My father-in-law is wears a diaper that needs changed frequently. He weighs 270 & has mobility issues. Any suggestions?

Take a chux pad with you to dinner and place it on the seat before your FIL sits down. If he refuses, stop going out to dinner with your FIL. As an RN you know better than to enable your FIL and his wife to not care that he soils the seat.

You need to have a calm and gentle discussion with your husband about the reality of his parents' decline. He needs to understand there has to be a plan, from him if his parents are resistant or unable to make/carry out one themselves (I understand your MIL is already in AL?). Make sure you are clear that hands-on caregiving from you will be very limited due to there being 2 of them and your FIL's size and issues and your immediate family comes first and you have a job. Present your husband with the options. Help him to be the leader of his other brothers and have a family meeting to see where people are in their willingness to help solve the problem.

1) what are the problems?
2) what are realistic options to solve them?
3) does anyone have the legal ability to advocate for them? PoA?
4) who is willing to do what in the short term to make the solution come about?

It will no longer matter what your FIL wants as his willingness/unawareness to sit in his own poop indicates he's no longer able to function in reality. Now it's about how the family is able to solve this in their best interest, but in a realistic way (so, FIL no longer going to be "independent" in his home, etc.)

This is what we did in my husband's blended family as I came to realize my MIL and stepFIL were in a rapid downward spiral, were resistant, in denial, broke, had Parkinsons, short-term memory issues, crashing their car, etc. I could see that this train wreck WAS going to land on our doorstep no matter what, so I chose to be proactive and lead before it became a flaming dumpster fire crisis (which so often happens). Because if it gets to this point, everyone's options are very limited and the amount of emotional, mental and physical stress will be unlike anything you've (probably) ever dealt with. I wish you luck as you try to start this ball rolling!

Are you saying that he needs to have the adult diaper changed frequently and they don't do that, thus, the spillage on the seats, OR that they take proper care of the changing, except with away from home excursions, where they don't protect the places he sits?

My initial reaction is that if they know he is spilling urine and feces onto seats in public places and do nothing.....something is not right with them. I can't imagine a normal adult with average cognitive function to leave bodily waste where they sit. I can't see how a discussion or plea for them to stop would help. I might start with their doctor or social services. I would let the church officials know, because, at least they can then take measures to protect their congregation.

I guess I'm a little surprised a retired RN would call adult incontinence products a diaper... That language isn't usually very helpful when talking with someone having embarrassing issues. Maybe I can even understand not wanting to use a pad and calling attention to his issues. He may feel people only know there's a problem after he's gone. I'm actually surprised he's still going out. My understanding is incontinence is a primary reason seniors start staying at home all the time. Or the non-concern could be a dementia indicator. Does he do this at home?

Why doesn't he want to change the incontinence underwear? Even at his size I would think the handicap stalls in public restrooms would afford adequate space. Is the home bathroom small? Sometimes seniors with mobility issues resisting changing depends or pants because they have difficulty with their shoes. Switching the shoestrings to the stretchy shoestrings so a favorite show style can be taken on/off like push-ons can get around that problem. Has anyone demonstrated how you can thread a pair of pull-up underwear over shoes and thru pant legs (so neither pants nor shoes need to be removed)?

I find the side tabbed product most looking like a diaper more difficult to put on an upright adult so we used the panty product for my mother. In the handicap stall, Mom stands so I can pull down her pants then sits back down in the wheelchair while I "thread" a clean panty over her shoes and thru the pant legs. She stands and we pull the clean panty and her pants high enough on her thighs for her to take a couple of steps or turn to position herself in front of the toilet. I tear the side tabs on the soiled panty and remove it, Mom sits and uses the toilet, then stands and pulls up the clean panty and her pants before seating herself back in her wheelchair.

