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Getting her to dropping the tissue in toilet is difficult. She just doesn't want to wipe herself. I think she knows better but when you ask her she just wants to pull he pants up and keep going. She doesn't like the wet feeling against her bottom so she'll pull them off and get another pullup. I'm thinking if she knows to get another one and put it own why can't she go to the bathroom. Sometimes she's good other times she just doesn't and I don't know if it's just not clicking with her or she's just using the pads and not putting in the effort.

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I would set up for bidet, it might not comfortable for person has dementia/_Alzheimer's .... but works great when I was working for Stroke client.
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I did put the small sign of cute picture flame on the bathroom counters for my client said " PLEASE WASH YOUR HANDS". Dementia/ Alzheimer's, they could read.. they just forget how to do right things....
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It sounds like she's reached the stage of dementia where she needs "verbal cueing" for each step. You need to stand outside the bathroom and walk her through the steps one at a time. It's part of what dementia robs--procedural memory.
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I have to ask my dad if he washed his hands after using the toilet. Sometimes he says he couldn't find the hand-basin, then I send him back and tell him its right there.

I took him to a close family function (his), and on our way back home, he told me he liked those people, they were all so friendly.

Then one knows that they cannot help themselves and it makes one understand it better, because often they don't make sense.
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You will have to supervise the toileting activity. She probably cannot reach all the way around to the back and will require assistance from now on.
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Maybe, if you ask her to help you out, something may click in? ... They like to feel like they're helping 'you'... just a thought
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I can definitely understand where you're coming from, Doncarlo - my own mom has started "forgetting" to wipe, or not wanting to, or...? Not sure. It's not dementia - not yet, at least. Much of my mom's issues stem from her weight - it's not easy to reach certain parts of her body for hygiene, so I've started investing in various little helpers to try and keep her from just ignoring the issue altogether, which is what she was doing for a couple of years before I moved in as her caregiver. But I think much of it boils down to her simply not really caring anymore, or not thinking about it. Her memory is starting to slowly go downhill, so that may be part of it as well. (She often forgets things, what day it is, what tv show she's watching when the commercials come on, etc.)
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You're not the only one with this kind of issue. I've seen posts on here about elderly parents who use their underpants as toilet paper, elderly parents who throw their underpants or pullups in the toilet, elderly parents who throw their soiled underpants (not a pullup) in the trash....on and on and on. I think you'll get a lot of great responses.

Not clicking vs. not putting in the effort. I vote for not clicking based on what you wrote. You said your mom doesn't want to wipe but then you said that she wears pullups so I'm kind of confused on whether she is continent or not.

When she goes to the bathroom go with her and hand her a wad of tissue and tell her not to forget to wipe. Always have gloves nearby in case she hands you the soiled tissue.

We all know that people with dementia gets worse and when they do we have to step up our game as well. This might be a new phase for your mom. It sounds like you might have to start overseeing her toileting habits.
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