What to do with elder in AL adamantly refuses to wear Depends?

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What to do with elder in AL adamantly refuses to wear Depends?

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My dad adamantly refuses to wear depends, not even overnight. He is increasingly having incontinence, both urine but also bowel movements. He cannot get to the bathroom in time when he gets the urge, so soils pajamas. if its urine, he is fine setting the underwear and PJ's aside and getting them washed. However if its a bowel movement accident he refuses to have them washed, and puts the underwear and often also the PJ's into the trash.
THere is often a mess on the floor when he is trying to get to the bathroom with one of these accidents, so then the staff have to clean that up also. I have repeated tried to say, "You have to wear Depends, at least at night." But he adamantly refuses. What to do? The reason given is non sensical given what is happening with the accidents. He says if he is wearing them he may sleep right through an accident and doesnt want to be sleeping with a "wet diaper" on at night. I'm sure part of this is also him not wanting to realize another inevitable part of the aging process as you get near age 90.the doctors have been informed, there is nothing really medically wrong, he's incontinent due to age. His geriatrician has told him to wear depends, even wrote it as a prescription. But still he adamantly refuses. what to do?

Adult Diapers Hygiene Incontinence Refusing Care

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"...there is nothing really medically wrong..."

What is medically wrong is that he may have the beginnings of dementia since his logic and reason and empathy have obviously diminished. Maybe start with a discussion with the AL admins to see what they recommend. Maybe there can be an added service to help him navigate this transition? Maybe he is now more of a candidate for MC...?

I'm assuming all his cloth undies have been removed? If not, time to do this and only supply him with pull-up style disposable briefs.

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Reply to Geaton777

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Have you tried throwing away all of his old underwear, and replacing them with his new "underwear"(Depends)? If not I would try that.
Otherwise you may have to threaten that if he doesn't start wearing his new "underwear" 24/7 that he won't be able to stay in assisted living but will have to moved to skilled nursing where he won't be given a choice.
I'm surprised that the folks at his facility haven't addressed this with him already as I'm sure they are not thrilled to have to continue to clean up his messes daily.
Either that or they will start charging him more for the extra care.

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Reply to funkygrandma59

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Exactly what I was going to say. The AL is not going to keep putting up with cleaning up his sh-t daily and will soon force him out of there.

(4)

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His actions DO have consequences. I'd ask the AL to tell him he must start wearing disposable briefs or he must move into the Memory Care wing where he won't have a choice.

Your father's dementia is quite a bit further along than realized, I think, now that he's refusing Depends in spite of bowel incontinence! His incontinence isn't due to normal aging, but to dementia. My Uncle George was 102 and fully continent with no dementia.

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Reply to lealonnie1

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Have AL tell him it's required and maybe you and they can take his undies away and replace with pullups. Don't call them diapers.

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Reply to againx100

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Certainly has dementia , and heading to MC sooner or later . Dementia , plus a strange type of OCD towards germs along with it . Psychiatrist said unlikely that meds can fix it .
Good idea to just remove all undies to force it ! He won’t like it , but probably necessary at this time. For sure - I’m not going to buy new ones

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Reply to strugglinson

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As a last resort he can be put into an anti-strip jumpsuit (with a disposable on), and this way he won't be able to remove a soiled brief without help.

(3)

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His actions and decisions are those of someone with dementia. Take the decision out of his hands by replacing his underwear with Depends. I did this with my mother. Yes, he’ll be mad and say rotten things to you. So what. Be the adult. Be in charge. Also have him screened for dementia because his behavior is not just a simple result of aging. Good luck.

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Reply to RLWG54

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I think that with this the choice of AL is almost certainly going to be removed from him. Strugglin, I cannot quite remember the level of dementia your Dad has, but this is sure sounding more like a dementia than anything else, given, as you said, this makes no sense.

I would tell your Dad that the option for AL likely will soon now be removed because of the numbers of accidents. If that happens he will have a roommate, like it or not, and not an especially "good" roommate in all likelihood.
If that doesn't work, I can't imagine what might.
Not everything can be fixed.

