Warning, this gets graphic. My great aunt has Alzheimer's and I am one of three caregivers. She has quite the disturbing bathroom habit... Every time she uses the bathroom, even if she just has to pee, she tries to disimpact herself. Meaning, she sticks a finger or two up her rectum and tries to pull the feces out. This results in a horrific mess. Feces all over her hands, her bottom, the toilet, and even the bathroom counters. Worst of all, she doesn't even really wash her hands afterwards. I've done everything I can think of. I've increased her fiber in her diet to try and make her bowel movement easier and decrease her need to disimpact. I've even tried to go in the bathroom with her and hold her hand while she uses the toilet. But now she gets very aggressive when I try to enter the bathroom with her. Is there anything else I can do? Sorry this got so graphic.

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Thank you both for your help! I will talk to her doctor, or have the caregiver who goes with her to her next appt, talk to her doctor about the possibility of hemorrhoids causing her to feel like she is impacted. For now, going into the bathroom with her is not an option. She will get aggressive and even violent when I try to help her in the bathroom. Outside of the bathroom she is generally a very pleasant person but once you try to infringe upon her privacy she gets outraged and violent. I don't know if medication is the right choice for her, as she is hardly aggressive and doesn't seem to be anxious about anything else, but I will bring it up at the next doctors appt. Again, thank you both for your help! P.S. She is currently cooing over a baby on television, she really is a pleasant person to be around (Outside of the bathroom)
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I just went through this with my mom in April. She is in assisted living and the staff swore to me that she was getting up on the vanity to use the sink as a toilet. She is has the strength of a kitten: both knees wrecked by arthritis, both shoulders broken in falls, her right wrist broken in a fall and it healed wrong. She was not getting on the vanity, but was washing feces off of her hands after using the toilet. The nursing staff tried some suggestions from me and her doctor prescribed stool softeners which caused her to lose control and soil her panties which she then washed out in the sink. And then put back in her dresser thinking they were clean (NOT!!! as I discovered while switching out her winter clothes for summer ones) The situation reached the point where she was sent to the behavioral unit at the hospital. While there the staff discovered that she was digging out the feces. She had swollen hemorrhoids causing her to feel as if there was still poop in her rectum. She doesn't have the muscle strength to poop out hard stool so one thing lead to another. She was placed on a toileting schedule, given stool softeners, suppositories to shrink the hemorrhoids and now takes an anti-anxiety drug to stop fixation on her bowel movements. She did well on the toileting schedule at the hospital and the ALF is trying to keep that going forward.
I was told that most folks with dementia will eventually have some type of bowel fixation.
I would talk with your aunt's doctor and have her checked for hemorrhoids or other physical blockage or irritation. Then discuss medication for treating the behavior and associated aggression issue.
Hope you have a quick and positive outcome. No pun intended ;-)
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You will have to disregard her annoyance with you in the bathroom and monitor her antics. YOU will have to be in charge now.

Have a box of gloves for yourself in the bathroom, so in case you have to wipe the "rear", you can be protected. I found baby wipes (to clean her), Lysol spray (to get rid of smell and sanitize surfaces) and Clorox cleaning wipes (to wipe down the toilet seat and sink) invaluable also.

It sounds like YOU need to clean her, remember, wipe front to back (or top to bottom) to avoid a bladder infection.

It is not uncommon for Alzheimer's patients to "get physical" with the back end.
You have to be the adult now and not "let" her continue with this unhygienic behavior.

Distraction often works well. While in the bathroom, "Auntie, we can have watch a favorite show (or some other enjoyable thing) when we're finished in here." She'll fight you but, as it goes on, she'll give in.

Good luck.
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