My dad has bowel incontinence. Within the past two days, he's had two "accidents" in his diapers.

The accidents have been very wet. He is ambulatory, usually we're in the bathroom while he's trying to sit on (or, more likely, stand in front of) the toilet. Trying to take it off without spilling the contents while also accommodating his fragile physical condition is proving mighty challenging! Then he gets impatient because he's uncomfortable and I'm taking too long that he starts to fidget.

The first accident was yesterday, RIGHT AFTER he had told the social worker who was assessing his needs that he was still capable of changing and dressing himself.

The second accident was at 2:30 this morning. He was really fidgety that the diaper spilled on his pajamas. In a panic, he tries to get up from the toilet and I'm trying to tell him to stay put or THAT would spill onto the bathroom floor. I did NOT feel like doing a full bathroom cleanup at 2:30 a.m.!

My dad doesn't have dementia, but his body is very frail. Sometimes, I don't think he realizes his body can no longer keep up with his mind.

Anybody there with tricks? Also, how do I dispose of the fecal matter in the diaper? Last night I threw the entire thing into the trash before any more spills occurred, but I don't believe that's the right way.

Thanks!

A bulb enema was what she used to use daily to try to keep her hemeroids from recurring, when she was still in charge of her own toilet. (3 years ago). When she was hospitalized at that time for her liver inflamation, she drove the nurses nuts insisting that this was what must be done. Her Dr. told us all to stop her from doing that, and to get her natural, even if we needed milk of magnesia or miralax, at first, and wean off, make her gut work. She had less problems for 2 years, no need for any laxative at all for the last year, but to keep her moving to her satisfaction, required prunes, prune juice, apple juice, high fiber cereal or oatmeal, plus 1/2 a banana, several strawberries, and a small tossing of blueberries, And a splash of lowfat milk, all for breakfast.
That kept her "regular" with no straining. I would have trouble eating all that.
This loss of control was such a shock. We started cutting back on one thing, then another , now we will slowly add back and see if we can get to the middle again.

Ahhh well there you go Apple juice and stewed prunes thats a deadly combo here too back before we had major problems this could always jump start her but not to be given everyday...try one or the other and see if that works first. Oh yeah then theres the ole tried an true....Enema * I know lol did I hafta go there?!

Yeah, we have been able to stay all natural for several years. We weaned her of laxatives and were doing real well until this last few weeks when she got so loose, and started cutting back on her stewed prunes, then the apple juice, with luck, I think we are about to find a balance for her. We'll see how it's going when I check in today.
Fruit Eaze looks like good stuff. She eats right much fruit.

BC you are trying to stay natural right have you tried the Fruit eze yet? I use this with MIL for almost a year now and havent had any problems getting a bowel ever since check out the page on it they are fast to deliver too usually within 3 days of ordering
http://www.fruit-eze.com/

So now Mom is constipated.,we slowly removed some of the things we put into her diet that were concerned with constipation, A little at a time, and now she didn't have a movement in 36 hours. So now she is demanding her prunes back. Lab work got done today, she got some prunes, she moved a bit. Hear more tomorrow.

maybe she had a touch of some virus, maybe it has run it's course. Who knows what tomorrow bring, and does this incident even matter, tomorrow.

I will be collecting a fecal sample(easy enough to do) and a urine specimen before we leave home, to take with us, and she'll get her blood drawn there. We go to a small lab in the same complex as her docs office. All 5 minutes from home. The CG is going to let us off at the door. The entire amount of walking involved is no more than her daily walk around the house. Her labs were due next month anyway and only the fecal sample will be different and she doesn't even have to know about that. I already talked to the doc about the concern that she may have a UTI as a result of the BI not as a cause. We are usually out of there in 15 min. Then we take a ride around town and sight see a while.
Her liver went crazy 3 years ago and her doc needed labs done every month for six months then every 3 months for 3 Xs now it's every 6 months. I always get the lab work done before going to the doc so she has the result in front of her when we go. Usually her office calls me back and says that if Mom has no additional concerns, I can just pick up her scripts and Mom doesn't have to come, at all.
When Mom has to go for any reason, they know she's coming and she goes directly to an exam room and doesn't even sit down in the waiting room. Usually out of there in 30 mins. Then sightseeing.
Everyone of her CGs tells her these things happen to every one from time to time and we are there to help her and clean her as quickly as we can and still do a thorough job. The arthritis in her shoulders has made it impossible to clean herself after a bowel movement for a long time so she is used to that sort of help.
If there are no indications from the lab work that a trip to the docs would be of value the doc will tell me that, and we will continue to see her only if something specific arises (like shingles ) her doc is good aout not bothering her for no good reason.She and we know thay no one can roll back the clock.