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Reply to AlvaDeer

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If I were in dad's situation and had a brain cell remaining, the idea of a roommate--and a stranger at that--would convince me. Bring on the Depends!!

(2)

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I did the switch out for DH aunt. She didn’t refuse to wear the pull-ups but when she had a choice she would choose her regular underwear. After removing the regular, she never mentioned the change out. Just wore the new ones. She had been wearing pads all on her own for years so maybe not as hard a transition for women.

I know this is hard to believe strugglin, but once they change over, they often feel so dry that they refuse to change, not believing they are wet.

Does this only happen at night?

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Reply to 97yroldmom

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As of now just at night . In the day when awake he still realizes the need to go to bathroom and will get there in time

(1)

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Too complicated for him to comprehend .
Don’t make daytime underwear different than nighttime underwear.

Remove all his cloth underwear , he only gets Depends( or another brand ) pull up to wear from now on .

Tell him it’s ” Doctor’s orders”.
No long discussions about it . If he gives push back “ No Dad , you need them , period”. Or “ It’s not up for discussion “ and leave whenever he brings it up .

No making deals like asking him to only wear them at night. He should not have any say anymore . He is using this as a form of control . He’s always controlling about hygiene etc .

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Reply to waytomisery

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Good idea. Yup a big part of the stubbornness I think is maintaining control

(3)

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strugglinson, do what my Mom did when my Dad refused to wear Depends. Mom (in her 90's) got so tired of cleaning up the mess whenever Dad had an "oops". So the next time that happened, Mom handed Dad the rug cleaner and rag and told him he now needs to clean it up. Next time I had gotten Mom's grocery list, listed on the list was Men's Depends.

I also think some men relate Depends as being a "women's period pad" and will refuse to wear one. I remember my Dad saying something similar.

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Reply to freqflyer

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Yes, perhaps take the pants out of the packet, so that he doesn't see it, if that brand is associated with sanitary towels.

(1)

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5 people I know well have needed incontinece underwear. I believe it is a personality issue to accept or use denial.

3 said well if I need them, I need them. 1 in 90s, one 80s during an illness & myself after childbirth both times.

The other 2 had a mixture cognitive impairement, denial & pride. Or maybe more lack of insight? (Anosognosia) Flatly refused & carried on just as your Dad is doing.

You mentioned not buying more underwear. Excellent!

Let his supply dwindle way down.

Have at the back of his drawer *for emergencies* a packet of disposable/pullup briefs.

Then, find his *currency*.

Money? If he has a money-saving thrify lean use a little 'therapeutic fib'.. "There were on a GREAT special!"

Choice & Control?
For the OCD/controlling type, buy TWO brands. Then it can still be Dad's CHOICE right?
(Not between regular underwear & disposable - but between brands).

Pride?
Have an acceptable way for him to change his mind. "Says here these are VERY soft & stretchy. See what YOU think?". Or buy the most 'manly looking' packet you can, with a silver fox dude on the label.

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Reply to Beatty

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Pride and old age are a bad combination
I bought my dad a baby nappy bin
i don’t call it that otherwise he wouldn’t use it and nappy disposable tie bags -again I don’t call them that

my father wouldn’t accept he had a problem
we use disposable under pants and leave the Disposable bin!! (Baby bin) In His room and on the table couple pairs of disposable pants so he can put the soiled pants in tie bag and in the no smell bin and retain his pride

