How do I approach my father about a bathroom disaster?

Your mother is not the only one with dementia here. Your father has it too.
The smearing of crap all over the place and on the person themselves is not unusual with dementia.
I've had many homecare clients who did this.
Your parents have to be placed in AL or managed care, or they need a live-in caregiver who will toilet them both and clean the bathroom continually. They cannot be allowed to live alone without supervision anymore. Neither of them possesses the mental ability to handle the activities of daily life independently anymore. Crap smeared all over the place in only the beginning.
Their feelings and not embarrassing them really isn't important at this point. Their living environment is a biohazard. A danger to them both and to anyone else in the house.
If you don't have POA or conservatorship over them, petition the probate court in their area to get it.
Then speak to the state's department of social services and ask them what their options are.

This will work only if you can keep the person sitting on the toilet. Maybe a camera in the bathroom ( for patient’s safety) to allow the caregiver to stand and watch from the hallway when the person appears finished. At that time, you could rush in and use another device before the patient gets off the toilet…a bidet. There are many on the market and sure would offer cleanliness. Sounds like a lot of work or lack of privacy. Not really. People do as many surveillance strategies for infants and toddlers. Mom and Dad can get to that point and need constant monitoring.

Tawheed1: This malady needs immediate remediation. So toxic is this environment strewn with feces practically EVERYWHERE in the home and on the elders that there exists zero methodology for you to keep cleaning as it is a futile effort! Both your father and your mother will have to opt for managed care facility living. Your father's thought process is very skewed as he was UNAWARE that he was covered in feces, either by visual inspection with his own eyes or by malodor.

Also there are definite cognitive changes and movement disorders in the elderly that prevent them being able to wipe "behind" where they can't see.

I would take your Dad for an eye examination. Something similar happened to my LO and it became obvious she couldn't see.

Sounds like dad has some SERIOUS cognition issues. My mom says the same kind of thing whenever I tell her something weird that she's done - like threw up in the hallway one day and then when I mentioned it later she said "I did???". I was floored! How the heck do you forget THAT? I guess the simple answer is - DEMENTIA.

I could NOT tolerate this situation. It makes my skin crawl just thinking about it! You stay there? It is completely unsafe! Poop is literally EVERYWHERE since both of your parents are touching it and touching everything else. They have absolutely NO clue about hygiene, germs, etc. E-coli. What if someone has c-diff infection and everyone else could get it? Just not right.

Is there a POA for either of your parents? If not, that ship has sailed but you will need to make decisions somehow and get them moved along in to memory care ASAP. Talk to someone there and see what they can suggest. You might have to call APS or and/or an attorney to get things moving ASAP.

You mention dialysis so I’m guessing there are medical issues and probably medication to consider here. Many medications as well as medical issues can cause constipation and constipation doesn’t mean you never go. Since you have already traveled this road, it may be that he isn’t able to get his stool all the way out and uses his hands to try and accomplish that especially because he is used to having a bowl movement every day so he’s forcing it, it’s also common with constipation that stool is stuck but new stool moving it’s way through the system finds it’s way around via explosive diarrhea and he just doesn’t know how to deal with what’s going on. He’s too embarrassed like you, to mention it and tries to clean it up, unsuccessfully. These are of course only a fraction of possibilities. As others have mentioned your dad may be further into dementia than you realize and bathroom difficulties are fairly common with dementia, sufferers just don’t remember how to use and proper bathroom procedure, he may know he needs to clean up and thinks he is when he he is in fact spreading everything around. The reason both parents may not be using the wipes is that they remember when they had a septic system and it was bad to flush things like that down or they worry about the expense or maybe they just plain forget because it isn’t something they are used to.

If I were you I would mention it to his doctor and let them both have the discussion with him and address any possible cause. If your dad lets you or your brother a company him to doctor appointments maybe the doctor can start the discussion one on one and then invite you in to be brought up to speed, dad may be more willing to open up to the doctor and then if the doctor is any good he or she will set Dad at ease about it not being his fault and including you in the discussion about remedies. You may find that indeed Dad is very concerned as well as embarrassed by this new development. Then you may not and will know there is more to be worried about than his bathroom habits.

