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My dad's home health help has quit or can't come. He won't hire an agency because one treated him bad years ago. He hasn't had a bowel program this week. I am going down tomorrow. I have bathed my dad when needed, changed clothes, all of those things. But the bowel program is not something I want to do. I know my dad changed my diapers, I've changed my kids diapers. I will do my best. My dad feels bad but feels like he is going to poop his pants. My dad has a spinal cord injury. I will do what is needed but sometimes I wish things were different.

I've worked in a nursing home and I noticed it was a topic of discussion by staff of the residents' reaction to the assistance rather than the act itself. Staff are aware of the discomfort residents experience but the act itself is no big deal. They've "seen it all" but modesty is still the issue.
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I wouldn't leave him or her by themselves, but then if you're 2 hrs. away, kinda hard not to; last resort as someone said is ER, could just leave it at that and hope? he would call if needed; we knew a man who would go for that reason, not sure if he called himself
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Everyone needs to learn how to say NO. Remember, we, the caregivers/family/friends are important, too.
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my second post on this. I hope it helps. One poster said you will be rewarded. I grew with comments about rewards like streets of gold and you're a good girl and make your parents proud. My parents were never proud, if heaven has streets of gold I bet I'd have to scrub and polish them. I made a bad marriage and had two children always telling myself I couldn't support two kids. I waited for them to be grown and got a divorce, graduated got two degrees in 1.5 yrs. Parents were ashamed, never asked why the marriage did not work . I think it is wonderful when people have genuine faith to help them over the rough spots but you always have options. One is to be faithful and give up your options because others expect you to. I think you should find a warm, friendly Nursing assistant LPN, who has taken care of people like your, pay her fairly and tell him you have met this wonderful person who really needs the work
and bring her by. Or tell him you can't do the and you've invited her come by and demonstrate. And let her teach you. If you have the money, go on a two week vacation and pay her to take your place while you're gone.
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SueC1957, Thank you for the information. I didn't know what they were talking about.

I did this for my dad when he was dying of Mesothelioma in 1974. Something you didn't mention is you have to be careful and not hurt the Prostate because it caused him a lot of pain. My dad's mind was pretty well gone at this point, that is why his bowels were paralyzed. He was in this stage only a few weeks and we knew he was at the end of his life. He was on heavy morphine which made him constipated and the cancer was in his bones, so I had to be careful there also.

I don't blame anyone for not doing it. I never thought about hiring someone to do it. If I had, I would have tried to hire it done. In my culture hiring someone was never thought of. Of course back in 1974 a lot of things were different.
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I had this conversation with elder DD a while ago and asked her if necessary could she provide personal care of an intimate nature. She said she would not like it but she could however she would hire people for things like that. Hubby and i have managed to do that for each other.
Unfortunately a very common problem as we age.

Llamalover I don't think it was Mom's olfactory sense that was going. it sounds as though she has or had chronic diarrhea and when the urge suddenly came on she did not have time to get to the toilet. you can't wait you have to run at the first growl.
Explosive poop does go everywhere on the floor up the walls under the toilet seat and many elderly just don't have the strength to clean it up. Mostly it is not deliberate unless they make a habit of finger painting.

