I have been caring for my father for the last 20 years since my Mom passed away. He is 82 now. Recently he's been having "accidents" in his pants. He changes his clothes but doesn't clean himself very well and leaves the toilet seat a mess. He doesn't say anything, just leaves the clothes near the washer. Since I'm his daughter I find it hard to talk to him about things that are so personal and probably embarrassing. Looking for some advice.
NOT that this makes it any easier when dealing with clean up, but it may help to explain why your loved one doesn't seem to notice or respond or be bothered when they have a bm in their clothing or on toilet seats, etc. There's the additional factor of possible embarassment, like we see in toddlers, who will deny it when you confront them about a wet or feces filled diaper/pullup out of embarrassment or simply having something they are engaged in at the moment that they don't want to stop doing. As others mentioned, also, the sense of smell is often very compromised for elderly people. That's sometimes why they have a poor appetite...can't smell...can't taste...boring! As much as we take our toileting habits as a "given", there's actually a lot of social/cultural/learned factors influencing it. (Look at many animals....like dogs...who check each other other by smelling each others anuses when first meeting!)
Also do not set yourself up to be a doormat. Unless I missed something than your father is nog confused. Neither am I; so would you tolerate me leaving your toilet seat a mess and just throwing my clothes full of bm next to your washer. Looks like he is going to need complete care after being incontinent. He cannot even clean himself well. I would find the words to let him know in a loving manner that changes need to be made in his toileting habits. You may put him in Depends but he is still going to need help for changes . He needs to know to call you for help with changing the Depends and getting cleaned up properly.He must have proper skin care because he is at risk for skin irritation or breakdowns. The necessity for good handwashing is a given. A call to your family MD is a good idea to make sure no other underlying medical issues are causing this. You may also want to consider the need to protect his bed also.
the clothing it was so bad. He's always embarrased and my heart aches for those suffering with this lousy disease. Suppose you put yourself in their shoes and remember this is something they can't control. How about doing what you can to clean it up quickly and get on with it. I don't believe any advice you give will help the situation.
Mom always sat on a pillow with a towel over it so she wouldn't ruin any chair she sat on. You can also buy disposable underpads (chux) to protect chairs or the car seat.
Expanding on Isn'tEasy's theories...
I've written this before and really believe it's a factor - older folks' priorities change, and so do their sensitivities.
Maslow's heirarchy of needs is no longer multi-dimensional for them. Their focii drop down to the basic few needs and other concerns drop away.
If you think about it, they're in the last stages of their lives, have limited mobility, become dependent on others, and sometimes every day is a struggle. When you're in survival mode, a lot of things aren't important as they were when people were fully functioning.
I sometimes liken it to early humans whose focii were on food, shelter and survival. Higher level thinking processes weren't that necessary except to support the bsaics. Once their got their saber toothed tigers or mastadons, they ate, slept and then went hunting again. They all probably had horrendous body odors but I doubt if it was that important to them.
So, I wonder if they really do have awareness that they're about to pee or poop, have extreme body odor from not bathing, are spilling food all over themselves, etc... but, they're just 'ok with it'. Particularly men, who may have had many of their personal habits and preferences accommodated all their adult lives.
The squishy, smelly depends, the shirt that hasn't been changed in a week, the food stains all over the furniture...it just doesn't bother them. But, it does bother those around them.
Dementia in so many ways makes the elderly very toddler-like, so, I wonder if nagging should be employed in the same way as one might with a 2 or 3 year-old.
Obviously, in the later stages of dementia, consciousness of all of those things starts to wane. But, I'm talking about someone who's still communicative and can respond to instructions if they're reinforced repeatedly.
I've tried it with my dad with some success on other issues. I don't nag in the same authoritative tone I would have with my kids when they were young, but I do address the same topic over and over until he starts to change an objectionable behavior. Like it was with my kids, it's sometimes a 'last man standing' situation : )
I have IBS so I found it easier talking to her about her bowels because I can sympathize with the whole running to the bathroom thing. We can relate in that way. I always tell her I understand how frustrating it is but I can't do much about it.
Now that your dad is 82 it sounds like the caregiving is changing and you're facing some situations you haven't faced in the past. The best way to deal with them is head on and as they come up.
Talk with your dad and tell him what you need from him. Be compassionate. You could say something like:
"Dad, I've noticed recently that you've been having accidents in the bathroom and it's OK, it's a normal part of aging. My concern is that you're able to clean yourself up after an accident so I've put some Depends and wipes and wash cloths in your bathroom to help you get cleaned up. I've also put a small hamper outside your bathroom in case you need it so you can throw your wash cloths in there when you're done. I've also put some paper towels and Windex under your sink so you can clean up the toilet seat. I wouldn't want you to have to sit on the commode when it's dirty."
Be matter of fact, diplomatic, and do what you can so he can hang onto some dignity. As difficult it is for you to discuss this with him I'm sure it's more difficult for him to have to discuss it with you.
I'm sure you'll be very kind when discussing this with your dad. You acknowledge the embarrassing nature of this discussion which tells me that you're a caring person and that you are concerned about your dad's feelings.