How can we help stop dad from urinating on himself?

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We moved my dad to an independent living facility with assisted care. He has been urinating on himself and we bought Depends but he argues with the nursing staff and he will not let them check to see if they need changing, dad won't change them on a regular basis, and he knows he is wet because he will cover up the wet spot on his pants by pulling his shirt down. He does have memory loss (short-term) but shows no other signs of dementia. He is mobile, has no health issues other than diabetes, and the nursing staff checks on him every 2 hours. He is also not bathing or shaving on a regular basis, that is a struggle and argument with the nurses as well. He is not combative, he just argues and says he doesn't need to shower/change. I should mention that he has a hernia in his groin area that may be causing the leaking but I suspect that he is just not changing his underwear and they are soaked. He has issues with aiming for the toilet and says it is too painful for him to sit and urinate. We have a hand-held urinal for him but he never uses it. I have discussed with him many times about keeping clean (he has a couple of "girlfriends" where he is now) and I tell him that he is getting urine all over and his place smells, that he needs to keep clean or the place he is in will evict him, etc. He says he will listen and do what the nurses tell him to but he never does. I am at a loss. I told him if his hernia hurts he needs to tell us (doctor said surgery at this point is too risky) but he says it does not hurt him. He will put his urine soaked clothes on his bed, and I tell him to put it in the laundry basket but he never does. Sometimes he puts his clothes in the bathtub, sometimes he hides his soaked briefs in the closet or they are shredded and all over the floor.

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Eventually if he needs more care the facility will start plans for eviction. That is what happened to my mother in law. Family knew but were too sluggish to move forward. You may need to stay a step ahead and start looking at nursing homes before it becomes a crisis.
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Since you said that this is all new to you, I'm going to share the two most important things I learned about dementia. One will save you hours upon hours of frustration- the other will save you heartache and buckets of tears.

First - The Golden Rule of Dementia: There is no reasoning with dementia.
Don't expect them to understand reason or logic or even practicalities. Save your breath and your frustration. You might as well go beat your head against a brick wall. God, how I wish I understood this one earlier on!!!

Next: Don't take it personally.
Develops a thick skin and know it's okay to leave their apartments or hang up the phone when they become mean and abusive. None of this is your fault - don't let him make you feel guilty for the tough decision you'll need to make. Just do the best you can and know when to say when.
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I agree with all the other postsDad has got to the point where he is unable to follow instructions so there is nothing you personally can do to make him "toe the line"
I think it is only a matter of time before he is asked to leave his current living place. he needs to have staff who have training in dementia and experience in dealing with people like your Dad
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Thanks for all the suggestions. He does see a doctor regularly and had a full work up done less than a year ago.
I am thinking he needs to move to a facility where he can get the proper care he needs, the nurses now do check on him every 2 hours but I am wondering what another facility can do that isn't already being done. If he does have dementia (which is probably the case) I don't know how someone or someplace different can help him out more. I will be visiting some places tomorrow and see. The place he is at now has assistance and we have increased his services to get him more help but it is still the same situation as before. This is all new to me. My dad has always been very lazy (no hobbies or interests other than watching television) so I was initially thinking he was just being lazy and he tells the nurses "I worked by whole life and if I want to sit in my own swill , that is my right". Then I thought it was his hernia hurting him to get up, urinate, and causing the aiming issues, but I am thinking it is dementia. He has another doctor appointment on the 26th
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It was the "no health issues other than diabetes" that leaped out at me.

Your dad needs a full medical work up. Depending on how long he's been diabetic, God knows what it's been doing to him.

If you're going to struggle to get him to see a doctor, tell him this is a routine assessment required by the facility as part of their terms and conditions and cross your fingers behind your back. Prior to the appointment, give the doctor a summary of your concerns so that they can be investigated tactfully.

And adjust your expectations. He is not lying, his promises are given in earnest, but he *cannot* cope with remembering basic hygiene routines; and, besides, bear in mind that he may feel embarrassed and humiliated at discussing these issues with his daughter. Make sure you're not even internally blaming him for any of this.
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Shredded used Depends on the floor is a huge red flag - Dementia.

You're not doing your father, yourself and the staff any good by not recognizing this sad fact. It's hard to accept, I know.

In my case I just didn't know much about dementia and what I did know - was wrong. For too many years I thought my eccentric mother was just getting quirkier in her old age - quirkier, more stubborn and at times downright mean.

How I wish I knew in the beginning all the things I learned too late. But at least I was armed with knowledge- largely supplied by the good folks here - in my moms final year. It made a world of difference.

Good luck to you. I'm wishing you knowledge and grace - all the best.
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I agree with BarbB. The behavior you describe is not all attributable to "short term memory loss." A man who goes around in urine-soaked clothes is not someone who "has no health issues other than diabetes." He needs a thorough evaluation and then careful consideration of the best residential situation for him.

You "have discussed with him many times about keeping clean." Those discussions are not achieving the goal. Time to try something else.
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"No other signs of dementia"?

Urinary incontinence a symptom of dementia. 

The inability to process and sequence information ( I am wet, i need to change,  this is how I do it) is a symptom of dementia.

Your dad needs a higher level of care, better trained staff and would benefit from a consult with a geriatric psychiatrist to see everyone if meds might ease his agitation.

Please get him the help he needs.
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It sounds to me as though he needs a higher level of care than an IL can/will provide.
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Check out Abena Abri-Flex. My DH uses size M3 - he is 6 ft, 180 lbs. The have HUGE capacity (rated for 84 ounces) and have a snug fit. LOVE them, but can only purchase online. I don't work for them or profit in any way. Only a very satisfied customer.
Jamie
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