A friends MIL comes to mind. When they visited the house smelt of pee and MIL did not wear underwear. i explaned because she was so obese and debilitated she just could not get her pants up and down and on her way to the bathroom just leaked and was something she could not help. Friend was quite shocked she thought MIL was just being lazy.
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I know where you're coming from to some extent. It took me a while to realize that my mother had lost her olfactory sense because I was wiping up the bathroom floor and the toilet seat before I could use it. Also, she was waiting too long to get to the toilet. Phew!
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After being a CG for my wife give or take, 25 years, I found this task to be one of the most emotionally challenging for me. I cannot imagine having to do this with your parent.
Of course, going digital, was a last resort. From mild stool softeners and laxatives to mag cit, nothing worked. Eventually Lactulose, which was eventually effective. But even then, it didn’t work within a reasonable time frame. Eventually, my last resort was the ER. The nurses there, where as not jumping up and down with joy to take this on, were fantastic in their attitude. They kept checking on her until the Lactulose succeeded. I had told the ER how there hadn’t been a BM for a week and that MS was the reason why. With this info, they checked her into the ER and took over. It was medically necessary by their definition, and Medicare handled it.
I don’t know if you’ve been able to get a prescription for Lactulose but I’d check with your doctor. I’d also see if your local ER could be a short term option.
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He is very lucky yo have U, But whn u get to this point - You are the Parent & You just can NOT allow them to make the calls. I tried to run every decision by my Mother in beginning & please her. Tbey just can not comprehend what u are sacrificing / time away from your family & your job. Most elderly are self-adsorbed they just cant understand whats going on in everyone elses life that is put on hold for them. U hv to stop alliwing him to make the decisions. Do what is best for you. If you do not hv POA, seek Guardianship w/Eldercare atty. best of Luck !
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Thanks everyone I really appreciate the support and care. All very good points. Believe me I'm trying. Thank goodness I was able to do what was needed. Not something I want to do to my dad on a regular basis. Thank you it has really helped to talk it out here. Best wishes to everyone to on their journeys.
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Everyone should know what a "bowel program" is:

Methods for Emptying the Bowel;

Manual Removal
(my note: You, the caregiver, physically remove the stool from the rectum-picking it out, so to speak.)
Physical removal of the stool from the rectum. This can be combined with a bearing down technique called a Valsalva maneuver (avoid this technique if you have a heart condition).

Digital Stimulation
(my note: You, the c/g, put your gloved finger in the rectum and move it around.)
Circular motion with the index finger in the rectum, which causes the anal sphincter to relax.

Suppository
(my note: You, the c/g, pushes the suppository into the rectum with a gloved finger.)
Dulcolax (stimulates the nerve endings in the rectum, causing a contraction of the bowel) or glycerine (draws water into the stool to stimulate evacuation).

Mini-Enema
(my note: You, the c/g, insert the tube of the enema bottle into the rectum, squirt the liquid in and remove the tube.)
Softens, lubricates, and draws water into the stool to stimulate evacuation.

Bowel Programs
Most people perform their bowel program at a time of day that fits in with their prior bowel habits and current lifestyle. The program usually begins with insertion of either a suppository or a mini-enema, followed by a waiting period of approximately 15-20 minutes to allow the stimulant to work. This part of the program should, preferably, be done on the commode or toilet seat.
After the waiting period, digital stimulation is done every 10-15 minutes until the rectum is empty. In order to avoid damage to the delicate rectal tissue, no more than four digital stimulations should be performed in any one session. Those with a flaccid bowel frequently omit the suppository or mini-enema and start their bowel programs with digital stimulation or manual removal. Most bowel programs require 30-60 minutes to complete.
Bowel programs vary from person to person according to their individual preferences and needs. Some people use only half of a suppository, some require two suppositories, and some use no suppository or mini-enema at all. Some choose to do the entire program in bed, while others sit on the toilet from the beginning. Some find that the program works better if they can eat or drink a warm beverage while it is in progress, others find that this is not helpful. What is most important is that you discover what works best for you.
(Taken from SCI-Info-pages website for quadriplegic and paraplegic persons.)

OK, now does anyone think an adult child should be doing ANY of this to their parent?

I'm another nurse voting "NO" to your dad's demands. Just say no. Mean it.
Hire a c/g or aide from an agency, use "therapeutic fibs" by saying she's a friend of a friend (not connected with an agency) and have her complete the task.

Sorry if this is too much info for some.
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RE:cwillie's post: Just to let everyone know...
Bowel management after a spinal cord injury is not the same as toileting, it is a whoooole different level of care.

