My grandfather is in respectable health for 84 years old. He is coherent, he shops, drives, cooks - he smokes like a chimney but thankfully he is doing well. He doesn't like bathing, changing clothes, etc, his personal care is a subject of great debate in our house (we suggest he clean up a little, he stubbornly insists he just did a few hours ago - really was a few weeks) but we don't push the issue too hard as it could be much worse.

The problem is this:
When he has to pee, he does not lower his pants (elastic-waisted) - he pulls the leg of his shorts up and pees out the leg. He gets it all over his leg, his feet, the rugs and floor. He HAS to notice because he is soaked afterward, but he simply doesn't care. I don't want to call him lazy, but really, what IS this? And how many times can one mop the floor in a day without seeking advice?

How do we approach this topic? This behavior mystifies me completely because he is of decent physical and cognitive health but simply chooses this behavior. In fact, wouldn't standing there hiking up one leg of pants be HARDER than the other options? I'm at a loss. Thanks for any advice.

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Sounds to me as though there are signs of early dementia going on here or it may just be weariness from aging. I've known several seniors whose interest in personal hygiene declined, however they had no signs of dementia. I think it's an aging thing...they get tired of routines, their patience can be shorter and their priorities change. Their mental and physical capabilities are not what they were, which can be frustrating. Sometimes I think ithere can also be a sense of entitlement. After 70. 80, 90 years of doing what "they should do", they think they are entitled to not have to do it anymore...because they don't want to due to lack of energy and/or caring. A decline in personal hygiene can also be caused by impaired eyesight or other physical issues...such as problems with bladder, kidney and prostate, considering your GF's peeing issue. Arthritis or sore joints can also contribute to the difficulty in doing what were simple activities. But, what sent up the red flag of dementia concerning your grandfather was your comments: "we suggest he clean up a little, he stubbornly insists he just did a few hours ago - really was a few weeks." Either he doesn't remember or he's intentionally lying to get you to drop the subject. He's controlling the discussion and issue. You're correct, it is illogical to think his 'via the pant leg' route is easier, simpler or better than the usual way. Though he may consider "the usual" more of a chore, especially if his elastic-waisted pants don't have a fly. If not, it is more work to have to pull the pants down to pee. Make sure all his pants are equipped with zippers. Illogical thinking is a sign of mental decline as well.

I can relate to your story. My mother had early dementia and would make up stories, told as the truth, in order to support what she wanted to do or didn't want to do. In her case she didn't want to use a walker even though she had fallen several times and had been advised by more than one doctor to use a cane or walker. She would come up with some tall tales to justify not using a walker. Ultimately it was an attempt to take the air out of anyone's balloon whom thought they would get her to do something she didn't want to do. It was a way for her to be in charge of herself. She stopped the storytelling with me when I called her bluff. And, she did finally use a walker, at times.

There were also some bathroom issues with her, though not intentional as with your GF. My mother couldn't get to the bathroom in time...which was mainly due, to a benign intestinal tumor, found during a Colonoscopy.

So, first I would investigate if some changes could be made where your GF lives which could make things easier for him. (all pants zippered?, higher toilet? No button shirts? Does the washer need repaired? etc) Ask him "why" questions in trying to find out if its just laziness or perhaps physical or mental obstacles which have led to this change. (Considering the topic and your GF's age, perhaps a man should have a talk with him.) Next, a doctor's appointment should be arranged and your concerns raised with the doc. He/she may want to explore the possibility of a physical problem which has led to your GF's laziness or lack of initiative in peeing the right way. The doc may also be able to evaluate your GF's mental state, by talking with him and asking questions. Based on what the doc says, medication could be prescribed, tests ordered and/or some suggestions for a response.

Rest assured...while your GF's actions seem weird, they are not uncommon among the senior citizen set. I think it is such out-of-the-ordinary actions as what you've witnessed that often times is our first indication that a loved one is declining. It is a surprise in more ways than one.

Please keep us informed about what you learn.

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