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My mother is 88 and has difficulty walking and getting up out of her chair. She began wearing adult diapers about two years ago, because she couldn't get to the bathroom in time when she needed to go. Now she relies completely on the diapers but will sit in a dirty diaper all day, rather than cleaning herself up and changing into a clean diaper. I don't know if she has reached a point where she can't anticipate when she needs to go nor whether she realizes when she's urinated or had a BM in her diaper. She wants to live independently and has a woman who comes 3 hours a day to cook and clean for her, and has another aide who helps bathe her. My siblings and I can't convince her to change her diaper more frequently. We're shocked that she seems fine sitting in a wet diaper or in her own feces. We know it's hard for her to get up (she has a power chair and a walker) but she will go to the kitchen when she's hungry and she does get up when my brother brings her grandchildren over for a visit. So we know she can do it, she just doesn't seem to care about getting a clean diaper.

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That’s a tough one
Is there dementia? She may not realize that she needs changing.
Maybe a discussion with a visiting Nurse can be helpful to see if she’s a candidate for Bowel and bladder training .Also consult your do doctor to understand why this is happening
Best to you
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You may need to have an aide come several times during the day to help her change her dirty diaper, as her sitting in it for too long, can lead to all kinds of sores from the urine and poop eating away her skin. That can be very dangerous. It may just be that mom is forgetting how to change herself, so having someone come to help her, is just what she might need. Good luck.
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DenverGuy, the situation you described seems most likely to be due to dementia, but regardless of the cause, it is dangerously unhealthy for your mother and, if a solution isn't found soon, besides causing a serious medical problem, it will also likely result in one of her aides calling adult protective services (APS). Assuming you and your siblings, not to mention your mother, want to avoid APS involvement, you'll have to quickly find a full-time solution, of which possibilities include each of you sharing 24-7 care, hiring 24-7 aides, taking your mother to adult day care (or likely a combination of these three), or moving your mother to assisted living or, more likely, to a memory care facility.

Best wishes in finding the best solution for your mother.
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Thanks for all the helpful suggestions! Unfortunately two of the three siblings live far away, so the load has fallen on my younger brother is close by. We have been trying to convince my mother to let us hire additional help and she is steadfast against it. We are at the point where we are discussing doing things without her consent, but we also want to respect her wishes and her right to self-determination. We feel uncomfortable forcing into anything, but at some point, it's a health and safety issue. Doesn't make it any easier regardless...
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bicycler Dec 2020
I fully sympathize with your mother not wanting more help and with you and your siblings wanting to respect her wishes. This is a difficult dilemma, but it is also an unfortunate fact that her health and safety is at severe risk and that will be adult protective service's (APS) focus when it gets involved. Some APS agencies are more aggressive than others, but I've never heard of one that would be willing to ignore this situation. If the family isn't able to resolve it, then APS will probably recommend that your mother be appointed a legal guardian by the court and that appointment probably won't fall to any of her children who knew the situation but were unable to resolve it.

Also, one thing I should have mentioned in my first reply is that your mother should have a medical exam ASAP and she should be accompanied at that exam by at least one of her children. Urinary and/or fecal incontinence often cause urinary tract infections (UTIs), which can, in turn, cause dementia-like symptoms and a downward spiral. If you think your mother will not be comfortable with any of you in attendance and/or will not likely be honest with her doctor, then prior to her appointment it would be appropriate to send a letter to her doctor that explains her situation.

This is a hard time. Again, best wishes on this journey.
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Then she can no longer live independently if she continues to sit in a dirty adult brief all day long. She can have the choice of changing herself, or being changed, every few hours throughout the day, using the toilet every few hours, or moving into Assisted Living and going on the Incontinence program where she'll be changed regardless of whether she wants to be or not.

If she's 'able' to fix herself something to eat, she's also able to go to the bathroom and change her adult brief and/or use the toilet.

If dementia is involved, then a Memory Care AL would be the answer. My mother is checked every 2 hours for a wet brief, and asked if she needs to use the bathroom, so there's no rash or other skin breakdowns to cause huge health concerns. She's even woken up at 5 am for the exact same reason, and then goes back to sleep. It's THAT important.

Give your mother the choice to make herself.

Good luck!
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Lealonnie1 is correct. Your mom can no longer live independently if she continues to sit in her soil for long periods of time.
If you look at age progression and the loss of basic daily care/skills as a normal thingy you'll be able to tackle every step with more objectivity, love and good care. Whether you do it yourself or hire help.
Your mom being "ok" with sitting in her soil IS an 'OMG my mom's sittin' in it! What do I do!!!?' moment. It's also, objectively, an indicator.
If you objectively see each step of progressive deterioration as an indicator, you'll be able to seek the appropriate help she needs in a timely manner. It may reduce the frequency and intensity of the overall negative emotions that come with this gig, it really did for me.
Things are kinda rootin' tootin' at my house with my old mom. Mostly good on a daily basis for us all.
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If she is still legally competent, then it's her decision to marinate in this diaper for however long competency lasts.
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First I would stop referring to her disposable undergarments as diapers, especially in front of her, it’s just an association thing but the need for incontinence underwear is hard enough to accept without being reminded you need diapers all the time. Then as someone else suggested I would get her to her PCP for an evaluation and maybe to order a VNA eval for her incontinence. It may very well be that she isn’t feeling that she needs to change or the urge/need to use the bathroom, it isn’t uncommon and there are various causes as well as solutions that could help. Just as important they should check her for UTI and go over the risk of that and how much damage it can do (take away her independence) along with the risk of rash and sores by not changing her underwear often enough. Let an unrelated medical professional go over the need for keeping the area fresh and how to do it, maybe even talk about the various types, choices for incontinence underwear so she can make a choice about what works for her best. Let her off the hook a bit, she may not be on control of this and knowing that it happens more often than people talk about and might even have a solution beyond disposable underwear could give her new hope. This is a tough subject for any older adult but often particularly awkward for a mother and son to deal with so step aside and let someone with more training and experience in this area do the work, have the talk. Maybe between treatment and less threatening or embarrassing conversation her habits will change and this won’t have to be the problem that uproots everyone’s life and maybe not but at least you can feel confident that you did everything possible to help her resolve this problem.
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"She wants to live independently".

Independent people either change their own soiled garments or arrange caregivers to do tasks they cannot.

It sounds to me like your Mother is in denial over this issue. If fact, that she is no longer independant - maybe now semi-dependant or even dependant.

My relative described herself as *living alone independently*. But on questioning for a needs assessment, the Social Worker re-labelled her situation as *living alone, dependently*. Wow. That label hit us like a rock! But it was correct.

Have a look with fresh eyes over Mother's whole situation. You may be seeing a small problem with an easy solution or you may be seeing the tip of an iceberg.
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