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after all the destress Mom has displayed, about her recent toileting difficulties, to me and other CGs, I tell her last night that I have her labs scheduled for Tues., to see if there is something going on that can be helped. She hears the word DR, and suddenly decides it doesn't bother her after all, the way we are handling it is fine.

Ya gotta be a leedle sneakier than that, BC! Monday night (better yet, Tuesday morning) would have been PLENTY of notice for Tuesday labs. The devil one knows is better than the devil one doesn't know... I don't blame her for not wanting to go to the doc.

What "labs" are y'all doing? Do you suspect a UTI or what? Although a UTI can have profound symptoms, I don't recall bowel incontinence being one of them, particularly during a mild, asymptomatic UTI... I read something about "arthritic bowels" once, but since I have RA and appreciate the stiffness and aching in every joint of the body when it flares, I sure as heck didn't wanna know about arthritic bowels... Figgered I'd save that tidbit of info for another day, yaknowhutImean?

It is always good to check things out to be sure that the symptoms we see are from attrition and not from some other easily treatable cause, but pick and choose wisely, m'friend. All those tests and trips to the doc, etc. wear on our LOs. Although most docs are happy to do lots of tests and lots of follow up visits, it isn't they who go through the ordeal of it all...

Mom was surprised many times to see what her Depends was concealing... keeping in mind that this is who the aides ask if she's had a BM today when in the hospital...

If your Mom is distressed about these "surprises," I would venture to say it isn't only what's in her dipe that's causing her concern - it's also how to clean herself up after... In my mom's case, although she was foggy, she was aware that something was going wrong and that she used to handle toileting by herself... Rather than echo her alarm and distress, I simply acted like it was the most normal thing in the world, no problemo. I did mention it to her docs at her next routine visit, but was told it's par for the course - and that was correct in her case.

Oh Mae, I really do feel your pain. My knees have been on and off again for years. Evidently I had a bakers cyst from some previous but ignored injury and started it leaking while I was picking butter beans. (about 5 years ago). Had no idea I had one or what they could do. Got out of my truck at home, and the leg had cramped up so bad that I fell and sprained my ACL. Had no clue what was going on but just knew I'ld be better the next day, or the next, or the next. They got so sick of watching me gimp around at work that they told me I was grossing out the customers and to go home until I saw a DR. The Dr did exrays and did not find arthritis, gave me an awful shot of cortisone, in case it was a bursitis, I nearly kicked his teeth in. boy did that hurt . Did no good at all. Next step, MRI. Sprained ACL, whopper baker's cyst. Physical therapy helped. I think I made history as the only person to sprain an ACL as a result of picking butterbeans. The other knee is stressed as a result of bearing the weight until the first knee got better. Which is the good knee? Depends on from which direction the cold front is coming. Either one can give me a fit with no warning. Have to be real careful how I move around .
Whacked the heck out of that knee stepping out on Mom's porch and slipping on a slug just the other night. Is better now. Did you know windex, (or a home blend of diluted ammonia) kills slugs better than salt? I don't step out there anymore without looking around with the flashlight first and having the spray bottle handy. Right now(or ever ) is a really inconvenient time to be crippled. I won't go into details about garden slugs here, but I have ones that reach 8-10 inches and crawl in and out of beer traps like it was a health spa. Got my own ways that are not pretty. Glad to give details in PMs if anyone is at WAR. WARNING graphic descriptive material! asker beware.

