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I'm sorry, this is a delicate subject, but I'm the daughter of a 90 year-old, ALZ father. His bathroom aim has noticeably been off for the past week or so. It's noticeable he's rushing faster to the bathroom, too. The shower door is now getting wet and the toilet lid, the under side, is splatter painted. His medications tend to make him loose, but he's getting spots now on his shorts and socks. I am wondering if incontinence is far behind. I try to pick my fights carefully with him, as I know this is one that will embarrass him and cause immediate denial, if I suggest Depends, which will also cause a problem to his skin with his loose movements.
Any suggestions? Thanks so much!

A useful description is : disposal underwear.
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Reply to TouchMatters
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While it can't hurt to introduce disposable underwear now, that isn't going to solve the current aim issue. He is still attempting to toilet, so other tactics are needed! If you can swap undies without discussing it and he accepts them, go for it!

I knew my mother wouldn't even want to discuss this or acknowledge she had a problem, much less agree to using them. She isn't really incontinent, but does sometimes have trouble getting clothes off in time. In her case, the staff and I removed ALL her underwear and left the disposables in various places (two drawers in her room, one drawer in bathroom.) Never brought it up, never discussed it, never heard a word or complaint about it!

With any kind of cognitive issue, just telling him how to do it, what to wear, to sit (even if it is his doctor) isn't going to stick with him. He will likely need some gentle guidance when he goes.

It might be wise to have a doctor and/or urologist exam, just to rule out any potential medical issues that might be contributing to the issue. It could be balance, eyesight, prostate, or just absent-mindedness (little boys will tend to not pay attention and sometimes 'miss', and with various types of dementia, they are becoming more and more like little boys or girls again!)

Meanwhile, suggesting bathroom breaks on a regular basis might help with the "rushing" and/or dribbling before he "shoots." For instance, if he is going every 3 hours, prompt him at 2 hours. Prompting by saying you have to go might be enough to get it in his head. I also find while sitting I might not notice that I need to go, but when I get up and gravity kicks in 2 seconds later, oh boy, make way for ducklings!!! If you can accompany him (might not want a "girl" there with him, don't know how well he accepts personal help from you!), you could suggest sitting.

I do like the idea of a large fly or other creepy crawly at the bottom of the toilet! Boys "love" to shoot things in the toilet! :-D

Elastic waist bands also allow quicker "access", although this doesn't help our mother very much (weight/mobility/standing issues are the problem there.)

If medications are making the stools are very loose, I would discuss this with his doctor(s) or pharmacist (they might know more about side-effects and possible alternatives.) Perhaps they could find a replacement medication or suggest something to bulk up the stools that won't interact with or be affected by the medication he takes. Check out this page for some information and potential natural remedies (aka foods we eat):

https://www.webmd.com/digestive-disorders/chronic-diarrhea-16/diarrhea-more-fiber

You should consult with his doctor before trying anything, but this would be good to read before asking. IF he has taken any antibiotics recently, his gut flora may be out of whack too. There are so many pro and pre biotics, I would consult with doc on those, for sure. If he didn't have antibiotics and is eating a good, varied diet, this shouldn't be an issue.

Unless he isn't able to hold his BMs, the disposables won't help there either (refer to Ahmijoy's telling of two incidents - just like with missing the toilet with stream, if someone is still attempting to toilet, these won't really help.)

HOWEVER, if you can swap them with his undies, and get him used to wearing them now, it won't be an issue later, when he might be less able to understand or cooperate. I would also check with/have him checked by his doctors, just to rule anything medical out.
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Reply to disgustedtoo
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Check his vision, too. I read somewhere that perception is more difficult as you get older and we tend to have white toilets in white bathrooms. In some memory cares they use a bolder color backdrop behind the toilet to make it easier to see.
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Reply to Invisible
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Lots of older guys have trouble shooting straight. Prostate or bladder issues. Urgency and frequency are also common. Yes, have the doc check him out but in the mean time just ask him to sit down to pee. Good luck.
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Reply to WVson1
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stick a decal of a fly or something in the bottom of the toilet. It is human nature to want to aim at that darn fly.

