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He uses his disposables like an infant. I don't know if he is cleaning himself properly? if he is really messed up he will go have a bath. Many times we smell him before he notices or cares and then we tell him he needs a bath. If he is sitting for awhile in dirty pants, he could get rashes and sores. I am concerned but I don't know how to explain it to him, or how to help him. How do they deal with this in the homes? I am not getting answers. The obvious seems like we would have to do it for him, but not an easy discussion to try and have when he wants to be independent. Any ideas would be appreciated.

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It's not nearly as expensive as the monthly rate at a long term nursing center where skilled nursing is needed.

I would say 2 hours in the morning from 8-10 or 9 - 11. And then again around 7pm - 9pm or 8pm -10pm. Twenty is the typical agency rate but usually someone doing it directly not thru an agency usually charges 15 - $17/hr.
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How would you know what two hours and they charge a minimum of 4 hours most of the time at 20 bucks per. So that is not a cheap way to go either.
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The other options is home health aides for two hours once or twice a day.
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Well I think you answered you own question, you have to either do it yourself or have him put in a board and care that will take care of him as he should be cared for. This is the time that most people place their parents when they become incontinent. You can't keep putting him in the shower every time. It is a tough job that most people don't or just can't do. You are at that crossroads and have to make up your mind.
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SOME incontinence is related to B12 and other B-vit. deficiency--not all.
We use Biotics edible tabs--always get B12 that also has folate, at minimum.
Most have about 1000mcg B12.
Biotics is pleasantly tasty--good for compliance, usually.
Some advanced senility elders can't manage sucking on a tab--will chew it or spit it...injectable better for those. It's also good for some auto-immune and neuro issues.

Goal with incontinence is minimize skin damage and infection.
IF appropriate, an indwelling urinary catheter might be useful--connect to collection bag. With confused elders, be watchful of tem messing with it--could harm self,or pluck it out.
For males, there are condom catheters...a condom-like device sticks onto the penis and drains to a connected bag....except in my experience in caregiving, unless the man stays fairly still, those come undone too easy. The sticky stuff that's supposed to hold it onto the skin always gets other stuff [hair, blanket fuzz...] stuck in, making it less effective; old shrunken skin is very difficult to apply t to.. Many caregivers simply cannot learn to apply it properly--eve medical staff have difficulty.
Catalogs like 'Dr.Leonard's', often list a male drainage device---but it looks like that only cups the penis and depends totally on man staying vertical [standing], in order to work right.
Could seek diaper inserts that have the gel that better absorbs wetness away from skin.

Explosive poop or diarrhea is another wicked issue.
ASK: WHY is person having explosive bowel movements?
WHY loose stools?
Answer: What they consume is affecting that. What they consume causes conditions like IBS, Chron's Disease, etc., which result in poor digestion, malabsorption, bowel issue. Some drugs cause it.
The solution is most often to correct what's consumed [stop eating allergenic food and drink; see if drugs can be adjusted], supply something that is very hypo-allergenic instead; then massively replace a broad spectrum of good Probiotics, daily. These can even be given between doses of antibiotic, too--some docs are clueless about this--but if enough are given, it stops the bowel problems and increases overall health benefits.
Acidophilus, alone, is listed in the PDR specifically for stopping diarrhea.
Bifidus is better at helping loosen up chronic constipation.
Rhamnosus helps decrease anxiety and depression.
There are LOTS more kinds.
Best is to get Probiotics with a long list of kinds of probiotics, to help the best.