This message has been edited. Last edited by: Bobcat,

One never knows how our loved ones will react to what we tell them.From past experiences they do fear hospitals and doctors.The fear of the unknown.Heck I fear the same topic.I would never tell my mother when her symptoms advanced.I would wait as long as possible, before leaving, to inform her where we were going .I would lie and tell her the doctor needs to check me out and maybe they will have time to see her and find out why she was not feeling like she use to..
She was never a problem once we got there.But her mind seemed to be going in circles with the information and she would ask so many things.Not always about the appoitment.When she was nervous and fealing afraid she would talk on and on.
I am having those feelings right now.My injured knee is not better. hurting and swollen, so have to make an appt with orthopedic doctor.Problem is, many times they cannot see you for a week.Heck if you have a break it could begin to heel.
My other knee, which was the bad one is not bad.But I have to laugh when going up and down the stairs.From mother I always recalled good leg first up , bad leg first down.So with 2 bad knees which one fits the equations.
So I will call tomorrow and try.
I do hope your visit is one with no incident and you find answers

Junybug, MB, Mea, and all. Get this, after all the destress Mom has displayed, about her recent toileting difficulties, to me and other CGs, I tell her last night that I have her labs scheduled for Tues., to see if there is something going on that can be helped. She hears the word DR, and suddenly decides it doesn't bother her after all, the way we are handling it is fine.
She is so afraid of being hosptalized. I told her the best chance of avoiding that, is to find out what is going on and not to ignore changes, and checking it out. She is very brave, but I can tell she is scared just a little about all this.
Here's where all the tips I've gotten here about taking charge and being firm are paying off. I guess I should have paid more attention to the tips about not telling them about DRs appontments until that same day, but I THOUGHT she might be relieved. It would be so easy to cave on this. Not that I expect results that will make a change, but I can't just ignore possiblities, and let things deteriorate with out checking into it and keeping an eye out for UTIs. So I am standing firm and she will get her labs done, and when the results are back, we will go to the PCP and have a discussion. At the moment, nothing indicates an ER visit, no indication of blood, or dehydration, or pain. But the PCP told me a long while ago that you can't wait for pain to set in as an indicator for someone Mom's age. They feel things very differently.

Moms Buddy, I have no self discipline when it comes to the out side.I go out, just to look around and then the weeds need pulling then this, then that.My house is out of sorts at this time.Worse then me.I just love the out doors.

Moms Buddy, I am serious about your ability to explain why changes in personal habits happen.I know so many find it hard to deal with.With your explanation it puts it into some understanding;I do hope you will find away to have this saved for others to refer.
Yes I jammed my knee.I was edgeing , which you do with a little force.Well IIII hit a root that wa never going to be edged.Yep, it edged right back .Then I turned my neck a certain way and now that hurts.That dam crazy glue I used to hold my body together, is failing me.I am gouing to demand a refund.
One year I broke a toe doing edgeing.My faught as I did not have great shoes on.

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I am up late as I hurt my knee working in the yard.I am so glad I came to the forum and was able to read your post.

HeeHee - Mae, you got the worst part of that deal! I sat on my fanny and wrote all that poop stuff instead of going outside and busting my knees weeding the garden! Your turn to write for a couple of days and I'll go outside and hurt myself for a change.

MomsBuddy, what a wonderful explanation you have given.I hope everyone considers all you have said when the task of cleaning a loved one comes to be,
I am up late as I hurt my knee working in the yard.I am so glad I came to the forum and was able to read your post.Excellent

MB, you are absolutely right about the worst part. Cleaning her is manageable. It's the pain of the tears in her eyes when this tidy and meticulous woman Asks me what's going on? Why is this happening?
Thanks for taking so much time in responding. I knew some of it, but not so concisely put. Reading so many posts in the past has made me aware of the dangers of UTIs and that not always is it accompanied by the pain when urinating that most of us know. I really have learned so much here that's been such help.

By the way , JUNYBUG, how is it going for you. I hope MBs answer to both of us, was as useful to you as it was to me.

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What is the cause? is it just a natural progression, or a sign of something out of wack that can be treated?

Bobcat, as far as vascular dementia, AD, and other forms of progressive brain destroying conditions, this is a part of the progression and there's not a danged thing one can do about it. Sure, meds and illness and dietary intolerances can cause or contribute, but the bottom line is that this is part of it and a lesser concern, given the other health issues an elderly person faces.

