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While leaving him at daycare this morning, I was getting the walker out of the car, turned to see him with his pants around his knees preparing to relieve himself. Grabbed him and yelled "NO!" and pulled up pants. We were in the parking lot adjacent to a children's park. I was afraid of someone calling police for indecent exposure. Spoke to his caregiver later and he said it had happened on his watch also. He is a high functioning ALZ patient but has lost this inhibition. What should I be doing to control this behavior?

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instead of a "straight jacket" how about "straight pants"?

His high functioning has just LOWERED...

When everyone knows that part... His functioning just lowered... Now what do you do? You need to protect him and also the public... Most importantly, you need to protect him...

You need to talk to his social worker or the caregivers involved.. What is next for your partner? You need to protect him.
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LoopyLoo Nov 2019
Agreed. If he’s doing this he is no longer high functioning.
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Make sure he uses the facilities before you leave the house and that he doesn’t drink a lot of fluids before you go.
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7again Nov 2019
A few years ago I might have said this too. After using drugs prescribed after organ failure, I know that the drugs often can and do override preventive measures.
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Dress him in a skirt. He can just squat down. Nothing to see. Probly rubber shoes too. :-)
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earlybird Nov 2019
LOL!
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Probably, careful supervision at all times would remedy this. I don't know of anyway to convince him not to do it, since, that is out of his control, due to the dementia. So, even if he's at adult daycare, he would need constant, direct supervision, so, he wouldn't do this at the center, leaving or entering, etc. It's a good idea, as stated below to ensure he urinates before you leave the house and not to overload on fluids. I'd also consult with a urologist, to see if he's having urgency.

There are also adult garments that button in the back that prevent the person wearing it from disrobing. You can find them online. If you do this, you might have to transition to a certain toileting schedule and Depends, though. I'd certainly discuss it with his doctor. It could be a medication that is causing sudden urgency.
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My oldest brother who died did this too. When I asked him why he said he couldn’t hold his urine because of his diabetes. It’s upsetting. So sorry that you and your husband are having this struggle.
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Thank you to those who answered. A skirt?? A tad too much to deal with. Maybe I'm fooling myself that he is high functioning........Has been to urologist who says age related appropriate urgency. I think social mores are breaking down. I carry urinals in car and thought I was always ready for emergencies. This caught me off guard.
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NeedHelpWithMom Nov 2019
Carrying the urinal is a great idea. Like you said, you were caught off guard and it’s an inconvenience and possibly dangerous if someone were to report him to the police for indecent exposure.

Hope that you are able to find a solution for this situation.
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I don't think you have to worry about anyone going to jail over him taking a pee in public.

Maybe some irate person throwing a fit, but I think that our 1st responders are pretty compassionate towards mentally compromised seniors. It would be different if he was behaving perverted towards anyone.

Some cultures think nothing of pizzing in public or non gender communal toilets.

I would have him toilet before you head out, that would probably help with the urgency that would produce this behavior.

I am so jealous that guys can just whip it out and go, just a small corner and all done. I have a bladder problem and there are times that I wouldn't care if someone saw my backside, sure beats wet britches. I have seen more public restrooms than anyone should be subjected to in their life time.
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My hubby has to take very strong diuretics to control his congestive heart failure. He would rather stand on the back porch and " let it fly" than walk down the hall to the bathroom. He has urgency problems and little control. I keep a bag with extra baby wipes, Depend pull ups and clean jogging shorts in the car for emergencies. I wish there were more uni-sex bathrooms in public places so I can go in and help him change.
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Franklin2011 Nov 2019
I would just take my husband into the handicapped stall in the ladies room. He never questioned going in and no one ever said anything.
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What can you do but laugh? Sorry, but I got a chuckle out of your post, picturing you getting the walker and turning to see... :-0

With AD, you lose the front part of your brain first. The deeper, more primal part of the brain is last to go, so it's not uncommon to see a lack of inhibition. Our societal norms teach us that it's wrong to pee wherever you feel like it, but our base instinct is to "pee if you gotta."

I would not worry about any action being taken against you or your partner. I would suggest, as did Isthisrealyreal, to take preemptive measures and pee before you leave. Someone with incontinence AND dementia (mild or otherwise) definitely needs some reminding. Make it a routine: Time to leave for daycare = time to pee.

Cheers!
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Some really good suggestions have come in on this, I thank all who have responded. To all those who have suggested a "Last Minute Pee" before we leave the house, yes, we have been doing this. He can pee at home and 10 minutes later be ready to go again, and he's not drinking excessive liquids.
I think one of the best/funniest responses I had was from a friend who suggested I walk away and pretend I don't know him. No, before you jump on me, it's not under consideration. I'l learn how to anticipate before the next event. Let's face it, It never happens, till it happens. And that is how we learn.
Thank you
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Isthisrealyreal Nov 2019
I think that your friend is right, walk away or turn around like you don't see. You can only do so much.

Maybe carry a towel in the car that you can use to shield him from someone seeing more then they want.

I know it feels huge for you, but it is not a big deal in the grand scheme of this nasty disease. My grandmother thought that the brown recliner was a tree and the green shag carpet was the grass and it was the perfect hidey spot to go pee. She would shoosh me and say don't tell anyone I am peeing behind the tree. It is so sad, but funny when you think about how their minds are finding solutions to real needs.

