My mom with dementia won't clean/wipe herself after a BM. Advice?

Oh dear. She stinks. Her depends are messy. Not great, but not a crisis. But the real issue is risk of sores and infection, isn't it? You have somehow managed to "make" her use depends and make her take baths. Maybe this will ultimately come down to having to make her let you help with cleaning her. I don't blame you for wanting to avoid this indignity (for both of you).

We really don't want to treat our parents as two-year-olds. We want to preserve as much of their independence and dignity as we can. And we also want to keep them safe and healthy. It is a very tough role to play!

Sorry I don't have an answer, but I do feel for you!

But would she use the bidet? Would she holler and make a fuss and refuse it? It is so hard to predict dementia behaviors.

It's difficult because your mother is aware that she's not a child and she "can" cope with cleaning herself. Except, clearly, she can't. Who knows what the gremlin in her brain is doing at the moment when she plans to take the paper, do the business and come up clean and shiny? - but whatever mean trick that gremlin is playing on her, the net is that her hygiene is poor and you're climbing the walls about it.

So you've got to do something. Now, this is what the brisker kind of HCA or community nurse does, and I copied them: breeze in there, like it was a matter of course, wearing disposable gloves, with a wet wipe, and just do it. The trick is to take it in your stride so that it's done before she knows what's happening. You don't sneak up on her, or try to pretend it isn't happening, and you keep talking in a cheerful, matter of fact way. So it goes something like…

[knock knock at the bathroom door, then] Just popping in to see how you're getting on, mother! Now, where are we, all done? Great job! Let's just check we're all clear here - [whisk wipe around operational area, dispose of wipe in sealed bin] - that's marvellous. Got everything you need? Can you manage with pulling up? I'll just fill the basin so you can wash your hands [you do that, check she actually is all set, then depart].

By treating this situation as normal you are avoiding embarrassment and minimising the intrusion into her privacy. Don't be stressed, don't be embarrassed, don't be ashamed for her. It's a practical matter that needs practical help. If you have a friendly community nurse or OT or similar, could you ask them to give you a quick demonstration?

By the way, if your mother locks the bathroom door, you want to take the lock off anyway. Because sooner or later she will be a falls risk, she will never remember to leave the door unlocked (no matter how sincerely she promises), and an injured senior lying behind a locked bathroom door doesn't bear thinking about - those are hard surfaces to fall on in there.

Currently your mother is already ashamed, that's why she's hiding things. I know the actual butt-wiping phase feels like a massive downward leap, but what you're really doing is restoring her dignity by minimising the problem and reinstating good bathroom habits. She just needs a little help with it.

And if you can't do it, and lots of people can't adjust so go easy on yourself, then ask for help. You'll be amazed at how normal, common, everyday, simple this problem is.

Thank you all for your replies. I did consider the bidet but is it automatic? She wouldn't do it herself that's for sure. Not sure how those things work? Would it spray her at just the right time without her doing anything? Does it work on BMs? I am not ready to wipe her myself....and believe me....she isn't quite to the stage where she would allow that in any way at all. I am going to remove the lock, though, just in case. I am sure she will ask what happened to the lock one thousand times though. I am really trying to maintain a sense of humor about all of this. But, again, if anyone could explain about a bidet and if it would work on someone who won't actuate anything to get it going....and if it works on BMs, I'd so appreciate it. They are kind of expensive so I'd want to know it would work. If it did, of course it would be worth every cent.

Akaheba, one thing you could do is visit your nearest nice nursing home and see what kind of installations they have there - you'll probably find they have a number of different varieties to suit all kinds of needs.

I would be surprised if your mother were able to use a bidet if she can't manage toilet paper - but then again, you never know; and in any case if she can't then whoever is helping her may well find it useful.

They do have automatic ones in Japan, for example, but apart from the expense they might frighten the life out of her - can you imagine, if you weren't expecting it?

Yes - I can see it now - it sprays her and she jumps up....makes a mess....or worse slips and falls....and then the slew of obscenities will follow. LOL.

My dear mom has denentia. I am using bidet. It helps to clean. But some times needs wipe grr. Bidet is an automatic toliet seat has sensor. This seat has button can be a remote or manuall. The buttons would be one for cleaning after urinating (only for women). The second button use after stooling. The third button for stimulating helps consiptation. I hope my info helped. But it really helped mom and me.

