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casenurse123 Asked April 2020

How do we best address basic ADL concerns?

I have a patient who is alert, oriented & continent. She is receiving rehab services to return home alone. This patient refuses to use the bathroom. She prefers to move her bowels in an incontinence product and have the staff clean her up. She states that she will have no problem going to the bathroom when she returns home. I find this behavior inappropriate but the therapist feels it's ok.

Ahmijoy Apr 2020
Is it possible that this lady is fearful that when she starts for the bathroom she will have an accident? I know myself that sometimes getting up from a chair causes particular strain. Maybe she waits too long or her bowels are difficult to control. If she passes stool in a Depend, it’s not considered an “accident”.

Geaton777 Apr 2020
I agree with JoAnn. It's weird and illogical. She should be able and willing to demonstrate that she can move her bowels in the appropriate place before she returns home. Or, she needs to be able to show she is willing and able to clean her own self up after going in the Depends. If she is made to do this, she may suddenly develop a willingness to use the actual toilet. Or, maybe the therapist should be made to clean it up ;-)

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JoAnn29 Apr 2020
Then I would go with the therapist. If ur a nurse, then I may mention it to the family. If your a CNA, then mention it to ur supervisor and let her handle it.

To me, anyone who would rather use a Depends, there is something wrong with them. Early signs of Dementia?

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