Now for another pressing issue, bathroom problems aside there is a reason you are spending Tuesday through Friday at their house as well as your brother living there and I doubt it’s because you feel they are able to care for themselves for any length of time. If Dad hasn’t actually been diagnosed with dementia and seems of sound mind most of the time I would urge you to find a non doom and gloom or threatening in his mind way to bring up at least POA with him. Maybe bring it up from the direction of the issues you have all the time getting stuff done because you don’t have POA, explain that as POA you are only able to do the things he is ok with and nothing can change when it comes to the ways you help them with bills and medical appointments. Then maybe another time bring up your concern that without MPOA you won’t be able to get medical information should he not be able to tell you for some reason (say an accident) and if there are decisions to be made it would be the doctors or the state that would make them while you stand by powerless. Maybe go to the place where you might not be allowed to care for Mom or be able to take care of her financial needs if he were in the hospital or something happened. Whatever it takes to get him to actively participate in getting at least those things in place. The hump may be the durable or springing (depending on your state) portion of what you need to have and I might leave that up to the attorney to suggest.

Then once you have POA/MPOA/DPOA in place it will be time to start action if you haven’t already by then. Start investigating your options now and try to have a plan in place but you and your brother can’t be the solution for your parents increasing needs, it’s already too much and probably not enough. They/you need help wether it’s aids coming in, another living situation or both a change needs to happen soon. I know how hard this is, hang in there.

I know you mentioned that your mom has dementia, but there has to be something cognitively going on with your father as well if he literally has feces all over him and the room and has no idea that it is happening. He can't live that way and neither can you. He needs to be seen by a physician and also have a mental eval to see where he is.... This doesn't sound like a situation that a simple conversation can fix.

My dad started a year or so ago problems wiping his bottom after bowel movements and would occasionally get poop on his hands. He used a very small piece of toilet paper to wipe. When he stood afterwards he allowed me to use adult wet wipes from Sams club to finish wiping him off. Then a smear of Desitin in the but crack. The wipes were disposed in a lidded trash can. You could use a diaper genie too. This resolved the poop everywhere. We now use a porta potty. My experience over the past years is sometimes they think they are done, stand and the motion of standing puts pressure on the bowels and there you have it a blow out as they stand and sometimes that means poop everywhere. Dad now slowly stands so he can sit quickly if he feels the pressure building. Make sure you by disposable gloves. Amazon has some good buys on them. Any potty help for 1 or 2 I wear gloves. Wishing you the best in coming up with a solution. As others said there is no such thing as flushable wipes, regardless of what the package says. My dad sits to pee on a porta potty or he will use a urinal at night, while he sits on the side of the bed. Dad only wears a shirt and depends during the day and puts a blanket on his lap to make using the bathroom easier and quicker. Before mom passed she just wore long night dresses for the same reason.

Also, wipes give them what they want of course they can use wipes keep tissues in there. Maybe ur Dad is trying to get back at u for that reason u said there’s wipes u didn’t say anything about tissue.

When a person can have feces all over their clothes and hands and feet--and it DOES NOT resonate with them that they cannot live this way (healthily!) then the time for gentle, tender 'talk' is passed.

Fecal matter can get into the most amazing places--having cleaned a bathroom or ten in my career, I can say that once a patient became clueless as to WHY they were covered in feces, and didn't care--placement in a NH was almost an inevitability. It's not out of meanness--it's out of care for the healthiest living environment. And the sanity of the CG's.

My FIL was on antibiotics all the time. He would not take them b/c they gave him explosive diarrhea, but if he didn't, he'd ramp up to pneumonia within days. Cyclically, over and over. AND the day I realized he was having blowouts and then just letting his clothes 'dry' on him and then just going about his day--I had to peel his pants off of him and cut the 'thong' underwear he had on, off. That, and scraping at the feces with a tongue depressor--DH was mortified but was so busy gagging he was useless. Forcing him into the shower when I knew I'd be doing the exact same thing the next day.

That day, his thongs were all thrown away and the best I could do was to get him to wear 'tidy whities' --in the hospital they insisted on depends, but at his home, briefs were the only thing he'd accept.

