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My 86-year-old father has advanced dementia and is in a memory care unit. He is peeing everywhere but the toilet. Depends don’t help. He wears them but when he has to go he just whips it out and goes. Thinking years of working in rural setting with earth moving business doesn’t help. He went outside whenever he needed to for literally years. You can sometimes get him to sit on the toilet proactively but he won’t go. 10 min later - peeing in the corner, or the hallway, or the closet - there is no 1 place. He’s still mobile but slow. Doesn’t talk much and seems to have no awareness that what he is doing is inappropriate. He’s not embarrassed or upset. He also wants to strip naked all the time and often walks out of his room that way. He’s been giving all the ladies of the MC wing quite a show and really upsetting everyone. I know the staff are also tired of cleaning up his messes. I’m out of ideas of what to suggest. Any ideas out there?

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What are their suggestions? What does the floor manager or facilities doctor or a social worker suggest? Obviously you are not making any progress --and perhaps you are not the one who should be responsible or embarassed.
Keep asking them for help.
Good luck.
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Assistance & supervision.

Staff can put Dad on the list with those that require scheduled toileting visits assisted by staff - on waking, after meals, before nap/bed etc.

Supervision to catch & redirect him at the other times.

This phase will pass. Once someone loses the ability to recognise their bladder signals, they will become incontinent. Pullsup style underwear or incontinence pads are then used & changed at regular intervals.

This is like Memory Care 101 stuff - speak to the Manager about his care plan & updating his toileting schedule.
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TeresaP Oct 2022
Thank you. He is wearing depends now but that doesn’t help. Seems to know he has to go but not where to go. Staff are not with him 24/7 so if he is alone will go where ever.

staff say they are trying to take regularly but he won’t go. I have witnessed that myself - even after he has verbalized he needed to go.

it would be better if he just went in his depends. It’s just so hard.
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Thanks. They are trying to take him proactively but he won’t go. Asking Nurse practitioner this morning for other ideas.

We’ve been at this facility less than a month. Moved my parents closer to me. Want to keep both of them in the same building. Worried they don’t want to deal with him and will ask us to move him to skilled nursing even though he doesn’t have any real medical issues. He’s in a memory care unit. My Mom is still on assisted living side. Both have dementia.
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Lmkcbz Oct 2022
You are a couple weeks ahead of me with dad on MC side and mom going to AL side as soon as she gets out of the hospital / rehab. Any tips or tricks or things you wish you would have known a month ago?
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Well--the 'worst' is over, he doesn't live with you, and luckily MC's have tricks and ways of diverting behavior.

At least they don't have carpet down and cleaning up puddles is probably a big part of the day.

This really isn't 'your' problem, so don't make it so. No doubt you have plenty of other stuff to worry about, let the MC do what they're paid for.

The naked wandering--my FIL did that and he was NOT demented, Just liked to walk around naked and stand in front of open windows and doors and give the neighbors a show. That is an actual illness and since he wasn't MY father, I never brought it up as being inappropriate. My DH couldn't deal with the embarrassment, so it fell to OB who is a psychologist and he tried to work with FIL--didn't make much progress, it was a bend in his personality that couldn't be 'unbent'.

THAT was a much harder thing to deal with. Had he just been peeing outdoors or wherever--nobody would have batted an eye. The naked wandering? IDK, it was never 'solved'.
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Run, don't walk to the nearest geriatric psychiatrist for medications to help him; don't want to have him expelled.
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Just wondering if posting eye level signs with his name in his favorite “spots” could possibly help. “John, no peeing allowed here, please use your toilet”

just a thought, I have no idea if it would work!
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When I worked at a national Memory Care ALF (Anthem), several of the residents acted JUST this way, and there was no issue at all. They were not asked to leave; this behavior is standard with advanced dementia and to be expected. If the staff is 'tired of cleaning up his messes', then something is wrong at this facility! Speak with the Executive Director right away about the entire matter to make sure they're not getting ready to ask dad to leave. And if they are, ask them what purpose they serve as a Memory Care ALF if not to deal with matters JUST LIKE THIS? When he comes out of his room naked, the caregivers should be trained enough to walk him back into his room and get him dressed once again. If they cannot do that, they are not properly trained to deal with dementia residents.

Of course, speak to the NP about meds, but I'm not sure which 'meds' would be prescribed to deal with these matters. Advanced dementia means that an elder is totally unaware of where and what purpose the 'toilet' serves, etc. There is an Alzheimer's anti-strip suit dad can wear if they run into continuous problems with BOTH of these issues (stripping naked and toileting), here is a link:

https://www.amazon.com/s?k=alzheimers+anti+strip+clothing+men&crid=3TJW08Y67D3QG&sprefix=alzheimers+anti+strip+clothing+men%2Caps%2C189&ref=nb_sb_noss_1

This anti strip suit may actually be your best bet to deal with these matters. The staff can dress dad in a Depends in the morning, and then change him a few times each day, even if he pitches a fit; this is again something a trained CG should be accustomed to dealing with in a MC ALF. THIS is where the calming meds could prove helpful: to keep dad calm during the Depends changes.

Wishing you the best of luck with all of this. I hate dementia with every ounce of my being; my mother died in February in a Memory Care AL with advanced dementia and heart disease, so I feel your pain.
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"One Fine Day to Be Nude" Family Guy Bill Clinton comes to mind reading this Lol
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TeresaP: The staff at your father's memory care unit are trained medical professionals to handle all of his issues. Speak to the director if need be.
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Well, just be thankful you don't have to clean it up or deal with it. People with dementia have no idea what they are doing, as you know, so really, there is nothing you can do about it.
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Another problem is that these places are short staffed, they really need more aides there to work with people such as your father. If he had more care, they might be able to catch him before he pees or takes his clothes off. But, everything is the bottom line, to make money so hospitals, memory care facilities, etc. are all the same. Not enough staff. Believe me, I have seen it with both my parents. I was lucky though, even if they both developed terminal illnesses in their 90's (which was tough) neither had dementia, and my mother was sharp as a tack, til the end. And they both lived at home btw hospital stays. And died at home, which is what we wanted. And they did too. After witnessing them both die, I will say that death is not pretty.
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Mariavictoria30 Nov 2022
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Depends & pull-ups over them. Perhaps private aide to stay by him ..don’t know if you can afford or not.
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