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Shari49 Asked May 2022

Mother covered in diarrhea AGAIN when I visited the home on Friday. Is it common for nursing homes to drag their feet when someone needs help?

This is NOT the first time, as my mother's bowels have always been an issue. This has happened more than once, when I arrived at the home. There she sat on the toilet, runny poop everywhere, down her legs. In her shoes, on the floor. I buzzed 5 times for help. I went to the front desk and pleaded for help. I had to forcibly hold her hands to keep her from trying to wipe the floor. 15 minutes went by and I finally flagged an aide that happened to be walking down the hall. This keeps happening with the explosive diarrhea. Should I look into moving my mother to a different home, one that actually is for dementia patients? This home is not. And if they don’t wish to help my mother clean herself, when I’m there, what about the days I’m not there? She has had all sorts of tests to find out why she has these stomach issues. No answers except to say it’s all mental. But it’s much worse now. Moving her from this home sounds so complicated. I know it’s going to alienate my family if I do this. But I feel like I need to do something. I’m really worried she will slip and fall in her poo or she will not be able to change her clothing to get herself clean.

polarbear May 2022
Shari - I know you mentioned dr ran all kinds of tests to find the cause for her constant diarrhea. I know of someone who also had problem similar to your mom, soft stool, diarrhea, upset stomach, etc. for years. She decided to mentione this to her doctor, he ran some tests, and it turned out that her pancreas didn't produce enough digestive enzymes. So the doctor ordered enzyme supplements. She started taking the supplements. And Voila! Problem solved!

I mention this just in case her doctor hasn't tested for digestive enzyme insufficiency.
Beatty May 2022
Interesting.

Everytime time I read something on innards (stomach, intestines, kidney, liver & pancreas, spleen) I realise how little I know!
happygo2022 May 2022
You buzzed 5 times and went to the front desk and "pleaded" for help?

Yes, I think you need to move your mom somewhere else. This is uncalled for and sounds likes she is not getting good care.

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babsjvd May 2022
my mother had chronic diarrhea, years… A number of months ago she decided she wanted cherrios for lunch…. diarrhea stopped. Prior, Gastro dr added cutrucil , said she needed more fiber, memory care actually just stopped giving it.. and truly I should have complained, because it was a drs order. But they said it wasn’t helping. I let it go..

Countrymouse May 2022
It isn't only people with dementia who have toileting and continence care difficulties, especially if they have chronic bowel issues; and *any* setting which purports to provide care for its residents should be on top of this (or at the very least making a visible effort). What the heck is going on? - five times you and sister have witnessed such a situation, out of a maximum of 18 visits by the two of you?

I know I've already asked, but what do the staff have to say about it? What is on the care plan?

I'm sure there has been much more to it than just that one word, but by what stretch of whose imagination could your mother's bowel habit (with frequent episodes of explosive diarrhoea) be described as "normal"? Immodium (loperamide) is a great face-saver for people who get caught short on a plane or have to give a corporate presentation, for example, but it is not a substitute for proper long-term management. Has it been formally determined that she is lactose intolerant? - and, what, she has either not understood or has chosen to ignore the advice?
Shari49 May 2022
There has been no real answers as to why she has had these bowel problems. She has seen several doctors during the years. My sister doesn’t believe it’s serious, that she would be dead by now if it were. I don’t think so. I think something is very very wrong, they just haven’t found it. She is always in pain, thinks she is pregnant, thinks there is something living inside her stomach. I cannot imagine going through life live that. The doctors have run tests on cultures and found nothing. She continues to suffer. Made worse by the head nurse shaking a bottle of robatussin at her and telling me they are tired or trying to help her.
I made an appointment to tour a memory care facility tomorrow. If they can’t give me something better than what she has, it’s not worth transferring her and all THAT entails. And I’m certain moving her is an all new set of problems.
sp19690 May 2022
The bigger issue is this isn't a facility that specializes in dementia. Best solution is to find a place that can handle the dementia which in turn will help with mom having BM messes.

Screw covid at this point. There are worse things like seeing your mom covered in feces and no one where she lives even seeming to gives a damn from even a health stand point.

Basic human dignity seems to be lacking at this place.

And who cares if it alienates the family. Which I am assuming is niece who is the admin there. This is not the appropriate facility for your mother. Maybe the admin niece can go clean up your mothers diarrhea if it bothers her that much for you to move mom to a new place.

