Dad is urinary & more recently bowel incontinent. Need him to go to the toilet more often in hopes he’ll change the wet pad in his moisture holding briefs. He refuses to go to the bathroom when asked. He is developing sores in his crotch area because he won’t change the wet pad for a dry one. He is distressed when he sees he has pooped attempting to clean it up himself but seems to get poop on his shirt, pants, toilet, wall, hands, etc. He does not seem to recognize he has developed sores or that he is wet or has pooped in his pants. Doesn’t seem to feel it or smell it. Appreciate any ideas on how to get him in the bathroom more often to change out the pads and hopefully have a bowel movement while on the potty.
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.
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.
Get support for yourself by getting support with him.
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
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.
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.
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.
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.
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.
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.
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.
Sorry to say my FIL is still very difficult after over a year of trying . Some of them will refuse frequent enough care and will always stink .
In the meantime since your father is refusing trips to the toilet, I think he is in need of incontinence briefs not the pads he’s wearing . You can get the pull-up kind that are more like underwear . Take away all his underwear and put the new pull-ups in his underwear drawer .
OP, I wish you better luck in getting your LO to accept help whether it be at home or hopefully in a facility . This will become more burdensome to deal with at 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.