It's important to have/use hypo-allergenic, non-toxic baby wipes and/or cleaning products too--gentle on skin, less trouble for any breathing issues.
Carpeted floors are ability--no good way to keep those sanitary.
No-barrier showers are very helpful.
There are no-rinse liquid soaps for cleaning bed patients with big messes, use with damp towels to wipe large area at a time.
There are riser seats for toilets that have cut-outs in back and front, to allow easier clean-up using a hand-held shower on a longer hose.
Try googling www.drleonads.com , or similar catalogs, to look for cheaper assistive devices and solutions.
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feehan: make sure your dad gets fiber. Also you can use baby anti-gas drops in his beverage. I make sure Dad has a slice of high fiber bread each day. He does not like the bread, so I put some butter and maple sugar on it. We switched from pants (with belt, button, zipper) to pj bottoms so he can get his pants down quicker. And for wetness only, pads inside his depends which I try to make sure are changed every couple hours. Good luck.
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Cute young chick, What is the strength of your B12? I take 5000 mcg sublingual daily. Still have some leakage, however.. And am not a cute young chick! I'm an old wrinkled hen - over 90..!
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My Dad is Bedridden and trickles all the time, we use Tena Male Guards and Prevail Briefs and ALOT of Aquaphor and Lantiseptic! When he is red we use EPC Cream, no break-downs as of yet and we have been home over a year! Plus we have had active C-diff two times. Make sure they get plenty of water and if bedridden when changing them roll to the left to empty the bladder and roll to the right to empty the colon.....Don't know to much on how to deal if not bedridden though...
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As people age, their B12 levels reduce, due to our body's inability
to absorb it from our food.
Incontinence is caused by a deficiency of Vitamin B12.
B12 sublingual tablets (HAS to be sublingual to work) cure the
problem - sublingual meaning under the tongue, where it's
absorbed directly into the bloodstream.
If I slow down my B12 intake, my incontinence returns, I have
my 6 tablets a day and it goes, I stop taking it and it returns. . .
Cheers x
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My wife of 58 years has had AD for 12 years. Still strong, but the disease progresses.
I use 2 "depends" at night and when out for more than 3-4 hours. The 2nd pair will be tighter and helps with any problem that she has. She has a companion for 40 hours each week, but I get the nights and early morn. She does not seem to know when she has an "accident". Suggesting that she sit on the toilet does no good. I am glad that this disease progresses slowly so we can adjust slowly.
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My Dad is now fully incontinent. We have been using pull up depends, but with overnight (max absorbancy) in the pull ups. He goes into the bathroom every hour (prostate cancer) but thinks it is "wasteful" to change the pads. I come in about every 2 hours while he is on the toilet and remove the pad and put a new one in its place. We have an arrangement each evening that I wipe his butt (wet ones) and put cream on it (Weleda diaper rash has been good) to provide a barrier from wetness on his skin. He is now having difficulty with his penis from not getting clean and changed, the 2 hour schedule has helped but the MD is also asking for 3X week bathing. He is very difficulty to get to bathe more than once a week, so a bathing aide is going to come in. Good Luck.
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My darling wife has been granted an in-home carer who comes for one hour twice a week and giver her baths.

She is also about to be granted in-home visits by a Doctor of Medicine. MD24. We feel very blessed in this.
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You just have to clean up after him, but do not castigate him or show disapproval or let him see that he has offensive odour. It's a fact of life with some elderly folks and should be taken care of quietly, kindly , and confidently.

I expect you have incontinence pads, the washable ones, between Dad and the bed, and then use disposable pads on top of that.


It is something that has to be done and looks like you are nominated for the blessings that come from making an elderly parent dry, comfortable, and clean.


Keep up the good work and remember, "God loves a cheerful giver."

:)
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Thank you all so much for your help and ideas. Yes, My brother and I are living with my Dad. Mum passed away last year and Dad has mixed Dementia. They both wanted to stay in their own home. A few months after Mum died, Dad thought she had been gone for years. We do everything for him and do not like to leave him alone very long, as he may wander or get in trouble trying to do something. He still goes up and downstairs but is very slow. He still dresses himself, but we have to give him clothes to wear. He still bathes but I think we will have to start helping him with it. We have some help coming in and he can help with bathing Dad, but Dad still doesn't want the help. That is why this going to the toilet and cleaning himself is a concern. I will work on some of your ideas and I really appreciate reading your answers. Thank you so much.
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Verify your insurance type and see if home care is covered. There are new programs in some areas for members with medicaid for homemaker and companion services (cooking, cleaning, reading to them etc).

The main concern for you is the initial assessment. The nurse will evaluate your father (check for potential or actual sores). Due to incontinence give you both tips on care to minimize skin breakdowns, possibly have an order for cream to use to prevent/treat sores or the aloe wipes. It's always difficult, but don't try to do it all alone!