He died before we had to have him placed. The Dr. told him he could not longer live alone and we had just begun the task of finding a NH for him and he passed away. He would have hated it, but I hated walking into his condo and smelling what my day was going to entail.

First of all, be straight with him in a nice way explain to him like ur explaining to us. Take pictures just to show him. It’s not able feelings it’s about clean and safe hygiene. Just tell him how having bad hygiene will cross contaminate and it’s unhealthy for everyone it doesn’t matter if it’s him or someone else tell him it applies to u and everyone else. Don’t hold back anything bc ur going to be resentful or angry so it’s best to be truthful and honesty and of course nice.

Why are there some POA responses in this "Poop Problem" thread????

As to your father's toileting problems, I think you are way past worrying about embarrassing him. You can address this issue as kindly as possible, but the situation you describe is definitely not ok. If it requires your or someone being in the bathroom with him, that may have to happen.

So sorry to hear you are going through what I think of as "the poop challenge". Address the first question: diarrhea, loose stool, or constipation? Maybe a combination of all three PLUS difficulty with wiping.

Start with getting an idea of any bowel movement issues.

I’m sorry you’re dealing with this. So tough to watch loved ones struggle in these ways. My dad had plenty of bathroom issues too and I decided to use humor when I could (Dad, you’re fired as a fireman- you’re not controlling your hose and getting pee everywhere). He’d deny it, so I took pictures and showed him before and after. I was also very direct b/c you have to be. He was embarrassed, but agreed we needed a better plan. He sat on the toilet and urine problems were mostly fixed. My dad also smeared a bit at times. We had a caregiver, so we made sure he/she wiped Dad after he tried (while sitting). They were just outside the bathroom, Your father would be mortified at what he’s doing if he was of sound mind. Also, ask him if he’s intentionally trying to get you all very sick or what? Explain that’s what will happen if this continues. He’ll say no and try harder to protect you! Sometimes posting a sign on wall helps, but keep the steps short n sweet. Heap on the praise when you can! God bless and hang in there!!

You had said "As it stands, I'm managing all the finances however, I'm not on any bank accounts or listed in any way to do this so I'm constantly coming up against walls when it comes to calling agencies, businesses, and other such places to try and manage things."

If he has a Trust then someone should be listed as Power of Attorney. There are two types of POA. One for healthcare and one for finances. If the agencies, businesses, etc. are sent a copy of it, the POA will be able to take care of things. You can also talk to the Trust attorney for some guidance. The attorney put the Trust together. I had to call my dad's attorney many times looking for "lost" documents.

My dad had Alzheimer's and colon cancer both late stages and he had bathroom issues A LOT in his final days. He was in AL and I hired caregivers for 24/7 care. I still had to clean up a poo trail on Christmas day last year...long story but the caregiver on that shift couldn't get down on the floor to clean it (bad knees?) and AL refused to help.

Also, call the Department of Aging for your county. They can offer some guidance. I would highly recommend at least getting a caregiver to help out especially if you parents have long term care insurance to help with the costs.

On a side note...Assisted Living doesn't always "assist". At least not in my experience. It's better if they can stay at home with additional assistance.

You really need to get yourself or someone POA and health decision maker. The latter can be set up at his next Dr appointment. It may be a "routine" form he signs. It was for me anyway. The POA is different, but also important. The longer you delay, the worse it gets. When the state gets involved, then it really gets out of your control and all his assets will go to his care bills (I know, not always and not bad, but just giving advice). After two months of weekly $300 plumbing bills with my aunt, I had to finally give up and move her to assisted living so they could attend every bathroom event. I really feel sorry for you and it is so difficult. It sounds like you are a wonderful, caring person!

Get a bidet cover installed. The only thing that might be a little fussy is getting a dedicated plug installed right next to the toilet, but I'm telling you it's well worth it. My daughter got one installed in her house just because she always wanted one, which I scoffed at. But then I started using it, and it is wonderful! I can no longer reach spots that I should, and I'm seriously thinking of getting one installed in my little apartment that's on the property. It solves so many problems!

Is there some additional medical problem? Does he suffer from extreme constipation? Other health problems affecting his bowels? Mental illness? (The previous writer asked about dementia- that was my next question.) Regardless, I would tell his primary care provider. He may need some testing to arrive at an explanation.

