My father went from being somewhat incontinent to an indwelling catheter for 7 months and now free of the catheter, but fully incontinent. Mom is wishing to be his sole caregiver, though we do have someone come in 3 hours, 3x week, against her wishes. She wants me and my siblings to help but not in very personal ways. She and my dad both have some degree of dementia so they are somewhat lacking in logic. I take them both weekly for doctor appointments, visiting friends and out to lunch. So here's my do I handle ensuring Dad is clean and dry? Yesterday as he got out of my car, I saw that the back of his pants were wet (and thus my leather seat). I've cared for lots of babies and I know how to check a diaper but I just can't seem to do that to my dad. My mom just doesn't even think about it. What do you suggest?

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If you are uncomfortable with this and Mom is not cognizant enough to take care of it, something different needs to be done. Dad cannot remain wet for long periods of time. He should be changed, at the least, every four hours and more frequently if he is on any diuretics. Staying wet for long periods can contribute to urinary tract infections, that area breaking down and getting irritated and infected and bedsores from compromised skin. Unless a Home Health Aide is 24/7, she or he would have to come in multiple times a day to change and wash Dad. Explain this to Mom and tell her that she needs to help Dad stay clean and dry. She will have to start thinking about it if she insists on being Dad’s sole caregiver for the personal stuff. Your not being able to handle this is absolutely nothing to be ashamed of. If both parties are uncomfortable with it, other arrangements must be made.

Keep in mind that if they have been formally diagnosed with dementia, it’s a progressive disease. I’m sure they will be dead-set against this, but you may want to start looking for Assisted Living for them.
Helpful Answer (9)
Reply to Ahmijoy

Is he wearing the proper "underwear"? (Depends, or other type product or regular underwear)
If Mom is not fully functioning she may not be providing the proper item for him to use.
If there still are regular underwear in the house I would remove them and provide only incontinent products for him to use. Unless they are VERY wet they usually don't leak. Although I have to admit my Husband leaked quite a bit because he would do what I called "re-positioning" himself and if the stream flowed between skin folds leaking is inevitable.

It may come to a point where they can not care for themselves, and that sounds close. You might want to start looking at either Memory Care or Assisted Living. If you go AL find a place that also has MC and that will allow both to stay in the same room.
Helpful Answer (6)
Reply to Grandma1954
Keepingthelove Jan 11, 2019
He's only worn disposables for a couple of years. And you are right, Mom is not the best caregiver. She loves well and does her best but her thought process is hampered by her dementia. I wish it were so easy. They've lived in this home for 60+ years. I also have many siblings and we don't agree on care issues.
Have him wear adult diapers. I would not handle that for my father either. It's just a line this daughter did not want to cross. As it was, I saw more, heard more, and smelled more than a daughter should ever have to. It was traumatic. 5-1/2 years. Emotionally and physically exhausting. Don't get me wrong. I love my dad so much. But it was really hard on me. The bad memories are starting to fade though (it's been 9 months since he moved into an apartment in an assisted living community.) But I digress. Adult diapers. And do like you would a young person. Remind him constantly to change them. They're like a pair of underwear. Set everything in the bathroom for him ... Some wipes or a wet cloth and towel. And some powder.
Helpful Answer (6)
Reply to Leonine1

Oh this sounds familiar!! I had to toss all my dad’s regular underwear, and put a stack of daytime and nighttime “disposable briefs” in his closet. I put a note on them for him to “change every day and night”... I put white towels on his chair/sofa so he might notice that he’s leaking., along with those bed guard protectors under his sheets. (On top of the waterproof mattress pad)
when he’s in my car, he sits on a towel, and if he gets stinky, I’ve actually sprayed his pants with febreeze.
Its a battle I’ve learned to let go of. He gets combative at the suggestion that it’s “time to change your clothes and undies” so, I’ve left him alone. I don’t invite him to my house if he’s leaky and malodorous, (where I can smell him over the cigarettes) and if it gets really bad, or we have to transport him, I’ve had my husband suggest that he change his clothes. He gives my husband no arguments so far.
The sad part is, I know that my dear mother, God rest her soul, went through this daily battle with him. She was in early MCI, but insisted he was clean, which lead to explosive arguments. Her heart gave out in her sleep..... was she stressed out? Absolutely. The constant verbal abuse from him, as an alcoholic and a heavy smoker with an outrageous temper - I’m not going to repeat what happened to her. If he’s wet, he’s wet. If he smells, oh well. I know he can get an infection, but it will be dealt with when/if it happens. These are his choices, and he has a right to make bad ones as an individual.
I know you want what’s best for your dad, but I totally understand how uncomfortable it is to approach the subject. As my dad’s caretaker, I’ve had to weigh the risks vs the benefits of each battle... very carefully. I ask myself, “what’s the WORST thing that can happen if I don’t get the desired outcome?”
Good luck and God bless.
Helpful Answer (6)
Reply to Dadsakid

