My mother-in-law keeps on going to the bathroom to take a bath. (every hour). Any advice?

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My mother-in-law has frontal temporal dementia with Parkinsonism. She is also suffering from depression, anxiety, and obsessive compulsory behavior. Her change in behavior happens when she has experienced fecal incontinence. The doctor prescribed lax-a-day, Pms-Docusate Calcium and suggested metamusil. We did everything according to what the Dr. suggested but she still have this faceal incontinence problem. We applied Adult Glycerin suppositories but she just fart it back out or she would use her hand to take it out.
What should I do? Thanks

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Thank you cwillie for the support. The nurse told me to keep on doing what works. So I am going to stick with the routine until something changes. I went to a Alzheimer Support Group gathering last night and realized how lucky I am. All of the participants in that meeting are elderly females (except me, I am totally outnumbered! ;-) who looked after their husband until they cannot manage. One participant just applied for a placement last year and she is 79. They experienced all the "horrible" experiences I encountered and continue to show their love and care towards their loved one. I am happy I went and learned a lot from their passion. This strengthens my belief that I am doing the right thing by refusing to put my mother-in-law in the emergency queue.
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Hi JT, just following up on a private message. Docusate sodium is smaller than docusate calcium and works better in my opinion, but if she is having trouble swallowing you may be better off to stick with the lax-a-day or generic equivalent, as it can be mixed into almost anything, I've even put it into a bowl of soup.
I understand exactly what you are saying when you talk about your case manager pushing you to put your mom into the queue for care, the same thing happened to me. When my mom first took her turn for the worse i begged for answers, for more help, for a nurse at least to come out and give me some guidance. My case manager looked at me like I was talking crazy and informed me that she WAS a nurse. Her personal belief that I should put mom in a nursing home coloured her judgment, and when I finally broke down and admitted I couldn't do it anymore she found my mom a placement within weeks. After an agonizing night of worry and second guessing myself I declined the placement, and was finally able to get supports in place to keep my mom at home. This website, although American, is a wonderful resource and helped me immensely. I'm glad you were able to get a nurse to come into your home, just keep pushing them to continue to cover your needs. Only you know if you can handle having your mom with you, don't let some bureaucrat talk you into going against your best judgment!!!
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Make sure she eats foods with fiber, ask her doctor or pharmacist about a fiber supplement, make sure she drinks plenty. Provide 'wet' wipes for clean up after an incontinent episode. Try using a toileting schedule, ask her or take her to the bathroom after meals, try every hour sitting her on the commode, then you may be able to extend the time she goes to the bathroom. Keep a journal, maybe you can get an idea of what food she eats and when she goes; this pattern may help you set a toileting schedule that works better for her. Good luck
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I don't have any advice for you but wanted to share my concern and respect for you and your wife's dedication to caring for your MiL, and especially for attempting to maintain and integrate your own cultural practices.

I do understand your reluctance to use a facility; it's my understanding that the Chinese and some other ethnicities have for centuries cared for elders in their homes rather than use facility placements. To me, that's very admirable.

As to all the medicines, I'm not familiar with them but just wonder if time-honored Chinese practices and good diet might be helpful for the bowel issues.

I think the reason your MIL feels the need for so many baths is probably because of the discomfort in her rectal area and the sense that things just aren't working properly there.
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nothing new to add to the advice but if she is admitted to hospital at any time and you feel she needs placement try and make that directly from hospital. i am not familiar with the canadian healthcare system but that is what i would try.
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P.S. Avoid constipation by all means, but diarrhea, loose stools are not good.
That is why the applesauce with easily digestible chia seeds may work.
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John Shiapi posts regularly and can be found here on aging care site. He recommends chia seeds mixed with applesauce to comfortably regulate the daily bowel habits (necessary with Parkinson's). Look him up, he is an amazing contributor, he has other ideas for Parkinson's. The medications may be too much. Your MIL may be extremely uncomfortable and need Tucks wipes or Ointment to calm the area. Look up "Sitz baths" or "Bidet" cleansing. I don't know what these are called in Canada. Her behavior may change once she is more comfortable.
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Thank you all the the valuable comments. It is our intention to keep my mother-in-law with us until it is impossible for us to look after her. It looks like this day is fast approaching. My wife and I know that it is better to put her in the emergency queue right away. I had this experience last year with my mother when she needs to be put in that emergency queue after the doctor found hairline fracture in her hip. My mother is going to be 94 this June. She always lived with me until last year. She still have good memory and reflex at that time. Since she was sent to the long term care facility, her memory is fading fast and her mobility is now limited due to her hip problem. I am worried that with my mother-in-law's mental condition, she will have a very difficult time to adjust to life at the long-term care facility. Hence my hesitation to put her name in the emergency queue. She tried to commit suicide 5 years ago. We all thought that it was due to her depression. It took almost a year to find out that she suffered from Frontal-Temporal Dementia. The Dr. told us at that time the average life span is around 8 years for FTD patients. We decided at that time to make sure she will spend her remaining years in a happy surrounding. She still can recognize our faces (not names) and looks happy to be with us. She would come to our room to watch TV with us even she does not understand a word of English. We subscribed to Chinese TV service and put a TV in her room. However, whenever my wife is around, she would come and watch TV with us. We know there will come a time that she needs to be alone in the long-term care facility but wish to delay that palliative care decision as long as possible until the time when we can no longer manage her.
This morning, we heard her going into her washroom at 5am. This is not her regular routine because she seldom wakes up at night. My wife and I jumped up to check on her. We are so happy to see that she finally had her faecal incontinence issue eased up a bit. The stool is very hard and not much, but at least it starts coming out by itself without my wife's assistance. It did make a bit of mess in her washroom because she used her hand to find out whether there are stool in her bum and then used her hand to touch quite a few thing in the washroom. I am fine with cleaning the washroom because we are happy for her. I booked an appointment to see the Dr. this afternoon. Tonight, depending on what the Dr. suggests, we may decide on whether to put her in that emergency queue.
Thank you all for providing me with the comments and allow me to share my concerns with all of you.
James
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If the galantamine + memantine does not improve cognitive function, there is really no point in continuing those drugs. Ask the MD
Apo-Ditiasz, Apo-Atorvastatin, Sandoz-Pantoprazole, Paradaxa suggests she has high blood pressure, high cholesterol, stomach issues and clotting problems. Again, be sure she really needs all those meds by reviewing them with the MD. Ask the pharmacy to run a drug interaction check on those combined drugs. If red flags pop up, call the MD and hold him accountable. Too many drugs can actually make things worse. Six different meds all at once would worry me.
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There will be long term care available with much shorter waiting lists if you are willing to place her farther away... I assume you are in a large urban centre? She can still be put on a list to transfer closer to home when an opening becomes available.

I would be cautious in using metamucil, if she doesn't drink enough it will have the opposite effect to what you need. Try giving her the docusate twice a day and add in a stimulant laxative like milk of magnesia every other day. The polyethelene glycol (lax a day) worked for us for a while, but it is essentially doing the same job as the docusate at a much higher price. Make sure she gets a good diet of fruits, veggies and whole grains, and push the fluids!!!
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