Oh yeah! And I thank God every day that I don't have to deal with that - but my neighbor does and you're right - a whooooole different level of care. Starting with suppositories. And she's been doing it for 5+ years now.
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I totally agree with Sunnygirl. I take care of my 95 year old father and he would rather die than for me this help him with that OR God forbid a shower! I’ve been caregiving for the last 15 years for different family members but I draw the line at that. It’s different changing diapers for a baby than for an adult man (or woman). He shouldn’t expect you to do this for him. Not trying to be ugly here but I think you might have to put your foot down on this one thing. It sounds like he needs to be in a facility or at least have someone coming in that is qualified, certified and trained to do this. Your back is sure to give out as well as your patience. Good Luck and God Bless.
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Others have mentioned prior about you "developing" a back strain that prevents your helping. Agencies have bad and good people...but if you/he hires privately get a consent form and find a background check agency to do all you can to make sure the person has no criminal record.
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Seems you have hit a brick wall with your Dad. Perhaps, moving forward with health aide is necessary. Maybe your Dad would be more open to health aide if you were present when aide is cleaning up the excretion; at least, for first few times. Then, he may adjust to aide doing the job and trusting her/him.
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I know how you feel. My sister and I cared for my dad, but I was a coward when it came to 'cleaning' it. My sister, bless her, was a little hysterical, but she did it nonetheless, until it drove her insane. He had dementia, and there were many other things that were difficult to cope with, until it was time to decide to have him looked after 24/7 in assisted-living. It is very difficult in so many ways, but there are times when we have to be firm, especially when it starts affecting our sanity. My dad had a prostrate problem, so he would 'leak' and he had to be cleaned several times a day. It was difficult indeed. We just don't see that one coming, when we're all younger, I know. I would suggest a carer, if he can afford it. Perhaps he might even like AL, with other people/friends around.
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I feel compelled to stick up for bowel program... I have no experience with toileting seniors, changing diapers, etc., but my dad's bowel program seems as though it must be easier compared to that. Including the time of transferring back and forth to the commode chair, it takes about an hour (using manual stimulation and a mini enema, and time for the enema to work) and then we're done for the day. No diaper changing, etc. which I can imagine must be very physically difficult to do, as well as unpleasant, of course.

It may help that my sister and I were trained on how to do bowel program by first RN's and then CNA's at spinal cord injury rehab. We agreed we would help and become trained in all care as a condition of my dad entering their program. First it was done in bed, with my dad lying on his side. Then after a few weeks when he was strong enough to sit up for periods of time, in a commode chair.

I was very upset at first, seeing my dear father in this way. He was so humble and frail... I was angry at the nurses (in my mind) for always gently pressing me to do a little bit more of the program: first just being present in the room, then helping getting supplies, then watching, then another task, etc. But the wonderful attitude of the nurses and aides helped so much. One fabulous nurse had bowel program down to an art form, including a neat folded towel on the floor for the family member to kneel on and suggestions about watching an interesting TV show at the same time. He also told funny (but not offensive) jokes. Another nurse told me that her priorities were air freshener and cleaning as you go along. Anyway, it was all very matter of fact and humane.

This isn't to say the OP isn't right to bow out of this task and make sure her father is getting appropriate care, etc. Just that from my perspective, having to help with bowel program hasn't been the end of the world.
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I admire everyone here who has actually done this, but I simply couldn't if I had to. I am very sensitive to smells and even had to hold my nose when changing my kids' diapers. If I had to deal with an adult's poop, I would throw up, and I don't mean maybe. I would definitely vomit. The only elderly relative we have left is my mother-in-law, and if it came to having to deal with her bowels, she would have to go to a nursing home. It would be more than I could handle.
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I’ve already told my mother,,,when that time comes, that I have to wipe her,.....she’s going into a nursing home...sorry, but that’s where it ends for me.
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smilebeth: Aww, your poor dad. I can understand that whatever this program is, that he is embarrassed that his own daughter would have to be the one doing the task(s). Is there a town Council on Aging? If so, they should have 2 dedicated persons there-1 is an elder care advisor and the other would be a social worker. They may be able to help or direct you to the VNA (Visiting Nurse Association), where a male nurse could come in.
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cwillie makes a good point--a bowel program for someone with a spinal cord injury often involves inserting suppositories and manual stimulation to get things going because the impulses from the spinal cord to the bowel are severed or disrupted and everything sits in there getting compacted. It's not just wiping them off. The poster mentioned being in the shower with her dad for five hours getting everything out if I read right. I'd rather die than have my kid do this for me or doing it to someone!
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All I have to add to what others have said is that you can take yourself out of the options and insist that he hire professionals to do this. It's something that has to be done every day, and the drive plus the caregiving when you get there are so exhausting that there's a danger of being overtired when you drive to and from, and if you have to do it every day, and you have a life of your own too -- it could get dangerous. What if you got drowsy on the drive?

