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He will say he needs to go, but then he refuses to follow through. He will not let me help him get his pants down and when I let him do it on his own he can not get his clothes back up and also he doesn't clean himself.

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I agree about trying to comfort the patient. Even with dementia, my cousin knew that she was not going to the toilet right. I told her that she should not worry and that no one had a perfect bladder and that I certainly didn't. I told her the depends were just a precaution until she healed. It seemed to reassure her. Of course, she has no memory of that now and she is double incontinent.
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Even wearing the diaper, the commode sits right beside the bed. I'm sorry if he's past this point.
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Have you tried a bedside commode?
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I am going thru this with my husband and he is very confused too. I do like you say, take control over the situation and it works. I also tell him I have little accidents too and he laughs and feels better then.
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Sometimes, just 'doing it' without asking questions helps. Also, perhaps, if they have respect for the doctor, have the doctor 'write an order'....write it out on a prescription pad by the dr, that says, depends underwear should be worn for two weeks or something like that....because if the dr says to do something, some people are very cooperative. By the time the deadline comes, it will be a routine. Or perhaps, if there are funds, it's time to think about a caregiver coming in for part of the day, to help with bathroom functioning and showering. My dad would not accept Mom's help, but after a PT caregiver, was there for a few weeks, and she knew how to communicate with dementia pts, she got the routine going, and then he did not resist the help by anyone. He got used to the idea that someone was going to walk him to the bathroom and assist and no one asked. It's like when potty training a child....the helper takes control of the timing....as soon as awake, before and after meals, before and after leaving the house for an app't , and before bed. If awake in middle of the night, assume the BR is needed first..... and don't ask. Just take their hand and say, 'Come with me. It's time for the bathroom."
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Take away all the underwear except for the depends and if they are argumentive and like their doctor, daughter, son or a person they really really LIKE say that ____said these are better for your skin and you are to try them for several weeks. Or they are free and we are going to tell them how they feel after several days.
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my mom refuses to wear the diaper.. she will use a pad, but only if I nag her. I do her laundry and it is a mess. changes clothes about 4 times a day. and then hides the wet ,soiled ones..it is always a battle..good luck with your husband.
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My cousin had issues when she first started with incontinence. The staff at her regular assisted living didn't quite understand her toileting accidents. They didn't get why she wouldn't take her panties off to use the bathroom. Eventually, she started using depends, which worked out much better.

I'm no expert, but from what I have read and heard, the dementia patient loses the ability to get the mental signal from one part of the brain to the body. So, he may want to pull his pants down, but the brain is not sending the hands the right signal and it can't happen. He may feel he has to go to the bathroom, but the signals are not going in the right direction. It must be frustrating, but there has to be some practical care application.

With my cousin, the Memory Care staff now place her on the toilet at certain times of the day. (morning, after lunch, after dinner, before bed,) I think that she goes at those times, but she also goes in her depends and they check those regularly and change them when needed. She is used to it now and it doesn't seem to bother her at all. She has no no infections or rashes.

I know it's a difficult thing to insist on, but if it's necessary, I think I would insist. You can explain why, keeping in mind that his ability to understand how keeping him and the house clean has been impaired. Convincing him or hoping that he will pick this skill back up is not likely, but you can discuss it with his doctor. You might see if something other than dementia is causing the problem.
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BTW, many of the Teepa Snow videos are available on You-Tube. If you google her name, you can find many of them. They are so helpful in dealing with Alz.
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brenda, the toileting problems can be exasperating when someone has advanced dementia. Teepa Snow has some very good advice when it comes to handling someone with Alz. She made several videos on how to address the combative type behaviors. I can imagine that in a situation like this, your husband probably feels that you having to help him is telling him that he is not competent to do it himself. I wanted to bump this question back to the top to see if others had ideas on how you could approach your husband so he wouldn't see it as a challenge. Are his pants easy to take off and slip back on? How does he behave when you offer to help him clean himself? I wonder if there is a way to let him know that you are working with him, instead of against him.

I know this isn't your fault at all. Many people go through the same thing. I am just hoping someone has some helpful comments.
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