Think about respite relief for yourself (now covered in some States such as Florida) for all qualified Medicaid members. Caregivers are screened and trained so your time can be quality and you will be refreshed to provide care.
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my 75 y/o husband can has explosive BM's and cannot always make it to the bathroom, so if we are on the road or know we will not be near a bathroom, he wears pull-ups.. which work great ( walmart) He is a proud person and it was a to more embarrassing when he had an accident.. just bring him some pull-ups and tell him to feel free to use them...that you know any who do... just check out the supply in the stores, they wouldn't carry them if they did not have customers.
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My husband could do things for himself, but he just didn't. His dementia made hygiene and trips to the bathroom something he just didn't do. It started with only showering a couple of times a week with no underwear changes between. He stopped brushing his teeth and shaving. Then he progressed to wetting himself and not noticing. At that point, I got him some Depends pull-ups and insisted he start using them. Surprise! He acted like he had always used them. Then he started soiling himself and just sitting in it until I noticed and marched him into the bathroom for a cleaning and shower. Once again, he acted like it had always been that way. I would do scheduled breaks for number 1 and 2, but an hour later he would do it in his Depends.

It was all frustrating, so I asked his doctor for an explanation of what I was doing wrong. He said that it sound like my husband's frontal lobe was being affected. He explained that was where decisions were made. That made perfect sense with what was going on with other things he was doing too. Everything just seemed to be ok the way it was and he didn't do anything to fix it like he used to.

If your dad is a veteran, get him into their healthcare system. All you need is his DD-214 and an appointment to your local VA clinic. At first you will have to fill out several papers about his time and place of service to decide if his ailment is service related. You will be asked to put him on the Agent Orange registry if he was in Vietnam, in case he has any of the illnesses that are associated with it. He will start getting medical care, physical therapy, mental health evaluations, eye exams, etc. He might be eligible for compensation. They will send home health aides (free!), if he is deemed eligible and give him durable equipment (also free) as needed, such as shower chair/bedside commode, custom wheelchair, hospital bed, Hoyer lift, etc. And bonus, they will supply disposables and underpads delivered to his door! The medical care and medicine is free or minimal cost ($15 for a doctor's visit, $8 for drugs) depending on his compensation status and financial need.
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My mother is bedridden with a Cath. And a Colostomy bag, she has been with me almost 7 years. I have a washable pad and on top of It I use a disposable pad to wick away any sweat or moisture away from her skin. I started using A&D ointment on her bottom and upper thighs the first day. She is. 84 and her bottom rivals a 40 year old lol. Never had a bedsore. She gets turned at night to her right side with a body pillow . She drinks 2 Ensure a day, and is sharp as a tack.
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There are many good answers here. You will have to check him often and also maybe bedside commode . It is only way I get rest at night since I am sole caregiver. Mom doesn't even know when she is wet, but thankfully still continent with bms
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If there's any way he can afford a visiting nurse or home health aide or if his insurance will cover it [if he's a veteran the VA may pay for it, but not always] they can change and clean him. When someone becomes incontinent, messes themselves, doesn't change as often as they should, then it goes beyond caregiving and into nursing. You can also buy a plastic sheet protector, as well as both washable and disposable underpads to keep both him and the sheets dry or at least drier. I assume you're using heavy duty diapers [the ones with straps tend to be better than pull ups but there may be exceptions]. If he can put them on and take them off himself that's great, but if he's not doing a proper job of cleaning himself, then you will need a nurse. In hospitals and nursing homes they use a foamy kind of spray to clean incontinent patients in delicate areas, but I can't remember the name of the product -- maybe someone else will. That is certainly a good product to use especially if you can't get a nurse. (I know my elderly relative that I cared for was very lax when it came to cleaning himself and developed issues until I had to clean and change him myself. Not easy -- and not recommended! I was hoping to get a visiting nurse but at that point his other issues necessitated a nursing home.) Best of luck!
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My advice is to let him know if he does not take care of it himself then he will end up getting sick or put in a nursing home for a while. Good luck! Hope this helps
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Oh, my, that has to be a real problem.. My hubby of 70 years is incontinent at night. He is in the nearly final stages of vascular dementia and is on Home hospice as of this week.

I am so grateful that he can still tell me during the day when he has to 'go'. I really fear the day when he experiences diarrhea - a former problem on certain meds. Thankfully, he does not resist my help - easier for a wife than a daughter or stranger, I'm sure.



Last night I had to change him twice after he asked for the bottle - he cannot walk, oops too late. It is almost impossible to not soil the bed each time. The Depends are not too dependable for me.

