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Now that your dad is 82 it sounds like the caregiving is changing and you're facing some situations you haven't faced in the past. The best way to deal with them is head on and as they come up.
Talk with your dad and tell him what you need from him. Be compassionate. You could say something like:
"Dad, I've noticed recently that you've been having accidents in the bathroom and it's OK, it's a normal part of aging. My concern is that you're able to clean yourself up after an accident so I've put some Depends and wipes and wash cloths in your bathroom to help you get cleaned up. I've also put a small hamper outside your bathroom in case you need it so you can throw your wash cloths in there when you're done. I've also put some paper towels and Windex under your sink so you can clean up the toilet seat. I wouldn't want you to have to sit on the commode when it's dirty."
Be matter of fact, diplomatic, and do what you can so he can hang onto some dignity. As difficult it is for you to discuss this with him I'm sure it's more difficult for him to have to discuss it with you.
I'm sure you'll be very kind when discussing this with your dad. You acknowledge the embarrassing nature of this discussion which tells me that you're a caring person and that you are concerned about your dad's feelings.
Expanding on Isn'tEasy's theories...
I've written this before and really believe it's a factor - older folks' priorities change, and so do their sensitivities.
Maslow's heirarchy of needs is no longer multi-dimensional for them. Their focii drop down to the basic few needs and other concerns drop away.
If you think about it, they're in the last stages of their lives, have limited mobility, become dependent on others, and sometimes every day is a struggle. When you're in survival mode, a lot of things aren't important as they were when people were fully functioning.
I sometimes liken it to early humans whose focii were on food, shelter and survival. Higher level thinking processes weren't that necessary except to support the bsaics. Once their got their saber toothed tigers or mastadons, they ate, slept and then went hunting again. They all probably had horrendous body odors but I doubt if it was that important to them.
Doing the same for a grown adult for an interminable amount of time, with a full-time job and obligations of my own, is not something I signed up for, as parents do when they decide to have children.
Of course, I would see to it that Dad would receive the best care possible, even if it isn't rendered by me personally.
I have IBS so I found it easier talking to her about her bowels because I can sympathize with the whole running to the bathroom thing. We can relate in that way. I always tell her I understand how frustrating it is but I can't do much about it.
So, I wonder if they really do have awareness that they're about to pee or poop, have extreme body odor from not bathing, are spilling food all over themselves, etc... but, they're just 'ok with it'. Particularly men, who may have had many of their personal habits and preferences accommodated all their adult lives.
The squishy, smelly depends, the shirt that hasn't been changed in a week, the food stains all over the furniture...it just doesn't bother them. But, it does bother those around them.
Dementia in so many ways makes the elderly very toddler-like, so, I wonder if nagging should be employed in the same way as one might with a 2 or 3 year-old.
Obviously, in the later stages of dementia, consciousness of all of those things starts to wane. But, I'm talking about someone who's still communicative and can respond to instructions if they're reinforced repeatedly.
I've tried it with my dad with some success on other issues. I don't nag in the same authoritative tone I would have with my kids when they were young, but I do address the same topic over and over until he starts to change an objectionable behavior. Like it was with my kids, it's sometimes a 'last man standing' situation : )
the clothing it was so bad. He's always embarrased and my heart aches for those suffering with this lousy disease. Suppose you put yourself in their shoes and remember this is something they can't control. How about doing what you can to clean it up quickly and get on with it. I don't believe any advice you give will help the situation.
I remember one "son" confronting me on hording his mother's diapers because she does not remember having any accidents. Guess what? He did it on front his mother and I still remember how painful it was for her to hear me saying that, indeed, she has accidents every day when in my care (respite/day care). Maybe because she is confused and not sure where the bathroom is, maybe because she does not feel it coming and, by the time she makes it to the bathroom, it's too late and we need to change all her clothes, not only diaper.... I refused to continue discussion on front of her. He called me very next morning and said: "I apologize! My mother just pooped her pants and it was awful! I do not know how you can handle it every day...." and I did hear his mother crying next to him..... What was really awful that he was very open about discussing it on front of her and I knew how heart broken she was to hear that.
So, be considerate! Do not humiliate your patents! Just clean it up or learn how to avoid mess by simply preventing it: trip to the bathroom right after meal, reminding them to use bathroom more often before it's too late, "offering" (insisting!) on helping them to clean up butt, etc.... That's what I do every day.
Besides, keeping that but clean and applying lotions all the time you might prevent "bad sores" which happen not only in the bed. Easier to prevent than heal!
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