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Inappropriate Toilet Habits

 REGINA D. Posvar LPN,RNA
REGINA D. Posvar LPN,RNA

Q: My mom has no respect for our home anymore! She is using the house as a toilet! She puts her pants down anywhere she feels like and just goes. She takes the poo and smears it everywhere. It is disgusting!!! How do I get her to stop!!!

A: I can certainly understand your frustration. Let me start with reminding you that your mom has no concept of what respect is at times because she has brain failure. This means she does not have control over what she is doing. She is not a child so you cannot scold or reprimand her. There are a few things you can do to help eliminate this behaviour:

Put her on a toileting schedule, every 3 hours, to start and learn a pattern she has for eliminating; look for signs that she may need to go; try different things to get her to go, like turning the faucet on so it will stimulate her bladder; if she is dropping her clothes off, I would suggest buying her clothes that she can’t take off.That way she is not playing in the faeces if you missed the signal to take her to the bathroom. Some families have found that to be very helpful. She may need a shower for thorough cleaning but the faeces is not spread everywhere; See if you can get help with caring for her; and always get protective coverings for things you cannot replace as accidents will happen. Another idea is to have portable toilets for her to easily get to at night, especially. Keep in mind that you are doing 24/7 caregiving and you need a rest from it. Take care of you.

Q: My grand dad seems to be agitated and aggressive a lot lately. We find it hard to calm him down. Our caregiver is fearful of him so his care needs are not being done, like his showers. What can we do?

A: I would need a little more information with this question. When you say “lately” my thoughts are this is a sudden change and I am inclined to question about pain, or infection. This needs to be ruled out. If it is pain, look for signs of grimacing, furrowed brows, teeth grinding, moaning, limping, and favouring a leg, arm or side. If infection, look for cold, sinus and breathing changes. He may need to be seen by a doctor. Increase his fluid intake including coconut water and cranberry juice.

If he has no pain or infection it is time to look at patterns to when he becomes agitated. Reflect the situation back to yourself and see if you logically would get upset yourself. Anger is an emotion, so what is he angry about? If you are not able to figure it out at the moment, validate his emotion with an apology. He has every right to feel his anger. Now unlike you and I, we can control our anger in situations, your grand dad cannot. Get his attention. Validating his emotion will help him to trust you and calm him. Change the mood after the validation to a pleasant mood. Play his favourite music. If the caregiver is becoming afraid, it is time for the caregiver to have a break as well and maybe get some training. There are many reasons that can cause agitation and aggression such as sundowning, frustration on not being able to communicate or do something in the later stages of the disease. Some people use medication to help with the anxiety and some use home remedies. I agree with some medication only as an absolute last result. Music will work like medication when used appropriately. I am sure there is more to this question but these tips can help you get started on a calmer grand dad.

Sweet and Silly~ Hearing laughter and talking from the back room a daughter came running to find her dementia mom facing the mirror. The mom turns to the daughter and states “ there’s another plump lady in here and she is a delightful old thing” (talking about the lady in the mirror which is herself)

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