The brisk, cheery business-like attitude CM explains is excellent! I found it is MUCH harder to achieve with a family member than it is for a professional to do it. My mother fought all of her daughters tooth and nails and vocal chords not to have to take a shower, for example. The first time we visited in the nursing home when an aide came in and said, "It is your turn for a shower now" and pushed the wheel chair out without out mother saying a peek we looked at each other and said, "Who is this woman and what have they done with our mother?" I know that my sister used the "it is time now ... here is your nice bath robe" approach and it is the only one that remotely worked -- but there was still a big argument every time.

Akaheba, you are not ready to physically wipe your mother's butt. She is not ready for that and can't do it herself. Sigh. I guess you continue as things are, perhaps insist on more frequent depends changes, and keep your fingers crossed against sores and infections!

Good luck.

Countrymouse is 100x correct in just treating it as "business as usual". My disabled adult son wears Depends - been in a diaper of one sort or another most of his life. My father was very involved in my son life and depends are just an everyday, no big deal thing at my house - so adult diapers were nothing new to dad. When the time came for my father to wear depends it was no big thing. My mom was tougher to persuade but since I was very comfortable talking about adult diapers, it didn't take too much to eventually get her to wear them. As for wiping - I do it almost everyday for my son. Trust me, it's not the high-lite of my day, but it's gotta get done. I've been lucky to never have had to change/wipe either of my parents - there was usually a caregiver around and now the NH. However - if I had no choice I'm sure I'd approach it in the same way I do my son. Slap on the gloves, have baby wipes at the ready (do not try to fiddle around with tp when your cleaning someone else's bottom!) grab a fist full of wipes (not the time to save the family fortune by being stingy with wipes) and just dive in - literally. If your shy and just dab around you'll just end up with skid marks and a stinky person. Wipe until no tracks. Have a plastic sack ready to go - put in the dirty wipes, tie off the bag - to be taken outside at the very first possible moment. I've been wiping someone else's button for almost 23 years now - some occurances are better/worse than others. But again, what other choice is there. The key, in my opinion is to be prepared with the right tools - it makes all the difference. Here is a tip - not sure if a parent would be as willing/ able/ comfortable with this - but if you can get the person to stand and bend over a bit you get the job done much faster, better and with less physical strain on your own back.

As with other key moments in life, maybe the first time is always going to be branded on our memories. My great aunt, aged 96, had been an awfully long time in the bathroom and we were waiting for her before going out for lunch. I knocked timidly at the door, heard her say "I'm a bit stuck," poked my head into the room and saw that she'd got her trousers twisted round and couldn't pull them up. I was a frozen rabbit for a full five seconds, but there was nothing for it - I said oh dear, went over to her, adjusted the trousers, and off we all went.

Laying hands on my elderly relative was not a thing I had ever imagined I would need to do and I will never forget the initial panic I felt. Thank God she had the presence of mind to speak up rather than struggle on and fall. Thank God she was a cheerful, laid-back woman who never made dramas out of crises. We should all have someone like her to practise on.

She is not getting clean simply by sitting in a tub of fecal matter contaminated water. Don't be fooled into thinking this gets her clean. Not even with soap.
Would you feel clean after a poop soak? I wouldn't. This can infect any open cuts, scrapes, sores on other parts of her body.

I strongly suggest getting an in-home personal attendant to come do showers on her 2-3 times a week. If you have to bathe her, just focus on the really smelly parts: pits, privates, feet. Skin cleanliness is the first step in maintaining skin integrity.

She *will* develop open sores from exposure to urine and feces. And then you really will have a fight on your hands over bathing and changing because it hurts.

This is also one factor in determining if someone needs 24/7 supervision. If they are beyond toileting themselves properly, then in a care center, they will be put in disposables and changed by staff every two-three hours to avoid open sores.

If you are willing to take this on, watch some of the tutorials on youtube for safety precautions when working with someone lying on a bed so you don't strain your back, neck, & shoulders. Especially if they can't roll from side to side for you.
My mom is totally incapacitated and it takes two people to change her, and use of the draw sheet to move her up/down/side to side.

If she won't cooperate for you, she may behave for a "professional" dressed in medical clothes (scrubs). This is really common. My mom thought everybody in scrubs was a nurse.

Good luck out there!

Sandwich - a poop soak? Lol, thanks for my first giggle of the day! I mean, I know this actually isn't a humorous topic but sometimes you just gotta laugh.

Laughs are free!