If he wants to keep living at home and avoid a facility, which I understand, he has to accept that you have limitations. Having you exhausted and overwhelmed is not in either of your best interests. I don't think they understand just how physically, mentally, and emotionally draining caregiving is. Try not to get started doing it - easier to not do it from the start than it is to stop - they come to expect things very quickly.
You're allowed to have limits.
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Just to let everyone know...
Bowel management after a spinal cord injury is not the same as toileting, it is a whoooole different level of care.
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My mom has advanced dementia and I am "elected" to do this for her. At times, she tries to wipe herself, but I want to make sure she is clean. My brother helps with mom but he says this is something he can't do. I do wear plastic gloves as occasionally by hand gets dirty and have used wipes also to make sure she gets clean. I can't plan when she will have to go, so this is the difficult part. I occasionally get out for a little time and hope this won't happen when I am gone or if I have a drs. appt. I can't be in two places at one time. So we are doing the best we can do. This is something I absolutely hate to do, but there is no one else to do it. I just try my best and do what I have to do, knowing it won't last forever but also don't know when it will end.
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wow i can relate to all the above. I was a CNA at 18 years old, and became a nurse at 26. so cleaning poop and peed is fine with me. I understand with parents is hard because they used to be so independent. it is truly hard to see them that way. My place turn to a nursing home. Right now i am taking care of my mom with multiple health issues. all of this will take a toll on you and it becomes a daily routine. I just snap out of that routine after 5 years and ask for help. you need to get help because you will loose it. you do have a life to live for.
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I would keep the conversation light. Dad, I don’t know what to tell you, but I know I’m not doing that again. What else can you think of? Since he is of sound mind, put the ball back in his court, but be sure he knows that you are not an option for a 2nd adventure.
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Just say "NO". You are not a slave. Your dad doesn't get to have what he wants, that is it. I have cleaned my dad's butt, he was constipated and I did it. He was dying with just a week or so to live. But, for a chronic problem, no way. I can hardly clean my husband's toilet because of his diarrhea. I had kids, it is totally different.
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This is a hard one for me because I have issues with my own bowel care. I absolutely hate even thinking about someone having to clean up after me because I hate cleaning up after myself. And I know the day will come when I have to accept help. I feel guilty about that and hope I can be grateful and accepting. I wish I could help you--I encourage you to talk with a therapist to accept that you are not bad because you can't control these feelings
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My mom is in assisted living for that very reason. I pay 3600 a month for someone to wipe her but. She is lucky to have such an income so I can waste it on but wiping. I will do whatever to avoid it. I’m sorry a infant but is way WAY different than your parents big butt
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Smilebeth, your recent post said that you spoke with your dad's case worker and that she said that because dad was of sound mind he could make his own decisions on this health matter. How closely is she following dad? Does she check on his hygiene, bathroom, laundry, etc. everyday? Has she had him evaluated by a professional to determine that he is competent? I'm just curious as to how she gets to make that determination, with overwhelming evidence to the contrary.

I might chat with her and ask her those questions, since if she is wrong, it could have substantial negative consequences to a senior, alone in his home. Good luck with this.
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