Countrymouse May 2022
Mother's bowels have always been an issue. Always? Really, always? Since when, and in what way?

All sorts of tests (what, and when?) with no answers except that it's all mental (meaning?).

But it's much worse now. Rule out: inappropriate diet, or trigger foods; inappropriate routine laxatives (it happens); infection (request a repeat stool culture); food and personal hygiene issues (handwashing, e.g.); lack of support for continence care products and toileting schedules.

Not the first time the OP has found her mother in (technical term that I use on handover notes) a bit of a pickle.

So what did the home have to say for itself last time? And what was the response this time?

Look at the care plan. What does it say about toileting, continence care, personal care and timings?

What time of day was your visit? What had taken place that day before you arrived?

Margaret suggests taking photos for evidence and acknowledges that this can go against the instinct to rush in and clean mother up. I agree; but the OP - reasonably and understandably - did no such thing. The OP called 5 times for help, waited 15 minutes, then took to the corridor and flagged down a passing aide; meanwhile physically restraining mother from attempting to clean up by herself.

Family members ought not to expect to provide personal or domestic care for a relative in residential settings, so I am in no sense criticizing the OP's actions on this occasion and I agree that a 15 minute response time (with no response - how long would it have taken, one wonders) is not acceptable. It's just that I dread to think how distressing this situation must have been for the mother - which makes it even less acceptable.

It sounds as though mother had already removed her soiled clothing (and any pull up or pad?) - and done what with it? The OP was concerned that mother would injure herself if she attempted to clean up after herself, but it is possible that in fact mother is managing this (to whatever standard) routinely, with or without the home's knowledge.

That's why you need to go back to the support plan and see what it says.

What's this about alienating the family if you move her? Whose decision is it?
Shari49 May 2022
Mom has had diarrhea issues for years and years. Cultures sent and nothing found. Everything normal. All that the doctors could ever say was to take Imodium and no dairy. She refuses any medications from the home at all including Imodium. Being totally suspicious of anything given. Even her temperature.
She attempted to clean herself up but it was so bad, so much of it, so “everywhere” I wouldn’t let her attempt it, and I couldn’t. I restrained her because she kept trying to take tiny pieces of toilet paper and bending over and mopping the floor, getting it smeared worse. Her pants and diaper were at her ankles. Shoes and socks covered. I’m so tired of finding her like this. This is maybe the 5 th time this bad in the past 6 weeks. I visit at 1:00 twice a week, my sister comes at 2 on Sunday. This is not a dementia memory care home—- and they aren’t geared for such. But it was all we were able to find a bed at the time. ( Covid)
MargaretMcKen May 2022
I’m not a medico, but my understanding is that bowel movements are largely controlled by the liver, with urinary issues largely related to the kidneys. Has she had liver tests recently?

If you find her in this state again, it would be a good idea to take photos. If you may end up with the Ombudsman, or even with company management, it’s much better to be able to show them the state she was in. When it’s reported verbally, people can always exaggerate. Photos are ‘proof’. I know that you probably want to rush in and clean her up, and that it’s not pleasant for her to see you with a camera instead of helping, but it’s likely to be worthwhile for her sake and yours.
Shari49 May 2022
You are right. Next time ) and there will be) I will take photos.
Geaton777 May 2022
Have you spoken to the admin at all? Is so, and there is still no improvement I would contact the ombudsman. If still no improvement I would pull her out of there, take her to the doctor to see if it's at all possible to diagnose her condition (with dementia she may not be able to accurately express what's going on, so you will need tempered expectations). Maybe consider giving her Imodium to see if helps her as a temporary fix.

Grandma1954 May 2022
She would be better in a facility where staff has been trained to care for people with dementia.
I would also be wondering why she is having explosive diarrhea and I would not accept that it is "all mental". There has to be an underlying reason. If it is stress related then there are medications that can help with anxiety.
You do not give any info on your mom.
Why is she in a skilled nursing facility?
Shari49 May 2022
She is in skilled because it was all we were able to get her into at the the time with Covid. My niece pulled strings to get her in there ( she works in administration there)
mom has dementia and also diagnosed with psychosis. Refuses all help, medication, assistance. Even getting her temp taken.

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