I taught a couple of family members the panty threading technique by using a large pair of men's summer shorts. You just need some pants to cover your own between knees and feet. This can be demonstrated with regular underwear if that's easier for your audience too. My mother has a injured knee so I start by putting the panty over the shoe of her injured leg, then pull the whole panty up thru the pant leg (one leg is now through one side of the panty and the entire panty is above the pants). Thread the open leg side of the panty back down the second pant leg, then thread the panty opening over the shoe/leg and pull the panty waistband back up above the pants. The entire panty is now above the pants. When using public spaces, I usually take a disposal pad to place on the floor so Mom's pants don't pick up dirt (and other stuff) from the floor. This technique is easier with stretchy pants too.

Many men keep a lot of stuff in their pants pockets which makes the threading technique difficult to impossible to execute. They may also resist wearing sweat pants because they don't have all the pockets men are accustomed to in their slacks or jeans. We were able to convince one gentleman in our extended family to start using a fanny pack instead of pants pockets. After switching to using a fanny pack, he began changing his depends and pants as needed.

I suggest you purchase 2-3 pairs of sweat pants and some incontinence products appropriate for your FIL and get your husband to demonstrate the panty threading technique to FIL. DH should also encourage FIL to practice the technique so he or you observe if FIL has any mobility difficulties preventing him from easily changing the underwear. MIL may need to help FIL or FIL may need a reach to make it work.

It's possible FIL does care, but feels he cannot do anything about his bodies failings and is trying to just ignore the issue.

Good Luck!

The aides in Moms AL put Depends on as TNtechie discribed but for a 270 man I would think that would be hard to do himself. I would think that for a man this large, it would be hard finding the right size in a regular pharmacy. Maybe they need to buy mail order to get the right fit. Maybe a higher absorbent one. Even though this might be an easy way to make a change, the wife may not be able to bend down for the length of time it takes to help him.

There is a problem here when someone is aware they have soiled something and don't feel or show embarrassment. Could there be some dementia here?

If this was my Dad I would have told him point blank. Because my Dad didn't embarrass easily and this was how u got the point across to him. But he isn't your Dad. Your husband should have a man to man talk.

The other thing, is getting him to use the toilet more often like every 2 hours. A commode can be put over the toilet and a splashguard used in place of the bucket. This will give him some stability when he needs to get up.

Not all Nurses work with the elderly. And even the ones that do, don't do the dirty work of changing "diapers" That's left to the aides. I worked with Nurses and they called them diapers. Probably not in front of the client but in the office they did. Easier than saying "adult incontinent briefs".

1st thing to do is stop calling them diapers.

Obviously the product he is using is not sufficient or he would not be soiling the furniture he sits on with frequent replacement of the incontinence underwear.

Have you tried talking to them about proper fit and frequency of changing the underwear to protect his health and skin?

Those things are not cheap, do they skimp because of the expense? Has anyone talked about putting him on a toilet schedule to lesson his usage of incontinence underwear?

In continence supplies are difficult to manage. So many products to buy and try only to find that they won’t work given individual needs. You have done the right thing by posting your concerns, go forward by finding out all the supply options for them and go ahead and purchase some things for them to try. Some suppliers offer samples and advice. Either let it go or get on board with finding a solution for them. It will gain their trust going forward when you will need their cooperation to plan for their future needs. Maybe there is no solution that they haven’t tried and they are stuck and need help.

Maybe he's watched My 600 lb life. Some of those people probably have similar issues. He may be at an age where he does not care what others think about their actions, words, etc. He also probably figures let others deal with his mess. Changing his ways may be hard.

"A brother that is POA lives close by, but is still over ruled by his abusive father and mother." Until they are deemed incompetent, there's nothing more to do. Your FIL and his wife will not change.

That FIL allowed himself to grow morbidly obese suggests a longer history of mental illness than his sons can accept. He's also abusive, which only makes matters worse.

You can help your BILs by encouraging them to set healthy boundaries with their parents. Your husband and his brothers can choose to stop enabling their parents. When the abuse starts, they can leave or hang up the phone instead of sticking around and taking it.