How do I approach my father about a bathroom disaster?

Your father has done everything imaginable to make it impossible for you to continue caring for them at home, Tawheed. The house is in disrepair, you're not POA for him or his finances so you hit a roadblock when trying to get things done for him financially, a caregiver cannot move in b/c the roof is moldy & leaking, your mother has dementia and needs care 24/7/365, he's now having bathroom messes that he is NOT acknowledging, etc. So, even if you were to broach this subject with him and say dad, there is feces all over the house after you toilet, he won't see it, won't admit it, won't say Oh Aha! I see now that I have a problem that needs attention. If he was surprised when you mentioned the situation the first time, why will he not be surprised when you mention it again? You have a serious situation on your hands, with toxic feces which can sicken both of them, not to mention YOU, and a mother who refuses to shower............you have to surrender now & hold up the white flag, especially since you suffer from anxiety issues of your own. Your brother is not equipped to deal with this situation either, by your own admission, so what are your choices here??

Managed care for both of them is your only real choice. The caregivers in a SNF will clean up the incontinence issues and dress dad in disposable briefs; they'll use wet wipes to clean him up properly after a BM, and they will shower mom 2x a week. They'll dress her in clean clothes, and make sure that both of them eat 3 meals a day.

If they refuse to go into managed care, you'll have to back off on the care you're giving them Tues-Fri, then call APS and report them as vulnerable adults, and have APS place them, which they would likely do if they find feces all over the house, your mother not showered and suffering from dementia, the house in serious disrepair, etc.

You're in over your head, your parents are in worse shape than you realize, and a chat with dad about his lack of hygiene is not going to fix the myriad issues that are going on here, I'm afraid. Dad's declined dramatically all of a sudden, meaning there's probably something organic going on; a stroke or something of that nature that hasn't been diagnosed yet. Meaning he's incapable of taking care of his hygiene now, and mom surely cannot take care of herself either.

I'm so sorry you are facing this situation. I'm sure you feel helpless, I would too, but I think the best way to help your parents is to stop helping them..........let APS take over if they are fighting you on placement, and that will likely ensure their safety moving forward. Or, if either one of them seem to be in dire straits, call 911 and have an ambulance transport them to the ER where you can get the social worker involved for placement.

Wishing you the best of luck and strength as you forge ahead with all of this. Hugs and prayers being sent your way.

3 Cs approach (courtesy of an Continence Nurse): Look for a Cause, try to Cure, or if not possible, aim to Contain.

Cause:
Is it loose bowels, striking so suddenly he can't control?

Recent change of meds? Antibiotics? Infection?

Is it worsening mobility? Just can't get there in time, bend, reach, work arthritic hands adequately? Manage clothes?

Fatigue? So tired he is holding the walls for support? Can't be bothered washing hands?

Cure:
Take your suspicions to his Doctor for advice/treatment.

Contain:
- Depends, pull-ups or similar.
- Easy trousers eg track pants with elastic waist.

"Dad, looks like you need a little help with cleaning up these days - so here are some new easier trousers & these great new style men's underwear. I'll be here in the bathroom to help".

Unless you are NOT ok with wipe-up duty! Which is FINE by the way, but does leave the question.. who will be?

Cos it is clear that Dad now needs assistance in the toileting department.

My mom began similar behaviors while she still lived alone. Her fingernails and toenails had feces underneath, her feet were dark with that and dirt, and her shins had huge red burn areas from urine running down her legs and soaking her pants and socks. Her solution was to occasionally go out in the backyard and hose herself off but only during the summer. It wasn't enough. She would regularly remove feces from the commode with her hands and wrap it up with tissue and put in kitchen trash. I would find bits of feces all over house where it just fell down through her pants, if she were wearing any that is. She would step in it and track it everywhere. She often wore nothing below the waist because she threw away all her clothes once they got soiled. She and her house smelled putrid. Dementia and incontinence are horrible to be faced with. There's no improvement. Mom lives with me now. I have to insist on her wearing pullups at all times. She is accompanied to toilet every 2-3 hours. Daily she resists and complains like a toddler and cries why am I all of the sudden making her do this. In reality she has been doing this for over a year now but she doesnt remember. There is zero tolerance on this. It has to be this way for the health and safety of her and my entire household. Plus my sanity. As for for advice on how to approach your father regarding the bathroom situation, imho he should be accompanied to toilet each visit in order to "help him clean himself where he cannot see or reach well enough, to prevent a rash" or whatever you want to tell him. And get him used to washing hands and wearing pullups. I hope you find something that works for you and your parents. It sounds like this is the beginning of them needing a whole lot more than you may be able to safely take on. Maybe consider looking into getting them care or placement.

