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He is too embarrassed when I help clean him up. is now sitting in dirty pants and refusing to let me clean him. He retreats to the bed and refuses to do anything at all that I ask.

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My dad will not let anyone help him with this same issue. He lives in assisted living and does not have dementia. I cannot change the plumbing there. I looked into the Freedom Wand but he does not have the dexterity in his hands to use it. I have found no solution yet that will work for him and allow him to keep his sense of dignity.
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Before I read these comments, I tried to clean him standing up in the bathroom, leaning over and holding onto the shower seat in the bathtub. He didn't like this method at all. Then I tried cleaning him in bed lying down over a quilted waterproof pad with moisten wipes. This way worked fairly well, but was a harder for me to do. I think the idea of installing a bidet sounds good. Will try to find out where to get one and who should install it. I know I need an aide but have had trouble deciding when to have them come and which agency to contact.
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There is also a special toilet which spray-cleans automatically, warm water, then blows warm air to dry. It also has heated seat! A friend had one installed, liked it so much they replaced their other toilet too. I saw one at Lowe's last week but I can't remember the name right now.
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You may have told us this in other posts, but I can't recall. (It would be good to update your profile so we could look it up.)
How old is your husband?
How long has he had dementia?
Do you know what kind of dementia he has been diagnosed with?

Does he have spells when he more coherent? If so, that would be a good time to try to talk to him reasonably about the issue. It may take several conversations, and even then the logic may not carry over to the less coherent periods, but it is worth a try. "Sweetie, when we took each other for better or for worse, I sure didn't think it might mean one of us wiping the other's butt. Did you? But this is something that is not your fault and not my fault. It is just part of a disease. I love you very much and I am very willing to honor my vows. I hope you will let me." Maybe a little talk about preventing skin damage, too.

My husband was not embarrassed about hygiene health. Where I had to reason with him was about going to a day care program. "You can't help having this disease. I doing everything in my power to make it possible for you to stay home with me. You have to do your part. I have to have some hours every week when I know you are safe and cared for. Going to the day program helps me be able to take care of you the rest of the time." We had to have reminder conversations, but appealing to his desire to help me be able to keep him at home was mostly successful.

If your husband no longer has periods when he is lucid enough to have this kind of conversation you'll need other strategies. A bidet could help. Showering is an option.
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I thought of something else. Is it possible to get him on a schedule of when he has to have a bowel movement? If so, you could just explain that he has to shower after that every day. Will he allow you help him in the shower? That might be rather challenging, but at least you can get him clean in the shower and maybe he won't be so focused on the feces issue. Good luck.
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Talk to the plumber about an add-on bidet with warm spray. Gosh, you might never get him out of there with that.
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I'm not sure what you could do. I never encountered that before. The dementia makes it very difficult, because it's not easy to reason with him and even if you resolve the problem one time, he may forget the next time, so you have to start over again.

Do you think he's resistant because it's you who is trying to help clean him? Would he respond better if it was a male assistant or someone he didn't know? How long do you intend to keep him in the home? Even if you have help come in for a few hours during the day, he could still need cleaning after they leave.

Perhaps there are some here who can give you some good advice. I'm afraid I can't. I do feel for you. This must be so frustrating. The only thing I can think of is to talk to his doctor and see if there might be some medications that might make him less resistant.
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