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I don't want to take away any more independence or dignity than she's already lost. She lives with me, has aides, but can go to the bathroom, shower, dress, ambulate, etc. all on her own. Lately, though, I've been seeing evidence of poo and/or toilet paper remnants with poo on her shower chair. I've mentioned it once or twice, but she has such memory loss, it doesn't stick.


She flushes, twice, and washes her hands thoroughly, so she's aware, but how do I let her keep her dignity, and get her to keep butt clean? I'm more worried about spreading germs, her getting a UTI, etc. than anything else.


THE BIG QUESTION: how to talk to her about it without embarrassing her.

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My 93 year old mum lives with me. I used to pussyfoot around things but now I just talk to her directly and tell her how it is. She wasn't changing her clothes enough so after hinting I just told her she needed to change more often and she now does. When she was a bit smelly I told her. She will deny it of course but she does take notice and I would rather tell her directly than it become a real problem. If I didn't have words with her now and then I couldn't live with her so I would rather do that than say to her she has to go because of the way she is. Sometimes just saying what is needed to be said is better for both of you. Good luck. X
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"Mom, I've noticed you aren't doing a good job keeping clean, I don't want you to end up sore or with a UTI. Here are some ideas that might help..."

Sorry, I guess I just didn't have that kind of relationship with my mom, for years she trusted me to be her eyes (she too had AMD) and to be straight with her. You mention your mother has memory loss, chances are this is a conversation you will have to repeat over and over, in my opinion it would be better to just be proactive and move on to solving the problem.
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Get a bidet attachment to your toilet or replace current toilet with a bidet-toilet which are 'not inexpensive', but 'worth for the cleanliness factor'. Push-button for 'water spray'...different push-button for 'air-dry' is easy for anyone needing to 'assist' if she 'isn't able'. More 'appealing' than 'reaching under to do it for her'.

Doesn't take much 'acclimation' other than the 'expected shower underneath' which actually is 'refreshing' with 'reassurance of being clean'.
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worriedinCali May 2019
the OPs mother has dementia so a bidet will require acclimation as well as the ability to remember how to use it......
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I would also vote for the bidet. I had eight fingers amputated last year. I cannot do a proper job of cleaning myself sometimes, and was never 100 percent sure that I had done a complete job. We bought a bidet that sits on top of the existing toilet. It was not expensive. It has a warm seat, it heats the water, it blows warm air, it saves the need for toilet paper - good for the environment, does a better job than toilet paper, and the remote is easy to use. I recommend it to all, not just seniors or people with hand issues.
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TMWKy2 May 2019
7again, Can you provide details of your bidet? It sounds like a fantastic option.
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I found that if I don’t make a big deal about and just say. “Let me check to make sure you got it all” she just turns and lets Me. Mom is 86 with a touch of dementia.
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You don’t. There’s no way to talk about such personal things without some embarrassment, BUT you can make it light hearted. You can say “Hey, I noticed when you took a shower that you got a little poop on the chair. I know it’s hard to reach sometimes. I got you some wet wipes to help a bit. If you have any trouble or do t think you got it all, let your aid know, because we don’t want to risk an infection.” You could also get a peribottle and encourage the aids to use it with her.
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Psalms23 May 2019
Great ideas
No way to avoid some embarrassment but to discuss in a light way... Not make Mom feel bad or being reprimanded for poo...
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There is no magic phrase that makes it easy to tell someone they aren't managing toileting properly, one of the central requirements of being a caregiver is to get over feelings of squeamishness and modesty and just get on with it. Aside from pointing out the evidence that she is not able to take care of this sufficiently you need a solution to offer - whether you want to use wipes or a bidet or you need to step up and wipe for her (yeah, it can come to that and believe me none of us ever envisioned going there) is up to you.
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jshdoff May 2019
I'm not being squeamish, or modest. I have no problem cleaning her up, and did when she was recovering from a broken back. I've used suppositories with her when needed. It's none of that.

I'm simply asking for people's experience in discussing this without infantilizing the person. She struggles with her dignity as it is, and just doesn't have the sight (macular degeneration) or sense of smell (long gone) or awareness.

I'm fully aware of the solutions and alternatives, I'm asking about your experience with language and dignity.
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You said you mentioned it and it hasn't sunk in or stuck, offering wet wipes is how you deal with it or get in there and clean her.
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I think being direct is the best approach. I've had to have talks to my mom about smelling like pee. Not fun, but necessary. I said "Umm, mom, I don't want to embarrass you but I have to say that you are smelling like pee and I thought you would want to know". Not saying that my approach was perfect but being subtle often does not work.
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Your profile says that you mother has dementia. Dementia really changes the equation, because, it's likely that this is not something that she will see the light and do it better.

If she has normally had good hygiene for her entire life and NOW she doesn't. I'd suspect that she just isn't capable. If she could do better, she would.

So, giving her new products or explaining how things should be given more attention, probably isn't going to stick in her mind. Also, it's not just the memory. With the brain not working properly, there can be a disconnect between the brain and the hands. So, coordination isn't quite right. (One of the first signs of cognitive decline with my LO was watching her try to make a sandwich. Her hands did not work right in placing the bread and food together.)

Focus is also affected. So, I'd take a deep breath and just handle it kindly, but, frankly. You might give the doctor heads up first. So, doctor can tell her that he wants daughter helping with her toileting hygiene for a little while. Just to ward off UTIs. That way, it's doctor's orders and then every time she goes to bathroom, you go too to supervise and assist. I don't know anyone with dementia who doesn't eventually need someone clearing them in toilet and later changing depends. It's so sad. I know.
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disgustedtoo May 2019
What you posted, Sunnygirl1, is pretty much what my comment would have included - if mom has dementia, most everything you do try to say or point out, no matter how discreet or matter-of-fact, isn't going to sink in. Dignity or not.

There were even mentions of choosing not to use wipes or bidet because mom wouldn't be able to learn. Certainly you can try to have a gentle discussion about it, but in my experience, most of that is likely in one ear, out the other. My mother can't remember what she or you said 1-2 minutes ago! She is still "capable" of most ADLs as well, but needs some reminding for some tasks, such as brushing her teeth (she doesn't live with me, so that is up to the staff.)

I would imagine you are aware of when she heads to the bathroom. Monitor and if BM is involved, step in before she leaves the bathroom to ensure she is clean. This would work even better if she is "regular", going around the same time every day. If no BM, leave well enough alone.
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