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I don't want to take away any more independence or dignity than she's already lost. She lives with me, has aides, but can go to the bathroom, shower, dress, ambulate, etc. all on her own. Lately, though, I've been seeing evidence of poo and/or toilet paper remnants with poo on her shower chair. I've mentioned it once or twice, but she has such memory loss, it doesn't stick.


She flushes, twice, and washes her hands thoroughly, so she's aware, but how do I let her keep her dignity, and get her to keep butt clean? I'm more worried about spreading germs, her getting a UTI, etc. than anything else.


THE BIG QUESTION: how to talk to her about it without embarrassing her.

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She may need wet wipes to do a good job. FYI: even though they say flushable, they are not, could definitely cause problems.

Or, she may need help because range of motion changes and as we all know it's already a tough yoga stretch, add any issues and you don't get a thorough job.
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Oh yeah, don't have her use wipes unless she can be trusted not to flush, they are definitely not safe in both septic or sewer.
Another option is the toilet bidet, these range from very basic to cadillac models, AgingCare advertises a couple of basic models

https://www.agingcare.com/products/sanitary-bidet-161675.htm

https://www.agingcare.com/products/hands-free-bidet-toilet-attachment-445749.htm

or you can see more high end options on the web.
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jshdoff May 2019
Thought of a bidet, but it would mean teaching her to use it, and she's not really in the learning new things stage of life. I'll look into these though, thanks.
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My mom uses flushable wipes, and they ARE flushable. That is to say there have been no situations of backed up toilets at the ALF where she lives, or the wipes would have been banned long ago. All of us on on a sewer system here, so I don't know about septic systems........that may be a different story altogether! Cottonelle makes a small wipe (which she dislikes due to their small size) which may be a good option if you're worried about clogging up the toilet.
Best of luck!
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cwillie May 2019
Even if they don't clog household plumbing these wipes are a HUGE problem in municipal sewage treatment plants.

https://www.metro.us/news/local-news/new-york/inside-nyc-largest-wastewater-treatment-flushable-wipes
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Folks - I don't need info on wipes or bidets or sewage systems. I need help in having the conversation. How to discuss it and still retain her dignity.
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whyme327 May 2019
My mom doesn't enjoy bathing so when I want her to bathe I just say, mom, you're begining to smell funny so we need to get you a bath and she will do it. Maybe you can say something like that and give her the wipes to help her stay "fresh" smelling.
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There is no magic phrase that makes it easy to tell someone they aren't managing toileting properly, one of the central requirements of being a caregiver is to get over feelings of squeamishness and modesty and just get on with it. Aside from pointing out the evidence that she is not able to take care of this sufficiently you need a solution to offer - whether you want to use wipes or a bidet or you need to step up and wipe for her (yeah, it can come to that and believe me none of us ever envisioned going there) is up to you.
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jshdoff May 2019
I'm not being squeamish, or modest. I have no problem cleaning her up, and did when she was recovering from a broken back. I've used suppositories with her when needed. It's none of that.

I'm simply asking for people's experience in discussing this without infantilizing the person. She struggles with her dignity as it is, and just doesn't have the sight (macular degeneration) or sense of smell (long gone) or awareness.

I'm fully aware of the solutions and alternatives, I'm asking about your experience with language and dignity.
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"Mom, I've noticed you aren't doing a good job keeping clean, I don't want you to end up sore or with a UTI. Here are some ideas that might help..."

Sorry, I guess I just didn't have that kind of relationship with my mom, for years she trusted me to be her eyes (she too had AMD) and to be straight with her. You mention your mother has memory loss, chances are this is a conversation you will have to repeat over and over, in my opinion it would be better to just be proactive and move on to solving the problem.
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Tell her what you said here "Mom I have noticed toilet paper on your shower chair. It may be time to use wipes to make sure your extra clean. Really don't need any UTIs"

My Mom always used wipes. So do I, so I had no problem with this. I suggest Huggies. They are big and thick. I fold them up when fished and put in a trashcan with a lid.
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I simply told Mom that I found these wonderful flushable wipes that are really nice to leave you feeling a lot cleaner. Kind of skirted the whole "you're not getting it all, Mom". She knew what I was talking about, and asked me to put them on her shopping list.

Next time I saw her, she had bought a pack and was obviously using them.

I made it more about ME having found these, and how glad I was, as I am on a medication that makes the urine quite foul. It put us on equal footing, so to speak.