also leave pack of wet wipes floor and personal wet wipes for him to clean up
so he does and accepts his situation and
now he accepts more help
still insists on wrapping his pants up in a neat ball ( hiding) then tie-ing the bag ..
Then we return to his room to help further
it’s not an overnight process
so maybe this can work
then he can throw away the pants if they’re disposable
putting them in a disposable bin ( nappy bin designed to keep smells in ) might help
then move to another step when that’s accepted
we allow my dad time to clean Up n knock on His door can we come in now to help
him out his trousers on
We act like it’s nothing and my dad now acts like it’s not a big deal
as I say it wasn’t overnight
try and get disposables and a bin and the nappy tie bags for him to clean up
snd say be back in five minutes to help you dad or give me a shout when you have changed pants for me to help you
Small bowl and rag with warm water and a little disinfectant In It for him to wipe down also helps
maintains their pride and for you helps solve the issue.
We tried my dad in no coffee
( switched to herbal and green tea and decaf ordinary tea) and after cutting out all coffee ( including decaf ) his incontinence issue is literally about 1/3rd if what it wAs
prob more -
couldn’t believe how much coffee affected the hormones so badly
good luck

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Reply to Jenny10

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Green tea has a lot of caffeine!

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1) Have one or two bedside commodes. My mom's commode is dressed up and very comfortable. I add 1" of water with lavender liquid soap and a spray of vinegar in the bucket.

2) Get your dad on a bowel regimen, with flax seeds, beans, green beans, chia seeds, pears, prunes, whatever it takes to get him to be "regular" like clockwork in the morning. Timing is everything. Sit-ups are a great exercise to get the bowels moving. Try to aim for 9:30 a.m. or some achievable goal. There are specialists who can give you more info on bowel training. There are laxatives, but hey are addictive, but may be that is what it would take in the short term.

3) Get absorbent underwear that can be washed.

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Reply to purrna2go

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Honestly he does not understand what is happening. His ability to understand is gone. So you must help in the only way you can to maintain sanitary conditions for him and to alleviate the work of the caregivers. You have to be the adult. It is difficult, it does not feel right, it requires making decisions without his input which feels sneaky. It is what adults do for those they love who can no longer do it. Talk to doctor about meds that will decrease his anxiety about this issue and do not discuss it with your dad. It would be like trying to explain something to a 2 year old and expecting him to be ok with it. You just do what you have to do. No one should punish him by making him clean it up or by becoming angry with him. Because there will be many other decisions he won’t understand in the near future due to brain issues in older adults, you will need to stay in contact with the Dr. Put the night time diapers with his pajama and daytime with day clothes if he dresses self. Put extra pads on bed at night because the night diapers may not make it through. May the Caregiver Forces be with you.

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Reply to RetiredBrain

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Yes, but perhaps use the same incontinence pants for both day and night, so he doesn't notice and take offence. At least until he gets used to wearing them because that's all he has to wear, or go commando. Hopefully, habit will stop him doing the latter.

(1)

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My dad had a house mate that willingly wore incontinence underwear. It did not stop the kind of bowel incidents your dad has. He would try to deal with the accident and make a bigger mess.

Sometimes there is no winning with these issues.

Has anyone talked to you about condom catheters for overnight? Something like this might help to get dad to try depends and not have to worry about sleeping through the urge to go.

Best of luck, this is such a hard subject for many elders.

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Reply to Isthisrealyreal

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My dad did the same thing when he became incontinent. He refused to wear Depends. Even after the hospice nurse insisted and my mom took away all his regular underwear. He just went “commando” with nothing on under his sweatpants. Sometimes she could get him to wear them by saying she wouldn’t put on a movie unless he put them on. We would find them balled up in his bedding, in his closet, under the bed, etc. He also almost never used the bedside commode. I don’t think he could grasp what it was. Sometimes my mom would insist that he clean up the messes he made because she couldn’t (mobility issues) but he didn’t do a very good job.

its not fun or easy. I hope you find a solution.

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Reply to Suzy23

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strugglinson: Remove all normal underwear and replace them with Depends. Ergo, there remains no choice.

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Reply to Llamalover47

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If you do this watch him carefully. Something like this happened accidentally because my wife hid her soiled underwear. Wore disposable underwear one time and then went without underwear

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Tell him newfangled diapers are WAY different than the cloth nappies of years ago, where a wet diaper could cause health issues and chafing, that they ABSORB and to some degree Deodorize whatever is deposited. And that the Overnight type are designed to be even more absorbent so you can sleep and change, clean up, in the morning. Try to appeal to his putting unneccessary work on the staff, not to mention the expense of replacing soiled underwear and pjs so often.

