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Dear community, I’m sorry but this will be kind of messy and specific. I’ve been assisting my 83-yr-old hubby (who has dementia) with toileting for a few years now. I’ve been successfully getting him cleaned up with not too much difficulty.
Lately it seems after bowel movements that no matter how much I try to clean him (including showers, bidet and wipes), there is always more material showing on the wipes. Do I need to be striving for 100% no staining? (And why doesn’t water get men’s bottoms clean, anyway?)
In the past week, he has expressed pain when I’m wiping him so I am worried about irritation, a fissure or hemorrhoid, as he has not expressed this discomfort in the past.
If I leave him somewhat dirty, then I worry about irritation or infection getting worse.
Has anyone else experienced the sense that you could wipe all day and never get the area cleaned? Any suggestions for best gentle ways to manage this? I also wonder if the dementia is exacerbating the discomfort he expresses, but I don’t want to ignore it.
Appreciate thoughts as always from this lovely community.
Ann

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OK...not to get graphic but..
Have you tried cleaning him while he is in bed, on his side. Lift a butt cheek and check to see if there is a reason for the irritation/pain that he is expressing.
If he has had any bouts of constipation or diarrhea he may be irritated and need a bit of a barrier cream. (If you use one use it sparingly and pat it on do not rub it on. Patting it on will leave a light layer that will be easier to wipe rather than a thick layer that will just be sticky and gummy)
If you can get him into a bath rather than a shower 1 or 2 times a week that also might soak off some of the fecal matter that remains after normal toileting.
Or if he uses a shower chair using a hand held shower wand you might be able to "blast the undercarriage" dislodging any "dingleberries"
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Beatty Mar 2023
Your last para.. 🤣 I understood but I just googled 'dinglberry' to make sure.. the Urban Dictionary has it of anyone needs..
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If the skin around the anus appears red and irritated (so something other than hemorrhoids/fissure) then he could be having a perianal yeast infect. They cause indescribable itching and also stinging pain if he is scratching there. Needs to be treated with antibiotics. Daily treatment is to wash the area with a mild soap (Dove unscented is good) and then using a blow dryer to keep the area very dry (and NOT using any barrier creams or Aquaphor or Proper pH, etc). But this is ONLY if he has a yeast infection.

Like Grandma1954 suggested, soaking in a warm tub would be the best, if possible, for cleaning.
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NYDaughterInLaw Mar 2023
I think you meant to write antifungal. Antibiotics do not treat yeast.
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Is he on any sort of bowel regimen i.e. colace, miralax, etc? If so, those chemicals can cause the mushy sorts of stools and smears that just keep on coming, are pasty, and are difficult to clean completely.

If you're using a bidet, are you letting the water run for several minutes? Have you tried soaping up the area first and then sitting him on the bidet?
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cwillie Mar 2023
I imagine they are talking about the kind of bidet that is attached to a toilet seat or perhaps a hand held sprayer, the toilet seat kind has a cycle that runs just a few seconds, there's no soaking.
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Hemorrhoids might be part of the problem, you could try a over the counter cream. I'm also going to agree with the suggestions for lots of barrier cream, basic zinc oxide or even just petroleum jelly - both will help protect the area from irritation and aid in wiping.
Another idea is to buy one of those inexpensive sitz baths that sit over the toilet seat and let him soak a few minutes in an epsom salt solution, it might feel soothing and may also help with the cleaning.
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NeedHelpWithMom Mar 2023
This is true. My mother would say that her hemorrhoids were bothersome. I bought cream for her to use quite often.
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When problems get to this stage, I'm for memory care. Have you looked into that? Keeping our LOs at home becomes extremely difficult at the point where you are now.

There are nurses and others who can advise you about this, but keep in mind that the skin of an elderly person becomes very fragile. Infection is a definite possibility with a skin break, especially in that tender area.

If you think you've got problems now, infection will make it much worse. I hope you'll investigate other options besides home care by you. Professionals are professionals, they have experience, and we home caregivers can't operate on their level.

Best of luck to you and your husband.
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My mother had hemorrhoids that she found quite irritating. I often bought cream to treat them.

I would mention his sensitivity to wiping to his nurse or doctor and see what they recommend.

I am so sorry that you are struggling with this issue. You sound so loving and patient with your husband. Wishing you and your husband all the best.

I totally respect your decision to care for your husband yourself. I do hope that you have a break from caregiving from time to time.

If caring for your husband becomes too difficult for you, please do not feel as if you have failed him or yourself if you decide to place him in a facility.
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If you leave quite a bit of stool on him, there WILL be problems. Plus it's hurting him to have you wipe. Mushy and impossible to fully remove stools come with Miralax and stool softeners.... find another product to use and that may alleviate the situation some.

I'm with Fawnby..... there comes a time when dementia gets to be too much to handle at home. Placing dh may be your best option or you'll be dealing with this and God knows what else for the rest of his life.

Good luck to you
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Our toilet seat bidet attachment that lets us run the water for as long as we like is made by LUXE Bidet mode Neo 185. We have had it for years and it has adjustable knobs for different water angles i.e. higher/lower and different pressure. We absolutely love it!!!
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NeedHelpWithMom Mar 2023
Thanks for sharing this info.
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Thanks to everyone for your helpful replies. I am not sure what I'll do if it becomes physically impossible to care for my hubby at home because I can't afford it. The monthly cost would about equal my entire retirement annual income. I housed him once last year for a 3-week respite stay, and I plan to keep budgeting for this as an essential item even now on a fairly tight retirement plan. The respite stay worked out extremely well, the place was great and he enjoyed it there. We both benefitted from the respite! I will say that when he came home he had a rash on his bottom, which cleared up quickly, but I can't agree that they would do any better a job on that particular problem. Thank you again!
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