My 83yo husband has had dementia for the last 10-15 years, but since I am with him 24/7, all his needs are taken care of and he doesn't seem to be getting worse. However, over the last couple of months, he's been unable to clean his bottom properly. His feces are soft and smeary (not watery like diarrhea) and smell much worse than mine, though we eat the same things. As a result, I have to clean him with wet wipes or, if it's really bad, put him in the shower. He occasionally has bowel movements in the middle of the nights, which is weird.
So here's my dilemma: what if he has cancer or some other disease that would require surgery? I wouldn't want to put him through surgery. Am I better off not knowing (i.e. not having him tested), or should I ask the doctor to order a Cologuard test?
What you do with that info is up to you.
Surgery is not always an appropriate treatment,
especially in elderly that may have difficulty with the anesthesia.
Some cancers are very slow growing and not an immediate concern.
There are many effective cancer treatments outside the corporate medical community for very little money.
When I brought my brother home, he had really foul, especially gross looking gassy stools and I freaked out.
His gastroenterologist was unimpressed and changed his medicine as others have suggested.
But I do wish I had known about those pants that unzip and unvelcro.
in the meantime if budget allows maybe get some disposable incontinence pads and sone incontinence pull on pants ( either disposable or washable)
That way you remove the pad and just slot in another
we use large wet wipes not the small ones and dip them in to warm water with a little disinfectant
hold the wet wipes in Kleenex tissue ( cut into two) makes holding wet wipes easier
then i pop at dry with soft tissue and anti chaff cream from his doctor to ensure no rashes
they have heavier incontinence aids for night time
And also incontinence sheets to lay on
we use disposable ones
but they have washable ones
it mom asked cleaning easier
all that said
changes in bowel motions can signify health issues so get the doctor to test - very important
if there is an issue the sooner it’s treated the better!
don’t delay
It may even qualify him for Hospice care.
Having a new disease does not "require surgery", if you opt to forego that route. Of course, it will be your husband's decision, assuming he is of sound mind.
If you are worried about taking care of him post-surgery, he should be in a rehab care facility for recovery. You need to make it clear to his care team that he will not have someone to adequately take care of him at home, and that he should not be released to his home until he can regain his former independent functioning.
I also agree that installing a bidet or "washlet" would be useful in helping with clean up.
As far as smell goes, I don't think you can determine how bad feces really smell until you're down there at the site cleaning up the mess yourself!! I would vomit if I ever had to clean up DHs behind. I can't even go near the bathroom for an hour after he's been in there, and he has nothing wrong with him. 😑
Best of luck to you.
Before hooking up that horse, let's get the horse and cart in the right order, because the option whether to want to know ANYTHING at this point is a good one. I would start with asking your gerontologist or PCP to refer you to gastroenterologist. The odor and consistency of stool has much more to do with BACTERIAL COUNTS than with cancers. Cancer doesn't change the stool usually unless there is bleeding in which case it is darker, or red dependent on where in system any tumor might be bleeding (higher or lower). If you and hubby are eating the same foods I can reassure you that your intestinal bacterial count isn't the same, as it is rather unique to us as our thumbprints.
The gastroenterologist can do many NON invasive tests to see whether stool has more fats not being digested, has high bacterial count, etc. They range from breath tests to stool examination.
That is where I would start.
Here is my best guess as an RN as to what is happening with consistency and difficulty cleansing and that is an aging sphincter that simply isn't able to "pinch off" the stool at the end, nor close totally at once. Our guts age as well. Some are helped with taking Citrucel (don't use Metamucil; while made of same stuff if ferments in the gut differently, causing gas and explosive stools at times) to give some consistency to the stool. It often leads to better evacuation.
Good luck. Big subject believe it or not and your complaints are NOT unusual at all!
One more helpful hint. Get the large side packet of "Handi-wipes" (a brand of cleanup rag found where bleaches, mops etc are in the store, or on Amazon). Cut each in half. Use with warm water to cleanse, wash with dedicated bar of soap. Keep near toilet. DO NOT FLUSH as it will clog the plumbing, but great for saving on wipes and great for cleansing. Can be thrown in laundry as you would used diapers and reused often.
Before hooking up that horse, let's get the horse and cart in the right order, because the option whether to want to know ANYTHING at this point is a good one. I would start with asking your gerontologist or PCP to refer you to gastroenterologist. The odor and consistency of stool has much more to do with BACTERIAL COUNTS than with cancers. Cancer doesn't change the stool usually unless there is bleeding in which case it is darker, or red dependent on where in system any tumor might be bleeding (higher or lower). If you and hubby are eating the same foods I can reassure you that your intestinal bacterial count isn't the same, as it is rather unique to us as our thumbprints.
The gastroenterologist can do many NON invasive tests to see whether stool has more fats not being digested, has high bacterial count, etc. They range from breath tests to stool examination.
That is where I would start.
Here is my best guess as an RN as to what is happening with consistency and difficulty cleansing and that is an aging sphincter that simply isn't able to "pinch off" the stool at the end, nor close totally at once. Our guts age as well. Some are helped with taking Citrucel (don't use Metamucil; while made of same stuff if ferments in the gut differently, causing gas and explosive stools at times) to give some consistency to the stool. It often leads to better evacuation.
Good luck. Big subject believe it or not and your complaints are NOT unusual at all!