A BIDET!! That's going in the new house. I forgot how great those are!! I wouldn't try one for mom,, she's doing ok with the wipes. Also takes a small portable container in her bag all the time.
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You said you mentioned it and it hasn't sunk in or stuck, offering wet wipes is how you deal with it or get in there and clean her.
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I have had conversations like this before (designed not to embarrass or humiliate the target). Get another third person willing to help. Have the conversation with that third person, in the company of your Mom.

Have the other person say, “I saw this great new product that makes me feel fresh”
You, “What is it?”
Go on from there, as if it was a scripted commercial.
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We have a bidet that is plastic that attaches to your orginal toilet and we trained dad on it. You can buy them on Amazon. Com. We have one on every toilet in the house. Hope's this helps.
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anonymous808816 May 2019
We had one put in way before things got bad with my LO and it is wonderful. He even has had really messy situations and the bidet took care of it! I also follow up with a wet one just to make sure nothing is left. We got our bidet at Lowe’s.
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My 93 year old mum lives with me. I used to pussyfoot around things but now I just talk to her directly and tell her how it is. She wasn't changing her clothes enough so after hinting I just told her she needed to change more often and she now does. When she was a bit smelly I told her. She will deny it of course but she does take notice and I would rather tell her directly than it become a real problem. If I didn't have words with her now and then I couldn't live with her so I would rather do that than say to her she has to go because of the way she is. Sometimes just saying what is needed to be said is better for both of you. Good luck. X
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read up on CDiff and tell her about it. Mom, just remember to clean up so you don’t get sick.
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How is her diet? A healthier diet means less poop mess.
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cak2135 May 2019
I think I ought to make some personal choices. I often have the poo problem when I eat one of those Eskimo pie treats or ice cream; I'm lactose intolerant
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I understand. Maybe you don’t have to say too much. Hide the toilet paper, say you ran out of it, and introduce the wipes as what YOU have been using and how great they are in getting things very clean and fresh. Good luck.
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Be very careful of "wet wipes"
If you are on a septic field you should not use them and if you are on sewer even the "flush-able" ones can clog a toilet.
And if you leave Mom with wipes they will go into the toilet even if you tell her not to put them there. It is an automatic gesture to toss what we have used to wipe ourselves into the toilet and flush.
I am wondering why she "flushes twice" Is it that the stool is so large and heavy that it will not go down with one flush? If so it is possible that she is needing a stool softener.
Or it might be that she just needs a little more help and it is time that you step in. As she declines you will have to step in a bit more.
If you do this without making a comment about it and just start helping I think she would not have a problem. Is it possible that you would be feeling more embarrassed about this than she would?
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You might try putting a box of baby wipes (Huggies Natural are very gentle) near the toilet. They do a much better job of cleaning than toilet paper. However, they are not flushable, so you will need a lined waste basket nearby that is emptied regularly. And, of course, you will need to train her on disposal of the wipes.
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Get her some of the wet wipes it helps a lot
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I found that if I don’t make a big deal about and just say. “Let me check to make sure you got it all” she just turns and lets Me. Mom is 86 with a touch of dementia.
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My mom has the same exact problem. If wet wipes are problematic, how about a perineal rinse in a spray bottle to apply to regular TP? A once a day, quick sitz bath either immediately after a BM or in the evening before bed is good. On the shower chair or on the closed toilet seat place a dry paper towel with a wet wipe on top of it. When she sits, both will stick to her bottom and you can peel them both off when she stands up. And you can tell if you got it all clean.
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cak2135 May 2019
Why does there have to be such thing as poo? I often have the problem when I eat one of those Eskimo pie ice cream treats; I'm lactose intolerant. It makes me run to the bathroom constantly at times
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I use the words “freshen up” or quick wash up. “Time for a fresh change up”. I have told my mom that “everyone uses extra wipes after a BM”. The sitz bath I recommend as “refreshing” and I talk her trough it with “isn’t nice and warm? Doesn’t that feel good?” Reinforce the experience as being a luxurious way to get ready for the day or bedtime and the “best way to avoid UTI’s and their harmful antibiotic side effects. Put a spin on it and sell it like you believe it is a natural way to maintain good health.
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moecam May 2019
Possibly do it yourself & let her see you getting it ready for yourself so it is now the new normal in the household - so it won't just be her but all as this is a practise that has been recommended - after it becomes habit you can quit [if you want to] - basically 'what is good for the goose is good for the gander'
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If you aren't worried about her flushing disposable wipes, get those. Wet wipes clean much better than using a dry piece of paper to clean a bottom. Go to sams and get their store brand - large and cheaper than anything else you're going to find anywhere. 12 inch square and 5 packs in a box.
Showers aren't great for cleaning that area either, especially if she uses a bench to sit on. Can she still sit in the bathtub? If so, that is going to give better cleansing.
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I think being direct is the best approach. I've had to have talks to my mom about smelling like pee. Not fun, but necessary. I said "Umm, mom, I don't want to embarrass you but I have to say that you are smelling like pee and I thought you would want to know". Not saying that my approach was perfect but being subtle often does not work.
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Your profile says that you mother has dementia. Dementia really changes the equation, because, it's likely that this is not something that she will see the light and do it better.