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Reply to Santalynn

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Make sure there are pads for his bed. Ask him to try the pull-up version of Depends which are more like underwear. Thank the staff profusely. Ask them to let you know when the time arrives for him to move to skilled nursing or memory care.

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Reply to Taarna

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Have wearing of Depends written into his care plan. Dispose of his underwear. Leave a stack of Depends. The CNA's are really good at calling the Depends underwear and getting them on clients.

Talk to the CNA's. Tip them well (gift cards)

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Reply to brandee

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Dementia isn't nice. If you take away his underwear he might decide not to wear any rather than wear disposable briefs. If you tell him he has to clean up his own mess he will probably be unable to do so. You can try that, but Dad may resort to hiding it if he can't clean up properly or is angry about it. You may have to pay an extra cleaning fee for his care, or the residence may insist he be transferred to MC sooner than you or Dad want. Your consideration of Dad is commendable.

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Reply to DrBenshir

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You know.. there is another option.

Let it go.

I tried to kindly suggest incontinence disposable underwear to my LO. Then firmly suggest & convince. Booked a continence nurse for a consult, arranged different products to trial, removed regular underwear from the drawer. Advised aides to check.

Well. I then got to THE END of what I could do.

I visited one day. LO had very wet lower clothing. I pointed out the wetness & asked if they wanted to change to something dry. "Why would I?" Was the reply.
I was done.
I let it go.

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Reply to Beatty

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LO wet frequently also . He thought his Depend which we called underwear only needed to be changed once a day . Could not get through to his dementia brain . I was told …
“No I’m not wet, I’m never wet, go feel the sheets on the bed , they’re not wet. “

No more outings in the car after that . 😒😩

(2)

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My husband refused to wear depends. We fought for a very long time. I finally removed ALL of the underwear from his drawer. He had no choice. He hates it but I do not care. He still has accidents not being able to get to the bathroom in time to pull them down and he hides soiled depends in his closet but it’s better than it was. He still pees on the floor I front of the toilet. It is my most difficult challenge in caring for him.

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Reply to LindaSG

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Dont call them depends call them underwear. Take them out of the package and place on shelf or in drawer.

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Reply to Ohwow323

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I like what funkygrandma59 says - you may have to replace all his underwear with depends.
If he (or you) has the money, go ahead and buy lots of underwear with the expectation of throwing them away, as if they were disposables.

But really what I get from this is it's probably time to transition from Assisted Living to a nursing home. Your dad won't like that. No one would.

If he's ok with soiling his pants, throwing them away and getting new ones, and you want him to be comfortable, then that is one option. Try and talk with him realistically. He will have to shower - or have someone clean him - after soiling his pants.

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Reply to CaringWifeAZ

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You have all sorts of good suggestions here but, please, don't be disappointed when nothing works. I went through this with my father. He didn't have dementia, just old age. He was slow getting to the bathroom, especially in the night. We tried the Depends at night, and he would just rip them off once someone left the room. He lived in assisted living and had a private caregiver and I had daily housekeeping so that they would keep his sheets laundered and clean but it was hard to keep up. His caregiver finally made his bed with layers of bottom sheets and absorbent pads between so she could rip one layer off and still have a clean one below. He died at 102, and pulling off the Depends was his last official act before he died in his sleep.

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Reply to jkm999

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I know none of this is funny but, I just giggled at your dad's tenacity about NOT wearing diapers. Hard for everyone else but his values and principles about that obviously remained in tack to the very end.

(2)

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You can purchase cloth underwear that costs 20 to 30 bucks apiece and claim to absorb five ounces of liquid. But that still wouldn’t solve the problem, which is that the longer the al staff is going over and beyond, the sooner he’s going to be told to leave.

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Reply to PeggySue2020

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What to do with elder in AL adamantly refuses to wear Depends?

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