New toileting issues are so difficult not just for the hygiene factor. It's such an obvious indicator things are not right. You can't ignore incontinence or someone of any age who previously did this for themselves but now can't. It's quite a rude event. It's very "real". Nobody gets a video in health class during high school on how to handle this. There is a safe way to do it, and an unsafe way.

Nobody teaches us what the signs are to ask for more help, or to change how things are being done. We wait until it's totally unmanageable and things are a mess (literally) to even contemplate asking for help.

Several years ago - before I had to deal with any of my mom issues - my MIL became gravely ill from multiple myeloma. She had been in the hospital, in another state far away. My husband went down to see about her and the hospital discharged her to his care. We had no idea you can or should refuse that.

He ended up taking her back to her house and discovered he had a 24/7 skilled nursing situation on his hands. His sister was there for a few days - she's a nurse - which really helped. She had run out of time off and had to fly back for work, leaving him all alone.

It took no time for this situation to devolve into a holy nightmare. The woman became 100% incontinent. My husband had to figure out what to do on his own. It was shocking, alarming, awkward, uncomfortable, weird, gross....you name it. Every time she tried to stand up, poop everywhere. Who is prepared for that?

He had only ever changed our babies, not a fully grown woman who was definitely a 2-person assist. Neither one of us knew that she should have been in a nursing home. Those are for old people, right? He fought the good fight around the clock for almost 2 weeks. He ran out of time off too, and out of sheer desperation called his aunts to come down. There was no way this woman could be left alone for a moment she was so ill.

There was nobody there to say "honey, put her in a care facility!", or to explain how you even do that. The discharge people at the hospital never mentioned one thing about that as an option, even when he explained that he lived out of state and she lived alone.

It was heartbreaking and she ended up passing not too long after that. The person taking care of her at the time was completely incapable and refused assistance from hospice or anyone. That story is a whole other soap opera though....

People with dementia can become incontinent rapidly. My cousin became double incontinent is a very short time period. Cleaning them or cleaning patients who don't wipe properly has to be a priority. You are passed the embarrassment stage. You don't have the luxury of waiting to see what happens or hoping things get better. If you are the one in charge, you have to take actions immediately to protect their health.

I don't see how a bidet would help, since it would only put water on the situation and wouldn't promise to clean it. She would then have a wet environment that would be ripe for fungus and bacterial growth.

If you can't jump in and take charge, you might contact an outside agency to help, but they would have to be available around the clock or teach you how to do it when they are not at home. You can't allow the patient to refuse to be cleaned when they are not competent to make that decision.

When people are not able to be cared for in their own home, placement should be considered as an option. Most people in Memory Care facilities are incontinent and the staff handle it quite well without much resistance. I wish you the best of luck.

Amen Sunnygirl1!

Thanks to everyone who commented. I got a lot of good ideas/advice, especially the hand bidet. I know an automatic one would be a disaster, but I think I'll try the hand bidet.

A sprayer may indeed be worth trying. Would your mother let you help her with it? If she won't remember to use toilet paper she is not going to remember this new-fangled thing. And keep in mind the water is cold. (My mother hollers bloody murder that the wipes the aides use in the nursing home are "too cold".)

If you do try it (or anything you try, really) let us now the outcome. Yours is a very common problem.

Yes, on second thought - I know she won't use it on her own; it will just hang there. She will not let me do it, either. And cold? Jeesh even I wouldn't want to spray cold water on myself. Well, I found these wipes that are larger than normal baby wipes. I put them right next to the toilet. While I know she will not just go ahead and use them on her own, what I am doing is when I see her go in the bathroom, stand by the door and when I think it's just the right time I'll say, "use those wipes in the blue box." I've been telling her the "doctor" told her she had to use them before her "appointment" -- I think she's more likely to use them if it's not ME telling her to do so. By the way, she will be having an "appointment" 3 times a day if necessary! There's one way memory loss actually comes in handy!

Just started doing this....I hope it works!

Watch out for the way they wipe after a BM though. For some totally inexplicable reason Mum started to wipe from back to front rather than from front to back and I could not understand for ages why she had 3 UTIs in a month - then when I took her for a shower I noticed that she did this and so I now do it for her. Very matter of fact but initially I said the doctor said I need to wash and use barrier cream after you poop Mum just to stop any infections. So I do wash her and cream her after she has a poop and all is well. Do I go through a lot of barrier cream? Yep but its better than the alternative (usually)