If she has normally had good hygiene for her entire life and NOW she doesn't. I'd suspect that she just isn't capable. If she could do better, she would.

So, giving her new products or explaining how things should be given more attention, probably isn't going to stick in her mind. Also, it's not just the memory. With the brain not working properly, there can be a disconnect between the brain and the hands. So, coordination isn't quite right. (One of the first signs of cognitive decline with my LO was watching her try to make a sandwich. Her hands did not work right in placing the bread and food together.)

Focus is also affected. So, I'd take a deep breath and just handle it kindly, but, frankly. You might give the doctor heads up first. So, doctor can tell her that he wants daughter helping with her toileting hygiene for a little while. Just to ward off UTIs. That way, it's doctor's orders and then every time she goes to bathroom, you go too to supervise and assist. I don't know anyone with dementia who doesn't eventually need someone clearing them in toilet and later changing depends. It's so sad. I know.
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disgustedtoo May 2019
What you posted, Sunnygirl1, is pretty much what my comment would have included - if mom has dementia, most everything you do try to say or point out, no matter how discreet or matter-of-fact, isn't going to sink in. Dignity or not.

There were even mentions of choosing not to use wipes or bidet because mom wouldn't be able to learn. Certainly you can try to have a gentle discussion about it, but in my experience, most of that is likely in one ear, out the other. My mother can't remember what she or you said 1-2 minutes ago! She is still "capable" of most ADLs as well, but needs some reminding for some tasks, such as brushing her teeth (she doesn't live with me, so that is up to the staff.)

I would imagine you are aware of when she heads to the bathroom. Monitor and if BM is involved, step in before she leaves the bathroom to ensure she is clean. This would work even better if she is "regular", going around the same time every day. If no BM, leave well enough alone.
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You don’t. There’s no way to talk about such personal things without some embarrassment, BUT you can make it light hearted. You can say “Hey, I noticed when you took a shower that you got a little poop on the chair. I know it’s hard to reach sometimes. I got you some wet wipes to help a bit. If you have any trouble or do t think you got it all, let your aid know, because we don’t want to risk an infection.” You could also get a peribottle and encourage the aids to use it with her.
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Psalms23 May 2019
Great ideas
No way to avoid some embarrassment but to discuss in a light way... Not make Mom feel bad or being reprimanded for poo...
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Get a bidet attachment to your toilet or replace current toilet with a bidet-toilet which are 'not inexpensive', but 'worth for the cleanliness factor'. Push-button for 'water spray'...different push-button for 'air-dry' is easy for anyone needing to 'assist' if she 'isn't able'. More 'appealing' than 'reaching under to do it for her'.

Doesn't take much 'acclimation' other than the 'expected shower underneath' which actually is 'refreshing' with 'reassurance of being clean'.
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worriedinCali May 2019
the OPs mother has dementia so a bidet will require acclimation as well as the ability to remember how to use it......
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Forget about trying this it won’t work, especially since you said she has memory loss. I’ve been in this boat and for 8 yrs been fighting my mother on this. They just can’t comprehend if they have cognitive impairment or memory loss. Just deal with it because you will never win. Trust me.
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Get a small bucket with lid to put by the toilet & go in with her to make sure they Do Not get flushed. They Do clog up municipal sewer systems even though the manufacturer states "flushable".
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my2cents May 2019
they clog up old plumbing too - even the ones that say flushable.
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This same thing happened to my mother, She totally used her shower seat as a toilet and didn't realize it at all until I told her. Oftentimes the elder is waiting to long to get to the toilet and accidents happen. I wiped up 1,001 "accidents" of poo.
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I would also vote for the bidet. I had eight fingers amputated last year. I cannot do a proper job of cleaning myself sometimes, and was never 100 percent sure that I had done a complete job. We bought a bidet that sits on top of the existing toilet. It was not expensive. It has a warm seat, it heats the water, it blows warm air, it saves the need for toilet paper - good for the environment, does a better job than toilet paper, and the remote is easy to use. I recommend it to all, not just seniors or people with hand issues.
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TMWKy2 May 2019
7again, Can you provide details of your bidet? It sounds like a fantastic option.
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