You are right to clean thoroughly and to worry about their safety. Maybe it would be a good idea to hire a CNA to drop in if you are not able to stay with them. Regardless of the cause, he needs help in the bathroom and this may not get better.

You don't mention it, but does your father also have dementia? What you describe is not uncommon when people have dementia. They "forget" how to use the bathroom. It's like a reversion back to infant bathroom behavior. It doesn't help to argue or try to explain things to people with dementia. They are not able to remember instructions or learn new things. When this happened to my mother as her dementia was advancing, the aides in her memory care facility switched her to Depends, but she couldn't learn that Depends were disposable, and tried to wash them. One of the aides put a sign up in the bathroom - the sign was useless, and I don't recommend this. The way they ended up handling it was to assist her with 'toileting'. Two or three times a day, they'd bring her to the bathroom, put her on the toilet, then change the Depends and wipe her down. The aides also helped my mother with showering and dressing, and they put the dirty clothes in the laundry basket. Her facility took care of the laundry, housecleaning, etc. By the way, 'disposable' wet wipes clog up many municipal sewage systems and shouldn't be flushed down the toilet. It's better to dispose of them in the trash. A man may find a male aide more acceptable to do these personal things for him. Get connected with a local social worker who can explain what your parents' (and your) options are regarding in-home aides, and other adult care. There are also government programs to pay family caregivers. Your parents' doctors may have to sign some papers to get in-home aides from Medicare. Medicaid covers in-home aides. Do you have POA for medical and financial matters? If not, you may have to apply for guardianship to be able to act on your parents' behalf. If you get aides coming to the house, lock up all valuables and personal papers, especially financial papers. Also have a plan for a time when caring for your parents may be too much for you to do alone. The two basic options are in-home aides or an assisted living/memory care/skilled nursing facility. All the best to you and your parents. You have a lot on your plate and I hope you can get the help you need with your parents' care.

My mom began similar behaviors while she still lived alone. Her fingernails and toenails had feces underneath, her feet were dark with that and dirt, and her shins had huge red burn areas from urine running down her legs and soaking her pants and socks. Her solution was to occasionally go out in the backyard and hose herself off but only during the summer. It wasn't enough. She would regularly remove feces from the commode with her hands and wrap it up with tissue and put in kitchen trash. I would find bits of feces all over house where it just fell down through her pants, if she were wearing any that is. She would step in it and track it everywhere. She often wore nothing below the waist because she threw away all her clothes once they got soiled. She and her house smelled putrid. Dementia and incontinence are horrible to be faced with. There's no improvement. Mom lives with me now. I have to insist on her wearing pullups at all times. She is accompanied to toilet every 2-3 hours. Daily she resists and complains like a toddler and cries why am I all of the sudden making her do this. In reality she has been doing this for over a year now but she doesnt remember. There is zero tolerance on this. It has to be this way for the health and safety of her and my entire household. Plus my sanity. As for for advice on how to approach your father regarding the bathroom situation, imho he should be accompanied to toilet each visit in order to "help him clean himself where he cannot see or reach well enough, to prevent a rash" or whatever you want to tell him. And get him used to washing hands and wearing pullups. I hope you find something that works for you and your parents. It sounds like this is the beginning of them needing a whole lot more than you may be able to safely take on. Maybe consider looking into getting them care or placement.

If he does not have dementia you should be able to tell him this is not acceptable. I do think he has some cognitive issues weather he has been diagnosed or not.
He needs supervision with bathroom trips and most likely in other ADL's.
The big question is can you care for 2 people with not just dementia but with medical issues also.

He doesn't smell the poop on his person?

He needs full supervision with all BR trips. Dementia has advanced

I think brother needs to check on Dad when he goes to the b/r. It must happen when he is alone with Mom. Your Dad needs a good check up. He is showing signs of Dementia. Its time to place Mom and Dad. You nor brother can continue like this. You spend what money your parents have and apply for Medicaid. Tge house is a exempt asset. Brother can be declared a Caregiver and be able to remain there if able to pay the bills because Mom and Dads SS and any pensions will go towards their care.