Good Luck, DebraLeigh, we all need a good dose of that. 'Wish it came in a bottle at the drug store.
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I am going through this right now with my dad. I make him wear them all the time the problem i have is getting him to shower and change his pants that are dirty. I understand why he does this his brain has shrunk way to much and the doctors tell me that is not good. Now he has to use a walker all the time and he complains about it but i make him use it due to him having to many falls in the home. He doesn't like wearing the diapers but he goes to the bathroom in his pants and doesn't even know it. I feel so bad for him but there is nothing i can do about it he has to hear the truth and he doesn't fight me now about wearing them.

Mary
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Nursing homes deal with it by being matter-of-fact and just doing it. (Whatever "it" is.)

I'm assuming dad lives with you. Have you tried getting him to the bathroom every couple of hours? Again, be direct: "Dad, how about going to the bathroom so you don't have an accident? Let's see if we can't make sure you don't get any skin ulcers from wet briefs. Urine is caustic. If your briefs are wet, be sure to change them. A skin ulcer is a terrible thing."

Have a supply of Depends sitting in the bathroom and, when he goes in there, remind him to change if he's wet. Before he goes to bed at night, remind him to change. Check the supply to see that he has. If he hasn't, ask him to please change so he goes into the night with dry briefs.

Once he has skin breakdown from constant urine exposure, you and he will realize that, as uncomfortable as the subject may be for both of you, it's NOTHING compared with taking care of an open skin ulcer that takes weeks to heal.

You put on your big girl panties. Have dad put on dry briefs. ;)
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It's painful to accept. So sorry you and your dad are going through this. Went through it with my dad. There's no good answer except to get help from a caregiver. Even once my dad was in assisted living, there were still issues. It's really hard for them as the know it's happening but can't do anything to stop it.
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debraLeigh this is a problem many of us have to face on a personal or caregiving basis or dare I say both at the same time.
Fisrt thing to do is determine if there is a physical cause for the problem and if so are there treatments, medications or dietry adjustments available. Many food allergies will cause bowel incontinence and a blood test and/or skin testing can rule these out. lactose intolerence can be a leading cause of fecal incontinence so you can eperiement at home by limiting or eliminating dairy products and if this solves the problem gradually reintroduce them one at a time and see what happens. There are OTC and prescription meds also available. Caution with these as they can cause drowsiness if your elder still drives.
From a practical point it may be essential that a family member helps dad with the toileting. if there is a male in the house who is prepared to do this it may be helful in the begining for him to do it and let dad gst used to the iea of help and when he is comfortable a female can take over.
The addition of a bidet to the bathroom would also make the task easier. Either a free standing one which I prefer or one of the ones that attach to the toilet itself. Whatever you do along these lines make sure to install a hot water line. If he freezes his "You know whats" ever time he uses it he will refuse and so would I.
you don't give any details about any medical problems or his living arrangements but it does sound as though he is still fairly independent as he can still take a bath by himself
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I feel your pain. My father is occasionally incontinent. I've seen him wet himself just sitting in his chair. He deals with it by pretending it isn't happening. Once in the ER he wet himself while being treated for a broken shoulder. He also has diarrhea sometimes. I once picked him up and he had actual poop on the outside of his pants (he had changed himself, but in the mess it still got on the clean pants).

I enforce a rule that he cannot get in my car unless he is clean. At the ER that day I asked them for scrub pants. I bought him the Depends and left them in his bathroom, I never said a word. He did get a script for over active bladder which has helped. If we are out somewhere I ask him often if he needs to stop. I try to make a joke of it like asking my kids if they need to go. It's very awkward but I decided to be straight forward about it.
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Sometimes these topics are difficult to discuss with our parents, but pray about it & ask The Lord to make your dad's heart open to this. Sometimes they know what's going on but don't know how to handle it themselves. Does he wear pull up diapers? Either kind (pull up or tape on sides) would be a plus. We use wipes to ensure cleanliness after toileting (after toilet paper etc). I helped my dad for several years after his incontinence, then we searched for & found a home health aide. The aide would come & bathe/clean him & do other things to assist him. You can assign bathing/assistance responsibilities to the aide. Consider this for him & this way, you can have help.
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My Dad always has explosive bowel movements that are a mess to clean up. For now he can still use a toilet, but my nightmare would be if he has to use diapers. How does one mentally deal with this or prepare themselves to deal with this? He had loose stools once already and I was changing him every 5 to ten minutes and he had about 5 bouts in a row.
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try to accept the mind is damaged. Forget about rational responses. we can run ourselves ragged trying to rationalize the irrational behaviors

He needs a full time heath aide caregiver
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