Our toileting abilities come from different places in the brain and body. Think about it. Toileting in modern society is actually a very complex procedure - not nearly as simple as the natural way of eliminating... The nerve impluses from the bladder, urethra, rectum and anus that tell the brain that one has to eliminate may get slowed down, crossed up and eventually, don't seem to get through at all. Once the brain receives the message, it has to send impulses to the thinking part of the brain to let it know to make plans to take care of business. So there's another step where things can slow down, get messed up or fail altogether. When the brain receives the message and decides what to do about it and when, it sends messages to the large motor groups that have to get us from wherever we are to where we need to be to eliminate. It also has to instruct the muscles and organs involved to HOLD it until we get there, which can take a long time when one's body doesn't move well anymore. Then, supposing we actually get to the bathroom intact, more reasoning ability and motor control enters the picture. First, one has to be able to reason and correctly sort the order of the steps of successful toileting. Closing the bathroom door is usually the first one. Walk to the toilet. Balance one's body while one undoes clothing and pulls it down (the right amount) or out of the way. Nerve impulses to fine motor movements are needed to accomplish these feats (while still holding in the goods) and seating oneself (still holding in the goods). Assuming one has gotten into the position with clothing rearranged properly, etc. and all is still well, then the brain has to send the all clear to the systems involved to release the "holding in" and let the bladder or the bowels do their thing. Once the task is completed, the systems have to tell the brain that everything has been completed. The brain has to receive those messages then reason what comes next in the progression - that it's cleanup time. Again, there is a lot of reasoning and motor control involved with the cleanup procedure. Your brain has to remember that hand towels are for drying hands after they are washed, not for use as toilet tissue. It has to know how much tissue is appropriate for the job at hand - not too much, not too little - and how to correctly direct ones efforts to efficiently clean without making more of a mess or using a roll and a half of tissue. I could go on through the whole thing, but I think y'all get the picture! While we may take toileting behavior quite for granted, it's actually a very complex situation where any number of things can go wrong and prevent it from happening correctly - not to mention the "after parts... don't forget to flush after everything has gone on, rearrange one's clothing correctly and thoroughly wash one's hands before exiting the bathroom. Heck it's a wonder ANY of us manage to accomplish this task correctly!

So the answer to your question, BC is that there that there are MANY causes and overlying effects of other problems and body systems that affect the ability to toilet efficiently. Treating this complex set of problems in elderly people where so MANY factors can be contributing is extremely difficult, if not downright impossible in most cases. There's no pill you can take that will help you remember how much pressure to use on the tissue nor how large the wiping movements should be, etc. There's no early warning pill that can make your body give you more notice to get to the bathroom because you don't move as quickly as you used to.

And remember: I've just been talking about the behaviors and systems needed for things to simply go RIGHT - what about when things go WRONG? Deciding HOW to contain a mess and then clean it up is a FINE ART as any homemaker can tell us!

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Still, concerned that all this Poop getting everywhere will initiate urinary tract infection.

{smiles} You begin to understand the plight of incontinent folks who are bedridden - the stuff gets EVERYWHERE!!

Your best defense against bladder infection is for her to drink copious quantities of water to flush her urethra and to keep her general immune system response as high as possible to fight off problems before they occur.

If your mom is still ambulatory, there's a LOT you can do to diminish this problem. First, notice about WHEN she usually poops during the day and check/change her as soon as possible after the blessed event occurs. Don't ASK her, check! If it's not a very wet BM, just wipe and clean as normal (always front to back). But if it's messy or wet, if she can stand, remove her lower clothing, take her into the shower, and, using a hand-held sprayer, wash (with antiseptic soap) and copiously rinse the area (front to back).

Cleaning up poop is often considered to be the worst part of caregiving, but really, it's not. The most difficult part is the brain/body damage that has occurred to someone making that task necessary. The absolute worst part is when they realize it too, and feel defeated and humiliated.

junybug welcome in
Boy do we know about this issue! Im sittin here chucklin cause Ive been there myself this week...as I seem to recall it was about 2am
Man thats just not fun!
But I have to ask too why so loose? Id get him to the doc to see if there is anything going on with him.