I think brother needs to check on Dad when he goes to the b/r. It must happen when he is alone with Mom. Your Dad needs a good check up. He is showing signs of Dementia. Its time to place Mom and Dad. You nor brother can continue like this. You spend what money your parents have and apply for Medicaid. Tge house is a exempt asset. Brother can be declared a Caregiver and be able to remain there if able to pay the bills because Mom and Dads SS and any pensions will go towards their care.

I cleaned up after Mom when she had an explosive BM. It was all over everything. It took me 3 hrs to clean up. I said then, if it happened again, she was going to be placed. I cannot take the smell. It actually makes me nauseous.

This is the point where you have to realize that his brain is broken and that you can’t physically take care of this. We all want to preserve our loved ones’ dignity, but reality is reality. The actions that he no longer can control have already shredded what we think of as dignity. You all need help, and it’s impossible to deal with this at home. Time for a conference with doctors, social workers, his dialysis team and maybe hospice. Pull out all the stops and push for placement in a facility where professionals take care of his needs. So sorry.

Assuming you've had him checked for normal things like a UTI, it sounds like he cannot live at home anymore.

Wait until he does it again and call APS.

You have to deal with this situation, whether it embarrasses him or not. Many people have dealt with it. He may not want to acknowledge it, but the alternative is he goes into a facility that will deal with it as a matter of course. He may want to think that it won't happen again, but it will. Depends are the first step.

It would be a good idea to read up about incontinence on the site – click on Care Topics at the top of the screen, then on I for Incontinence. It might help if he is able to read it too, partly to re-assure him that it is unfortunately a ‘normal’ part of ageing.

Not dealing with it is not a viable option, for any of you including him.

My dad had some similar accidents, in the sense that his bowels were loose and uncontrollable a few times and he made a big mess of trying to clean it up. The difference is he didn’t deny it and go on like nothing happened, that your dad does is the most concerning part. That really shows a mental shift that isn’t normal. I’d start with taking him to the doctor for an updated medical evaluation. Let the doctor know in advance of the appointment what all is going on, either by having a note passed to him/her or by letting the nurse know. And don’t hesitate to have an honest talk with dad, I’m afraid you might find he’s not able to process the information or make changes. It may be time for adult undergarments full time. And please seriously consider how long you can keep up this level of care on your own. It’s rapidly becoming unhealthy and unsafe for all of you, and your health matters too.

I know you mentioned that your mom has dementia, but there has to be something cognitively going on with your father as well if he literally has feces all over him and the room and has no idea that it is happening. He can't live that way and neither can you. He needs to be seen by a physician and also have a mental eval to see where he is.... This doesn't sound like a situation that a simple conversation can fix.

When a person can have feces all over their clothes and hands and feet--and it DOES NOT resonate with them that they cannot live this way (healthily!) then the time for gentle, tender 'talk' is passed.

Fecal matter can get into the most amazing places--having cleaned a bathroom or ten in my career, I can say that once a patient became clueless as to WHY they were covered in feces, and didn't care--placement in a NH was almost an inevitability. It's not out of meanness--it's out of care for the healthiest living environment. And the sanity of the CG's.

My FIL was on antibiotics all the time. He would not take them b/c they gave him explosive diarrhea, but if he didn't, he'd ramp up to pneumonia within days. Cyclically, over and over. AND the day I realized he was having blowouts and then just letting his clothes 'dry' on him and then just going about his day--I had to peel his pants off of him and cut the 'thong' underwear he had on, off. That, and scraping at the feces with a tongue depressor--DH was mortified but was so busy gagging he was useless. Forcing him into the shower when I knew I'd be doing the exact same thing the next day.

That day, his thongs were all thrown away and the best I could do was to get him to wear 'tidy whities' --in the hospital they insisted on depends, but at his home, briefs were the only thing he'd accept.

He died before we had to have him placed. The Dr. told him he could not longer live alone and we had just begun the task of finding a NH for him and he passed away. He would have hated it, but I hated walking into his condo and smelling what my day was going to entail.