One thing that I would caution, for your safety. Physically strong and able does not make him high functioning. My grandmother was strong as an ox, but her mind was gone. She beat up 6 nurses because she thought they stole her false teeth. Just a heads up about physical abilities vs mental capacity. It was hard to translate that grandma was sick because she looked fine.
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Dress him with adult incontinence protection and put the trousers on backwards so he won't be able to operate the wasteband and zipper from the front - - the equivalent of a "pants straightjacket' as already suggested (I believe you can also purchase men's trousers that are designed this way intentionally)...
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Grandma1954 Nov 2019
have you ever tried to put pants on backwards. It does not work. They are not cut to fit backwards.
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I know moms who take adult sons who have severe autism into the women’s restroom. He can’t be left alone to go to the men’s room. What alternative does she have?
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jacobsonbob Nov 2019
LOL this reminds me of when I was little and my mother took me into the ladies' room--I hated it as I was SO embarrassed! However, I understand and appreciate what you said about those having severe autism (and I'm sure there are many other conditions that necessitate this, including that reported by the OP.
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You can try a "onesie " that might work.
Adding suspenders might prevent him from dropping "trou" in the middle of wherever you are.
You might also want to notify the police department that he has been diagnosed so if there is a report they will know that it is not the act of a pedophile but one with Alzheimer's. (also a good idea in case he ever wanders they know this is a vulnerable adult and will search for him differently than a typical search....oh and do not wait "the TV 24 hours" to report a missing person)
Loosing inhibitions is very common and you learn to work around some of the problems.
By the way yelling won't help, it might scare him also embarrasses him just a quiet no and pull the pants back up.
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He's no longer high functioning if he is peeing in public.

He may be at the point now where he should NOT be taken out in public.
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bluefinspirit Nov 2019
That is sad! Would you say the same about someone with Tourette syndrome, severe autism, Down syndrome, epilepsy, or ???

Let's all try to remember that dementia (be it Alzheimer's, Lewy body, vascular, or mixed) is a PHYSICAL disease of the brain. As caregivers, we have accepted the responsibility of helping the person with dementia function to the best of their ability within society, not to just isolate them.

Sorry... I tend to be a bit emotional about this because I've had several family members suffer from AD.
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Don’t be too blasé about it. You might be seen by a cop that’s a Red Hot. I got a ticket on Thursday, July 20, 1972 @ 8:50 AM from the California State Highway Patrol. “Stopping on Freeway to Urinate.”  Still have the ticket. FWY 680 south of Walnut Creek, California, south bound. No place to stop between Fairfield on I-80 and Coyote south of San Jose. 

I was bob tailing a 3 axle tractor and was between the spare tire and the stack. Nothing could be seen. Gave me a lecture. I said, “Why don’t you ticket the Hippies that stand right out there in front of God and everybody and let fly? Cause they have no money? Not worth the effort?” He took umbrage at my simple question and said, “If you say even one more word I’ll write you for indecent exposure!!!!!!!” My lips became instantly sealed.
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it is time for the adult diapers. my mom hated them but she would just crap on herself wherever. she had no control. there minds are going and they don't know what they are doing.it is hard. this whole journey with dementia. my mom went through all of this. she passed away on sept 30, 2019.
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I agree with dragonflower
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This is a website for adaptive clothing. https://www.buckandbuck.com/mens-adaptive/jumpsuits/back-zip-jumpsuits.html

I even saw some pants that velcro in the back. It may not be a 100% solution but it may slow him down so you have time to react. My mother was taking all of her clothes off at night and peeing in bed. She never could figure out the jumpsuits.
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My dad with ALZ had to pee immediately whenever he put gas in the car.. Mom had a heck of a time getting from the drivers seat in time to stop him.. He'd just pee beside the gas pump. Now you don't see that every day at Costco! I got him a urinal from work.. better than nothing, and she could get him back into the car to use it ( most of the time)
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I don’t think there’s anything you can do but try to be patient with him, I know easier said than done but you my have to introduce him into underwear is for grown/pampers, When you’re out in public or constantly remind him to go to the bathroom every chance you get I’m sure he doesn’t mean it or is starting to forget what he is doing good luck
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So, at the first ALF my parents were at, there was a resident with dementia who was a mailman in his youth, delivering mail in the mid century. We would always find him peeing on the wall in the DINING ROOM when we went to visit! I guess he'd pee outside as mailman and still had that memory inside his head. He was eventually moved to Memory Care for obvious reasons.

When you take your partner out, you can dress him in a Depends underneath a Onesie garment you can purchase on Amazon. Look for incontinence garments or onesies in a search.

Good luck!
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There are adaptive clothing that makes it impossible - I used 'Silverts' for my mom & found them fast as well as easy to deal with - I had no billing issues just use a credit card - there is both male & female clothes

I found the nightgowns easy for mom & staff - hope this helps
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- Appointment at neurologist.
- Adaptive clothing.
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What in God's name are you doing by keeping him where he is not "controlled" so that his actions and behaviors do not harm? Place him somewhere. He can't be fixed and you can't do it any longer. Place him and start having a life of peace and tranquility - this has to stop - now. You cannot stop him - it will get worse. You do NOT deserve this. Place him now.
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Lealonnie & Worried…
Let me first apologize to Wobbly for making such a general comment on a post with a very specific question. There are a lot of great suggestions from responders, so hopefully things will work out. Fingers crossed!

You are both absolutely correct that there may very well be situations that are simply not within the capability of a person with advanced dementia. However, I do feel that simply not taking a person with advanced dementia out in public anymore is a bit extreme. In this specific case, I do think there are solutions that will work so that the loved one can still function within societal norms without having to be isolated.

Granted, it is HARD work for a caregiver to find solutions that work, but my hope is that we will all do our best to try.
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I received an interesting range of answers to my query. I still believe he is high functioning, just not in all areas. Obviously, some of the filters have disappeared but you can have an intelligent conversation with him. Still reads the newspaper and remembers what he read. We go out to restaurants and his behavior is fine so not allowing him to be out in the world is not now an option. That will come but until it is necessary I just have to be more diligent in observing his actions. Thank you to those who took the time to respond. (Bluefin, I like your spirit)
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