance, if he is going every 3 hours, prompt him at 2 hours. Prompting by saying you have to go might be enough to get it in his head. I also find while sitting I might not notice that I need to go, but when I get up and gravity kicks in 2 seconds later, oh boy, make way for ducklings!!! If you can accompany him (might not want a "girl" there with him, don't know how well he accepts personal help from you!), you could suggest sitting.
I do like the idea of a large fly or other creepy crawly at the bottom of the toilet! Boys "love" to shoot things in the toilet! :-D
Elastic waist bands also allow quicker "access", although this doesn't help our mother very much (weight/mobility/standing issues are the problem there.)
If medications are making the stools are very loose, I would discuss this with his doctor(s) or pharmacist (they might know more about side-effects and possible alternatives.) Perhaps they could find a replacement medication or suggest something to bulk up the stools that won't interact with or be affected by the medication he takes. Check out this page for some information and potential natural remedies (aka foods we eat):
https://www.webmd.com/digestive-disorders/chronic-diarrhea-16/diarrhea-more-fiber
You should consult with his doctor before trying anything, but this would be good to read before asking. IF he has taken any antibiotics recently, his gut flora may be out of whack too. There are so many pro and pre biotics, I would consult with doc on those, for sure. If he didn't have antibiotics and is eating a good, varied diet, this shouldn't be an issue.
Unless he isn't able to hold his BMs, the disposables won't help there either (refer to Ahmijoy's telling of two incidents - just like with missing the toilet with stream, if someone is still attempting to toilet, these won't really help.)
HOWEVER, if you can swap them with his undies, and get him used to wearing them now, it won't be an issue later, when he might be less able to understand or cooperate. I would also check with/have him checked by his doctors, just to rule anything medical out.
That said, as others have said its often an enlarged prostrate issue and instead of having a direct flow, the little guy becomes more like a sprayer hose.
Also try chia seeds in his oatmeal, muffin, on toast. They gel the bowel contents. Activia yogurt (not the sugar free) helped my dad's "digestion.
Try sticking pads on to a diaper. That way maybe you don't have to go through all the fuss of changing the entire depends.
Remove his regular underpants and put the depends with the pad attached in his underwear drawer.
Sure, this is a graphic answer to a delicate subject, but this is not the time for cocktail hour conversation, is it? Keep praying, get help (you might find a Health Care Aide can deal with his denial and clean him up much better than you can and in no time, and it will make you feel better too.!)
There is a product on the market to clean a urinal, but I had Hibiclens for his foot anyway and discovered that just the least bit in the urinal not only cleaned it but the smell was gone. Hibiclens is Pre-Surgical Scrub (soap) and even though DH is now gone, I still have it and use it to wash my hands after touching raw meats.
RE: loose stools: if Dad is on Stool-Softener, stop it. That was what happened to my DH. Also, keep a bottle of Anti-Diarrhea pills handy as diarrhea will cause dehydration.
Get Barrier Cream for his privates - Peri-Guard is my favorite for me - it helps to prevent "diaper rash" - and if he gets a pressure sore (DH had one in his crack), I found Colloidal Silver Gel to be the only thing to heal it. Personally, I preferred the Miracle Silver brand. It will also take down a blister in about 24 hours or less. I don't know why it works on blisters, but I've been thankful : )
You're a good daughter! Bless You!!
If the stream is straight out and his aim is truly off, then disregard this message.
Are you saying that the only normal flow for a man is straight out, with no leanings to one wide or the other (or even up or down)? I have only a 1 mans experience with this as a problem, and that is me.
I remember accidentally overhearing two young men, who played basketball in college, talking about how much easier it is to "sit down to pee". So if those guys can do it, so can your Dad.
He should be changing his underwear if they become soiled, same with a disposable brief.
He may not be able to see the bowl of the toilet easily. It is white, the seat is white so I can understand how an aim can go off a bit.
Suggestion...Turn the water off to the toilet, flush so all the water goes out and then dry the bowl. Get some bright color nail polish or even a Sharpie Marker and put an "X" or a "O" on the inside of the bowl. Wait for it to dry then turn the water back on and let the toilet fill. This will give him a spot to aim for.
The mark will eventually come off when it is no longer needed it can be removed. For the longest time I had 2 "X"'s on the bathroom floor so my Husband would know where to stand when I had to change him. Worked like a charm and now that he is gone..the marks have faded and I sort of miss them.