Hi Junybug, Ouch, this hurts. dignity, health ,all and sundry is at stake. Mom has had some urinary incontinance for years, so we already had her in adult pullups, with extra Boost pad, but after years of constipation being the main concern, now it is all working to well. Bowel incontinence has begun. We already had gloves on hand and lots of wipes of all sorts, so were not caught without what we needed, still it is a concern. What is the cause? is it just a natural progression, or a sign of something out of wack that can be treated? Those are questions I am working on now. I origionally attributed it to a round of antibiotics she had been on. Has your Dad been on antibiotics recently for anything? This is often a cause. Mom is so slow moving from arthritis that she may feel an urge but just not get to the pot. Still recently, she doesn't seem to know she has moved (BM wise). and is surprised when she gets to the pot and finds a MESS.
Most trash collection requires double bagging of human waste. For a long time now, we have kept gloves(the latex or vinel type available in the first aid section of department stores like WalMart, Sam's, any drug store. Lotes of wipes( flushable{careful not to clog the john} baby, sheilds, etc.) and keep plastic grocery bags handy to double bag soiled dipes and wipes.
Please note this. If there is a hint of tar like appearence to the bowel movement, it can indicate a bleeding ulcer. Even without this appearence, especially if he is taking NSAIDs or blood thinners of some type,regularly, The disturbance can be linked to digestive tract bleeding. Went through the mill with Dad. Starting now with Mom. Trying not to jump the gun, but still rule out other issues. got lab orders waiting to pick up tommorrow, but am trying to let her get through Mother's Day before bothering her, with all that, since at the moment, it seems to be more our problem than hers. Still, concerned that all this Poop getting everywhere will initiate urinary tract infection. (more a problem with women than men as a rule). Hang in there Junybug. You are doing a job very few take on and even though Poop cleaning may not be something resumes are built on, you are very special.
Glad you found this site. Looking forward to what your experiences may teach you that will help ME.

Welcome, junybug! Glad you found your way here. Jeeze, CHF, renal failure and cirrhosis of the liver - I guess he IS frail, bless his heart!

So what I am hearing is that he had diarrhea, or a very loose, unformed stool. Do call his doc if this persists - might be something going wrong or it might just have been the jalapeno peppers he ate... Unfortunately, adult diapers (or kiddie ones for that matter) don't contain "blasters" well... If it's not out the legs, it's up and over the back... I can understand your consternation at having to deal with this at 2:30 am, but that's when all the really crappy (no pun intended) problems seem to occur...

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Anybody there with tricks?

The key is fast-talking and organization. Have everything you need to clean him up, dispose of the used dipe, etc. at your fingertips so you do not have to leave the room. Take a moment to get things in the right order so you do not have to fumble around at a critical moment....

I am sure your dad was plenty distressed, especially when his PJs got messed up... It takes a lot of diplomacy, understanding and a good sense of humour to make it through events like these. My mom followed a slow progression of losing her toileting abilities... At first, it was finding stuff smeared on the seat after she exited the bathroom; later it was her not noticing that she had stuff on her clothing; finally, she just did not seem to be able to coordinate and perform the fine motor skills and logical sequence of steps required for normal toileting, let alone handling a night blaster. My involvement became more "hands-on" as her abilities declined. At first, I would just stand by or lurk outside the door telling her to lemme know if she needed help. But later, when her ambulation became poor and her sense of balance was waning, I had to walk her to the bathroom to prevent falls. It was a natural progression to start assisting... Everywhere I went, I packed vinyl gloves, disposable adult bathing cloths and Clorox Clean-Up wipes. NEVER leave home without them! And make SURE those supplies are in every bathroom in the house!

When my mom got upset about the mess, I would remind her that it's nothing soap and water won't take care of... (well, soap, water, bleach, OxyClean and many different air fresheners!) Sometimes, we made jokes about "blasters," remembered famous "blasts" from the past, made puns about what a crappy deal it was, a dirty job but someone's gotta do it, etc. I just kept talking and kept HER talking. As I was yapping away, she was focused on me, not the mess. I would be containing and cleaning and before she knew it, the embarrassing