Parent refuses to go to the bathroom. He appears to be doing this on purpose. How do I deal with his behavior? - AgingCare.com

Parent refuses to go to the bathroom. He appears to be doing this on purpose. How do I deal with his behavior?

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I am my father in law's caretaker. Over the past 2 months he became weak in the legs and has done nothing but sit and watch TV for a few months now. I took him to the hospital and the local hospital and VA cannot find anything medically wrong with him. As a matter of fact, health wise, he's perfect. He does not have alzheimers or dementia. He just refuses to get up to go to the bathroom. He pees on himself so much that he soaks through his diaper (which were only for accidents), a bed pad and a beach towel. It's much worse at night. I am literally doing 2 loads of just his laundry a day. Yet, we catch him up in the middle of the night getting into the sweets and will smoke a pack of cigarettes at night. So, getting up isn't the problem. We took away his cigarettes at this point. He has a nurse, a physical therapist, and an occupational therapist that come 3 times a week. He has built up some strength at this point. Anyway, the other night, he got up and went to the bathroom just fine and the next morning he was completely dry. So, his son gave him his cigarettes back that morning. After that, he peed all over himself and the couch twice that day and wouldn't go to the bathroom. Yet, he got up to eat the kids snacks. He even bragged to the nurse that having a "servant" (which apparently is me) is the way to be when she asked him why he was refusing to walk. He's healthy and it seems crazy, but he appears to be doing this on purpose. How do I deal with his behavior?

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I would think if you tell his VA docs what you've shared here, they'd work to figure out what to do for him. He's clearly got a lot of stuff going on and has for years. Now it's probably both physical and mental. You're a sweetheart for taking care of him; I couldn't do it.
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We were asked to move into his home about 15 years ago so he wouldn't lose his home. His daughter caused him to go into $17,000 in debt and the VA stepped in. At that time, his only issue was his diabetes and had very poor living conditions. (Best way for me to describe his home is that it took me a month to get it cleaned decently). His diabetes was out of control from a diet of poptarts, bologna, cereal, candy, basically all junk. He would also skip necessary meds and take only the ones to make sleep in excess. Basically what were to insure his daughter didn't come back (which she didn't because she left 2 of her kids that we ended up raising ) , and to monitor his diet and meds. After his stroke in 2009 (he recovered), I ended up taking over his diet and meds completely hence his blood pressure, sugar, and cholesterol all being in range today.
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How long has your FIL been living with you? And what was the original reason for his moving in?
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He's a Vietnam vet and sees a psychologist for ptsd and bipolar disorder. I can't remember specifically what his a1c was, but I do know that his last set of labs were about 3 months ago and all the results were in range.
After what he did this morning, I'll probably take him to see his psychologist and ask about adjusting his bipolar meds. As of this morning, he was dry and asked for a cigarette. I went in my room real quick and then went to take him a cigarette and caught him laying in the bed with his hand down his pants. So, I made him get up and discovered that he was purposely peeing on his bed because he didn't immediately get a cigarette. I'm starting to think his bipolar is acting up because he would do mean stuff 10 years ago before his meds were adjusted. I think they need to be adjusted again because if not, I'm gonna need some medication myself.
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A man who pees on himself, deliberately or otherwise, is not in perfect health. It may be his mental health that is slipping, but he is definitely not perfectly healthy. It must be very frustrating to you to not get helpful answers from the medical profession!

What condition does he see his psychologist about twice a year?

What was his most recent a1C test result, and when was this?
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Thank you all for your answers. he has been fully tested. He goes to both his GP and psychologist every 6 months and has for years and the VA did a full work up on him recently at the hospital . He was diagnosed with diabetes years ago, but his sugar has been diet controlled for about 5 years now. I do agree that he is using this as his last bit of control he has, although our family always asks his opinion before we make any family decisions. It's funny because it's 12:30 am and I just caught him in the kitchen cabinets again. I kind of startled him, but I did make him go to the bathroom. My husband does help, but mostly with the heavy lifting because his dad really stresses him and he does appreciate me. I think at this point, we're gonna start putting one cigarette in the bathroom at a time.
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It does sound like he is doing it on purpose to get attention and have his social and psychological needs met - through your "service'. He has money - he can purchase a real servant.
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Well, I'll be the hard a--. Tell your FIL that if he doesn't get up and go pee when he needs to (since he's capable), then he'll have to go to an assisted living/nursing home where they have the staff to care for incontinent patients.

I wouldn't have been so tough but I sure didn't like his degrading remark, 'he even bragged to the nurse that "Having a "servant" (which apparently is me) is the way to be.", when she asked him why he was refusing to walk."

Nonsense! Don't put up with that cr*p. You don't need to be anyone's servant. Tell your husband he can do half the work (wash urine soaked pjs and underwear) if he doesn't want to send him to a facility.
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Has he been checked for diabetes? I'd check for that first. Then check his cognitive abilities. If that checks out, I'd only give him a cigarette each time he got up and successfully used the bathroom. It seems like he likes the smokes.

How you can deal with this is beyond me. You are a good wife and I hope your husband appreciates you!
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Has he had the 6 hours of paper and pencil neurocognitive testing that will actual tell you what his reasoning skills, executive functioning and cognitive skills are like?

Don't let anyone tell you he doesn't have dementia based on a 5 minute memory test. Dementia is often not about memory, it's about a person's ability to reason and use good judgement.

And it sounds as though his is sadly lacking.
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