Tips On ... Toileting
by Edyth Ann Knox
More About Edyth Ann
Individuals affected by Alzheimers Disease will become incontinent unable to control urination or bowel movements as the disease progresses. This is both saddening and anxiety-producing for the caregiver. Too often, the caregiver (and other family members) see incontinence as a reason for institutionalization but you should know that many people still maintain their loved ones at home after coping with this new aspect of the disease.
1) Protective products: There are many kinds of products out there to help protect from leakage for your Loved One. Different ones have different advantages according to the stage of awareness and incontinence that the individual affected by Alzheimers Disease is at:
2) Make sure they can get to the bathroom: Not being able to get to the bathroom or recognize it is generally one of the first problems they will have. Leaving the bathroom door open may be helpful at times. Most houses now have two bathrooms and you want to leave the bathroom most familiar to your loved one free as much as possible.
4) Reminding your loved one: Once your loved one starts to lose a sense of the location of the bathroom they may need redirection towards the bathroom and possible cuing as to the chain of events. Because incontinence begins in the middle stages so must our assistance for our loved one. Watch your loved ones body language and behaviors because they may indicate that they need to find the bathroom.
5) Observing their normal bathroom habits: Make mental or physical notes of when your loved one normally uses the bathroom and when they have bowel movements can be of great assistance later when you have to take over taking them to the bathroom.
6) Conditioning: As the disease progresses and daily structure becomes more important, you may have to develop a toileting schedule. Once my mother-in-law got to the point that she needed me to take her to the bathroom, I had a good idea of her normal bathroom habits. I then would take her to the restroom when she was most likely to go, even if she was already wet. I would then sit her on the toilet when she was most likely to go. This way I began to condition her for results every time I sat her on the pot. It is very much like toilet training a small child. This helped a great deal in the later years when she was no longer aware of her needs.
7) Getting a resistant person to sit on the pot: The bathroom is a small closed in area and at some time when the individual affected by Alzheimers Disease is most confused they may resist being directed in the bathroom. They do not understand what you are doing, being pulled and tugged on and can become very anxious over the whole procedure, sometimes resulting in fighting back. Here again conditioning can help. In getting my mother-in-law, Milly, to sit anywhere I would stand on the same side of her when she was standing in front of where I wanted her to sit. I would back her up till the chair would hit the back of her legs. In some cases like with the toilet, I found it was better to place my foot at where I wanted her to start sitting down. Then when her heels hit my foot or the back of her legs hit the seat edge, she would stop. I would place one hand on her back by her shoulders and one hand on her belly. I would gently put pressure on her tummy and her shoulder which would start her in the sitting motion and help ease her to the pot of seat. Doing it the same way each time with what method works for you and your loved one helps make it less confusing. You can also give simple verbal directions at the same time. Give any verbal direction as one step at a time until that step is completed and the next step is ready.
8) Cleaning up after using the bathroom: Make sure your loved one is cleaned up properly after having a bowel movement to avoid infection, skin damage and unpleasant odors. The ease of this will likely depend on your loved ones state of mind. I found with Milly that I had better luck if I stood her up facing the sink (our sink was right in front of the toilet). I would then either let her have a wash cloth or hold on to the sink, while I stood to one side and slightly behind her and then I would wash her off with a wet, warm wash cloth with one end soapy and the other end wet enough to rinse her off with. If I was out of her direct line of site and especially when she was holding a wash cloth, I think that she felt as if she were the one doing the cleaning. It is best to clean from the front to the back to avoid infection from the fecal matter that may be there.
9) Setting up a regular routine: Setting up a regular bathroom routine is essential as the disease progresses. This does not mean taking your loved one to the bathroom at an exact time but at regular intervals that you know will work for your loved one. For instance at a certain length of time after eating, a certain time before bed or even during the night after going to bed. This not only helps to get to the bathroom before they have an accident but also allows you a regular time to help keep them clean. The object is not so much to keep them from using the protective product but allowing them to be able to eliminate as much as possible in the pot and also allowing for clean up when they need it the most.
10) Identifying environmental problems in the bathroom: Here are some items that can also cause problems for person using the bathroom:
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