I cleaned up after Mom when she had an explosive BM. It was all over everything. It took me 3 hrs to clean up. I said then, if it happened again, she was going to be placed. I cannot take the smell. It actually makes me nauseous.

I know you might be overwhelmed right now. Sometimes it helps to really simplify.

Q. Can your folks look after themselves?

If no - they need emergency care, either A. assistance in home or B. be transported out.

my mother is in memory care and recently she seems to have forgotten how to use the bathroom. a staff member accompanies her every time she goes to the bathroom now as there was apparently a messy incident that i don't want to know the details of! and someone else here posted they found their mother with feces in her hands and she said she didn't know what to do with it. it sounds like your dad may be getting into this phase, where they don't understand what to do in the bathroom any more. you could accompany him every time he goes to the bathroom (which my mother now accepts but when she first got to memory care she wouldn't let them go in with her) or maybe try to keep the door open a crack to see what he's doing in there and put a stop to it if he starts doing weird stuff. i did that tonight when i saw mom, when she went to the bathroom i observed through a crack in the door to make sure she was able to go on her own, and she was fine. this time.

I had similar issues with my Mom at home. Now that she is in Assisted Living Memory Care, they were clear with me that she needed pull-up disposable underwear. It would have help so much when I had her at home if I had forced her to use them. Helped me so much with clean up of bathrooms, clothes and sheets. I wanted to preserve her dignity but it would have helped her to stay at home longer and prevented me being so stressed out.

Your father has done everything imaginable to make it impossible for you to continue caring for them at home, Tawheed. The house is in disrepair, you're not POA for him or his finances so you hit a roadblock when trying to get things done for him financially, a caregiver cannot move in b/c the roof is moldy & leaking, your mother has dementia and needs care 24/7/365, he's now having bathroom messes that he is NOT acknowledging, etc. So, even if you were to broach this subject with him and say dad, there is feces all over the house after you toilet, he won't see it, won't admit it, won't say Oh Aha! I see now that I have a problem that needs attention. If he was surprised when you mentioned the situation the first time, why will he not be surprised when you mention it again? You have a serious situation on your hands, with toxic feces which can sicken both of them, not to mention YOU, and a mother who refuses to shower............you have to surrender now & hold up the white flag, especially since you suffer from anxiety issues of your own. Your brother is not equipped to deal with this situation either, by your own admission, so what are your choices here??

Managed care for both of them is your only real choice. The caregivers in a SNF will clean up the incontinence issues and dress dad in disposable briefs; they'll use wet wipes to clean him up properly after a BM, and they will shower mom 2x a week. They'll dress her in clean clothes, and make sure that both of them eat 3 meals a day.

If they refuse to go into managed care, you'll have to back off on the care you're giving them Tues-Fri, then call APS and report them as vulnerable adults, and have APS place them, which they would likely do if they find feces all over the house, your mother not showered and suffering from dementia, the house in serious disrepair, etc.

You're in over your head, your parents are in worse shape than you realize, and a chat with dad about his lack of hygiene is not going to fix the myriad issues that are going on here, I'm afraid. Dad's declined dramatically all of a sudden, meaning there's probably something organic going on; a stroke or something of that nature that hasn't been diagnosed yet. Meaning he's incapable of taking care of his hygiene now, and mom surely cannot take care of herself either.

I'm so sorry you are facing this situation. I'm sure you feel helpless, I would too, but I think the best way to help your parents is to stop helping them..........let APS take over if they are fighting you on placement, and that will likely ensure their safety moving forward. Or, if either one of them seem to be in dire straits, call 911 and have an ambulance transport them to the ER where you can get the social worker involved for placement.

Wishing you the best of luck and strength as you forge ahead with all of this. Hugs and prayers being sent your way.

This is the point where you have to realize that his brain is broken and that you can’t physically take care of this. We all want to preserve our loved ones’ dignity, but reality is reality. The actions that he no longer can control have already shredded what we think of as dignity. You all need help, and it’s impossible to deal with this at home. Time for a conference with doctors, social workers, his dialysis team and maybe hospice. Pull out all the stops and push for placement in a facility where professionals take care of his needs. So sorry.