Thank you so much for your thoughtful reply. I can see my choice of wording wasn't the best. What I meant by me being uncomfortable was that for my dad's dignity, I didn't want to be patting his bottom or pulling back his brief to be checking. I actually don't have a problem dealing with the messy side of things and have done it on many occasions.
Neither of my parents have a sense of smell so don't notice urine or BM. But your suggestion of just changing every 4 hours is a good one. Whether or not Mom can remember to follow through will remain to be seen. We've little to no success with her getting him to drink more fluids. Thanks again!
Helpful Answer (5)
Reply to Keepingthelove
Ahmijoy Jan 9, 2019
I did understand what you meant by being uncomfortable. And I do understand why. I know my daughter would be the same way with her father. Again, there’s no guilt to be felt.

It does concern me that while Mom has the best of intentions, she may not be a reliable caregiver. Most people with dementia do live in the past and Mom may be remembering when Dad wasn’t incontinent. It will take a lot of supervision on your part. Good luck and best wishes.
I agree with you.  I couldn't change my dad either. It took all 3 of us adult children and a close neighbor each talking to Mum on the same day, recommending a NH before SHE got sicker and died, before they agreed to a NH.  Enlist help from others to convince her.
Helpful Answer (5)
Reply to GrannieAnnie

Keepingthelove; Hello I would just come out and tell my dad your pants are all wet doesnt that embaress you dad I would also say cmon dad you do not want to be the stinky one in the room do you .....and throw away his underwear and put only depends in his drawer... try to get the grumpy old man on antidepressant .....Good luck!!!
Helpful Answer (3)
Reply to Lorraine12
Keepingthelove Jan 12, 2019
Lorraine12, I'm thinking you must have mixed up my post with one of the comments. My dad is not grumpy at all! He's the sweetest, most compliant man I know. And he's already been using Depends for a couple of years.
There's nothing to be embarrassed about. Funny story~About 5 to 6 years before my mother died, she suggested that I wear a feminine pad product for those times when I wasn't near a bathroom. She was a wise woman!
Embarrassment comes when one of your dad's friends tells him that he had an "accident." So best to come from you.
Helpful Answer (2)
Reply to Llamalover47

I have an annoying habit of finding a silver lining in any situation. A survival tactic, I suspose.

My son has severe autism- functions at about a two yr old level. Rainman went from baby diapers to adult ones. My dad and I were very close - so he was also very involved in Rainmans life.

Rainman was 19 when my dad passed and up until just a couple
of years prior, daddy spent a lot of
time with him. So - of course this
included taking Rainman to the bathroom - Rainman is “trip trained” - dealing with accidents, changing, etc.

In other words, adult diapers and the need there of was a regularly discussed issue between my dad and me. Nothing taboo about it and definitely no shaming or embarrassment. It was just a fact of life in my household - and therefore, also for those who participated in Rainmans life.

When the time came for my father
to use adult diapers - like your father my dad had come off an extended catheter use - daddy and I discussed it in the same “no shame, just a fact of life necessity” manner that we had when we talked about it concerning Rainman. Silver lining tie-in.

And - that would be my advice to you. Treat the subject as a medical necessity. And, for heavens sake -
no baby talk or terminology-
and no bottom patting to test for
weighty fullness nor sticking your fingers ANYWHERE - not without “permission” that is.

Just straight forward, adult language and actions. Perhaps - as you might if you were addressing a catheter bag needing attention.

“Dad, were off to your doctor appointment in 15 minutes. Now would be a good time to put on a fresh Depends. I’m gonna just check to see if you need to, okay?”

My two cents - for what it’s worth.
Helpful Answer (2)
Reply to Rainmom
Keepingthelove Jan 13, 2019
Rainmom, bless you for your loving care of your father and son! Good advice, just suggesting it be done as we are heading out, etc. The hard part there is that my mom is always with him 24/7 but doesn't remember to do those things. But I'll just try to be matter of fact and ensure he's clean and dry.
You need to stick to a regular program on a daily basis, such as after a drink or a meal and make sure that the incontinent diaper or pad is the right size, and volume capacity.
Helpful Answer (0)
Reply to Katz17
Keepingthelove Jan 13, 2019
Good idea, Katz17. My mom won't remember that but I can apply that principle when they are with me.
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