That said, as others have said its often an enlarged prostrate issue and instead of having a direct flow, the little guy becomes more like a sprayer hose.
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TouchMatters Sep 24, 2019
I appreciate your worthwhile suggestion and comic relief. Just what we all need.
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What have his urologist and gastro doctors said? Time for a visit.
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Reply to Llamalover47
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It’s not his aim, it’s restricted flow from an enlarged prostate.
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Reply to AlexNJ
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See if you can get him into elastic waist pants. My Dad was slowed by a belt, zipper, etc. Winter coming, fleece PJ bottoms are comfortable and snuggly.

Also try chia seeds in his oatmeal, muffin, on toast. They gel the bowel contents. Activia yogurt (not the sugar free) helped my dad's "digestion.

Try sticking pads on to a diaper. That way maybe you don't have to go through all the fuss of changing the entire depends.

Remove his regular underpants and put the depends with the pad attached in his underwear drawer.
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Sjcjuly Sep 23, 2019
Yes you are right absolutely elastic waist pants. No belt. My Dad wore jeans with elastic waist ordered from Buck and Buck. Easier to pull the pant or jeans completely down to have him sit on toilet and not stand.
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Incontinence in the future for Father? Probably. I have some good friends who have gone through this. He was diagnosed with Alz about 2016 or so, and She had been taking care of him when I happened to mention in a contact that my wife had been diagnosed with Alz, and so we had a very good exchange of correspondence beginning early 2017 and lasting all year. But at a time when we four had spent a long weekend together in 2013 I had noticed that He was having problems not being able to "hold it" and also it seemed to me that his BM's were not usual (since He managed to clog up our guest bathroom). So... fast forward to 2017, She told me that He was wearing at least three Depends at one time - She would cut the inner one free to remove it and put a new one on the outside when She changed him. And She told me that He was having BM's about every four or five days which were extra large. For sure He was incontinent! He died in March 2018 after the disease had progressed and He went downhill.

Sure, this is a graphic answer to a delicate subject, but this is not the time for cocktail hour conversation, is it? Keep praying, get help (you might find a Health Care Aide can deal with his denial and clean him up much better than you can and in no time, and it will make you feel better too.!)
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Reply to PungoMac
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There are disposable briefs made to resemble men’s underwear. My husband used those (Tena)until he became bedridden. They are pull-ups. I still refer to his diapers as underwear or briefs. It’s important to get his skin very clean to avoid a rash. A barrier cream also helps. I’ve tried many different kinds on my husband and found ones containing dimethicone work best for his skin. The hardest thing I’ve had to overcome was learning how to deal with my husband’s incontinence. I had a couple of meltdowns before I accepted that I was going to have to be responsible for this. He has dementia that over time caused him to become more and more dependent. It’s a kind of death by a thousand cuts as someone once said.
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Reply to MamaMamaMama
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My Dad encountered this as well. We always accompanied him and had him sit down on the toilet and not stand. It helped with him completely emptying his bladder and there were less frequent trips. His urologist suggested it. We also asked him quite often if he needed to go to the restroom. Most times he took us up on it. Dad also wore Depends we referred to them as a new type of underwear. Never as diapers or Depends.. At night time we had a bucket by his bed and he would get up and pee in the bucket. We emptied it in the morning of course. It was easy and convenient.
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Reply to Sjcjuly
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My DH lived to be 96 yrs 8 mos and the last year or so he too had trouble. Try getting Dad to use a urinal. My DH felt so much better when I suggested it to him and I didn't mind cleaning it. He had one in the bedroom, one in the bathroom and the last year we kept one in the living-room too. If the need arises, he can always ask (or you can ask) the "offended" person to please leave the room. Be aware, the day could come (like with my DH) when I had to support him and hold the urinal for him - but he didn't want to wear adult briefs and as long as I could find a viable solution for us, I never forced it.

There is a product on the market to clean a urinal, but I had Hibiclens for his foot anyway and discovered that just the least bit in the urinal not only cleaned it but the smell was gone. Hibiclens is Pre-Surgical Scrub (soap) and even though DH is now gone, I still have it and use it to wash my hands after touching raw meats.

RE: loose stools: if Dad is on Stool-Softener, stop it. That was what happened to my DH. Also, keep a bottle of Anti-Diarrhea pills handy as diarrhea will cause dehydration.

