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When younger and before memory impairment, my 95-year-old mother was compulsively clean. These days, she seems to have forgotten anything she ever knew on the subject -- kitchen cleanliness, bathroom sanitation, hand-washing, laundry -- you name it, she's stopped it.

In most cases, I can cover for her. However a recent incident causes concern. I was helping her get cleaned up when she had to use the toilet for a bowel movement. Then she wiped herself from back to front. When I commented, she said it didn't make any difference. Given her characteristic stubbornness and oppositional behavior, I knew that to say anything else would only make it worse.

But the incident made me think of the many reports on this website about urinary tract infections in elderly women and I wonder if there is a link with the wiping. Can anyone enlighten us on this?

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With many older people joint stiffness, arthritis and plain obesity make it very difficult to wipe from front to back from the back. It has to be done from underneath which is also difficult without contaminating the urethra and vagina. Wipes can be helpful, just don't flush them. Even those labeled flushable can get held up and cause a blockage in the sewer system. There are long handled gadgets available that hold the toilet paper and they can help. it is also very important to get the anal area really clean because any remaining feces will cause discomfort and irritation not to mention stained underwear. I have said it before and will repeat it a bidet is invaluable
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The main cause of UTIs in women is E. coli. The digestive and urinary exits of women are so close that it is easy to introduce the E. coli to the urinary opening. Wiping back to front is definitely bad. One problem older women have is it is difficult to wipe from the rear and not make a mess up their backside. It is okay to wipe from below as long as they don't drag anything forward -- IOW, treat the two areas as separate places to avoid contamination. Older people can have a difficult time with this.

I had a friend whose mother was in a NH. She became very angry when she leaned that her mother had a bladder infection with E. coli. She thought the NH had introduced it in the diet. I never could make her understand that it wasn't diet, it was hygiene. Probably even passing gas can transfer some of the E. coli, so staying clean is important.
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My mother-in-law is 89 and has dementia. Even though she has lived in asst. living and has now been moved into memory care I still take her places with me and spend lots of time together going to movies, road trips etc. One time while on one of our outings, I was helping her find the bathroom and making sure she was finding everything ok. When she seemed to be taking too long in the stall, I peeked in and saw her wiping from back to front. Oh my gosh, I'm thinking how long has she been doing that? Later on that day, I brought up the subject of bladder infections to her. She told me that from the time she was a little girl, her mother had taught her to wipe back to front. She also said she had NO idea that you weren't supposed to do it that way. Now I think that at the age of 89 that could be true then, since maybe women didn't know what we know NOW. But I'm 60 and my own mother always told me from the time I was little, which way to wipe your rear-end. So is that the way little girls were taught 90 years ago or has my mother-in-law just forgotten the proper way? Jury's out.
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Absolutely!
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