Get Barrier Cream for his privates - Peri-Guard is my favorite for me - it helps to prevent "diaper rash" - and if he gets a pressure sore (DH had one in his crack), I found Colloidal Silver Gel to be the only thing to heal it. Personally, I preferred the Miracle Silver brand. It will also take down a blister in about 24 hours or less. I don't know why it works on blisters, but I've been thankful : )

You're a good daughter! Bless You!!
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Reply to RayLinStephens
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He probably also has urological issues such as benign prostate hypertrophy which puts pressure on the urethra and gives men urinary urgency as well as weakened urinary stream. His doctor may be able to prescribe medications to help with BPH. Dad may also have mobility issues that make his walking and standing less steady. He may benefit from a walker and grab bars in the bathroom. Asking him to sit when he urinates may help with this but it will seem "different" to him from his usual. Depends type "diapers" may help if he is having trouble "making it in time" to the bathroom, but I would have a doctor address BPH and mobility first.
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Reply to Taarna
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You're absolutely correct. This is a delicate subject. In my opinion, it seems that a visit with his primary care physician is in order. Prior to the visit, I would contact said physician to discuss the issue so that the visit is productive. Depends are an option, however, getting him to agree and accept may prove to be difficult. A visit to a urologist also could be helpful.. Unfortunately as Alzheimer's disease progresses, incontinence could occur, but I would pursue the anatomical issues prior to blaming this on cognitive decline.
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Reply to Peanuts56
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Why don't you get him to do what my husband dies. When he has to pee which now is not often, he sits on the toilet like I do and does not stand in front and aim his now very weak stream. He pees like a woman.
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Reply to Ladyhawke51
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Gloria, have you ever tried a commode?  If he can direct the stream directly into the bucket, it will channel the stream down into the toilet.
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Reply to GardenArtist
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If the stream is not coming straight out and instead is bending to the side,he should be checked by a urologist.
If the stream is straight out and his aim is truly off, then disregard this message.
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Reply to OldSailor
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Bearly Sep 26, 2019
Dear Old Sailor,

Are you saying that the only normal flow for a man is straight out, with no leanings to one wide or the other (or even up or down)? I have only a 1 mans experience with this as a problem, and that is me.
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Make him sit.
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Reply to JoAnn29
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freqflyer Sep 19, 2019
I agree with JoAnn, time for Dad to sit down on the toilet. There is nothing wrong with that. Nothing sissy about it as some older men may think.

I remember accidentally overhearing two young men, who played basketball in college, talking about how much easier it is to "sit down to pee". So if those guys can do it, so can your Dad.
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Gloria, I know how difficult this can be. My husband and I went through it. He ruined the bathroom floors around the toilet with his lack of aim and our bathrooms constantly reeked of urine no matter how much I scrubbed. He had bowel “incidents” twice, one at his place of employment that almost caused him to lose his job because he simply left the bathroom and the awful mess behind and walked out. Another was in our favorite restaurant. I knew nothing about what happened until the manager came up to us on our next visit and told us that he knew my husband had left an awful mess in the bathroom. He said he had been told by the owner to ask us to leave and not return. I knew my husband would be emasculated and embarrassed, but at that point I had to insist he begin wearing adult incontinence briefs. You may need to insist that your father do the same. Others suggest removing all other underwear from his drawers and replace them with the disposable briefs. He’s never had any skin irritations from them, but hygiene is important. And consider that since he will need help changing, you may want to ask a male relative to step in.
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GardenArtist Sep 19, 2019
How embarrassing and sad that must have been for you and your husband.   And I do think it was also very inconsiderate and cruel to address you with the demands that were made.    Someday, those people may face a similar situation.
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Thank you for your suggestions, I appreciate it!
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Reply to GloriaHoward
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Disposable briefs should not cause problems with his skin as a matter of fact staying in wet/damp or soiled briefs will cause more skin problems.
He should be changing his underwear if they become soiled, same with a disposable brief.
He may not be able to see the bowl of the toilet easily. It is white, the seat is white so I can understand how an aim can go off a bit.
Suggestion...Turn the water off to the toilet, flush so all the water goes out and then dry the bowl. Get some bright color nail polish or even a Sharpie Marker and put an "X" or a "O" on the inside of the bowl. Wait for it to dry then turn the water back on and let the toilet fill. This will give him a spot to aim for.
The mark will eventually come off when it is no longer needed it can be removed. For the longest time I had 2 "X"'s on the bathroom floor so my Husband would know where to stand when I had to change him. Worked like a charm and now that he is gone..the marks have faded and I sort of miss them.
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Reply to Grandma1954
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