Spouse agreed to wear Depends. He does not change them often enough, not even daily unless there is a bowel accident. Any suggestions?

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Spouse agreed to wear Depends. He does not change them often enough, not even daily unless there is a bowel accident. Any suggestions?

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This is a repost of mine from December 2018. I am posting the question again to see if any newcomers or oldbies have thought of a solution to this problem. Spouse agreed to wear Depends 100 percent of the time back then, and that went smoothly.

He refuses to change them often enough. Outside of the odor, there is naturally the damage done to the skin. There have been problems with the place of worship because they billed for the soaked chairs they needed to discard since they were "contaminated and unfit for a sacred place."

The briefs leak after two days, onto his pants and the couch and the bed. I've changed tactics since December 2018 in that the kitchen seat gets covered with Chux, the sofa has a removable washable cover and I say, "You stink" when the stank gets unbearable. The PCP's nurse told him straight out that "when you come here you smell bad." Not much penetrates and overall, the condition is about 25 percent better than in 2018.

Reminders of "it's time to change the pants and the Depends" work only part of the time so I switched to "you stink," which is more effective. His VA PCP requested an in home aide 3x weekly for 3 hrs. that is helpful since June 2020. Any suggestions greatly appreciated, thanks.

Adult Diapers Hygiene Incontinence

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Can you make changing them a part of daily routine? Like say, when it's time for lunch you say "it's lunch time, change your briefs and wash up and come eat."

Or I saw someone else said when dressing for bed, "Time for bed, change briefs and put on PJs."

If it's part of a routine, then it's not waiting until it's too soiled.

This is very oversimplified, of course, but it could be an improvement. And I think people respond to routine in a way that they don't to commands to "Take a shower, you smell bad." To which my father would say "Who cares? Don't like it don't smell me." lol

But if they have to, in order to eat a meal or prepare for bed, then I see it as being easier to accomplish.

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Thanks for the thoughts - he wears the briefs as PJs pants with nothing else and a tee as the top. If he didn't socialize at the place of worship, I could see him responding as does your father.

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My FIL was much the same.

Dad is changing only 3 times a week??? OMG I feel so sorry for you. The smell must be unbearable.

When I was caring for FIL I would simply refuse to take him ANYWHERE unless he had minimally washed his privates and put on fresh underwear. Once a week I insisted on him showering, but that was the best I could do. My DH felt I was very disrespectful about this, until dad had a full blowout in HIS car. That changed his tune.

He did cave in and clean up a little. He also still had MANY accidents as he did not like the depends and he'd try to sneak on a pair of thong undies.

It's so hard to be respectful of our elders, whom we love and only want the best for...and to keep them clean so they can get out and about w/o offending others.

I felt it was a constant battle and one I generally 'lost'. If I were doing it today, I would be a lot tougher, while still being loving. I've learned a lot--the hard way.

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Thanks for the support; it's my spouse but yes, the stank is awful. I apply essential oils like perfume on wrists when it's overwhelming. It's a learning curve and my old post held good advice re the covering of surfaces so I needn't do any more 11 p.m. laundry stints. I look at that old thread now and then. :/

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Pronker...request male aids. Tell whoever is arranging the visits that he will respond and comply better with a male. The job of the agency is to help you and help your husband. If these are sent by the VA contact a Patient Advocate and ask if they can step in and help arrange a male.

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Good advice, thank you.

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Hi Pronker. I’m so sorry you have been dealing with this. How about some type of reward system. Change your depends now and I’ll get you —— fill in the blank. Change your depends now and we’ll get a treat while out for a ride. While he’s up could you direct him to the bathroom and tell him cleans depends in there, please change now. Dr just called and said you must change your depends now. Your son just called and wants you to change your depends now. I’m not sure how far along his dementia is and if any of these things might work. Do you think he could not always remember how to change. Would he resist if you walk him to the bathroom and help? What a terrible situation. Good luck.

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Good advice - rewards might be the key. I just now thought that he may not see the blue marking clearly enough that designates the back of the garment and might be putting them on backwards? Then the distribution of filler would be all wrong.

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We had a problem with my mother shredding her Depends and trying to flush them down the toilet, which of course blocked the pipes and flooded the house. I called the Alzheimer's Association hotline and got some good ideas. We ended up disconnecting the toilet flushing apparatus and placed a commode in her bedroom, which worked. At care facilities, residents with your spouses issues are placed on a two-hour toileting schedule. Your spouse is not working with a fully functioning mind, so it is up to you to draw the line at going out in public with dirty diapers. Change brands and refer to the diapers as underpants or briefs or whatever your LO has typically called his underpants. Maybe your spouse can't get to the toilet in time and needs a commode nearer by than 10 feet. In this type of situation it is difficult maintain everyone's dignity. Give the AA a call. Best wishes.

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Thanks for replying about AA; I've not tried there yet for help. The VA supplies the Depends, which isn't their name but it's the one he knows so I call them that. When my mom was totally bedridden in a SNF for 3 years before passing, her 2 hour changing schedule kept her fresh as possible; I watched now and then and the 2 person job was completed neatly in minimal time. I've concluded that it can't be me relating the necessity to change because he's argued that he feels okay even when the pants and Depends stink and leak. He's gone nose-blind and I wish that I could. The one thing that forced change is that the place of worship called re the problem back in November 2019. He began taking a washable pad with him to sit on their cloth covered seating.

That's quite a problem with shredding the Depends and flushing them - you got good advice because who among us can shadow another person 24/7? We need to alzheimer's-proof the home when we used to baby-proof it.

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I'd try to work on getting him to change when he puts on his PJ's and gets up in the morning (hopefully you've been able to get him to change his clothes then)

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Oops, double post.

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When resistance to care is that extreme, I might explore professional care or placement. I can't imagine how stressful it would be dealing with that struggle every day in the home. Plus, all the work.... A facility would insure that he was changed regularly though out the day.

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Yes, I've certainly given that serious thought in a VA facility. The 9 hrs. weekly breaks have helped a great deal. I just say I am going for a walk or bike ride and leave. Last Friday he questioned that I was gone for so long and it gave rise to an argument.

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Does he shower? toss them out when he is in the shower.
Does he sleep? they rip apart at the side of the leg just begin the rip and they will rip all the way to the waist. No choice but to change them then.
does he use the bathroom at all? If so when he is in there a reminder to change them or again rip them at the side.
One of the "jobs" of the home health aid might be to change the Pull Ups and get him into the shower.

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No, he bathes 1x weekly and changes at that time, so the improvement since 2018 has been changing them maybe 4x weekly from 2-3x weekly in 2018. He's an incredibly light sleeper; the ripping idea might work if he falls heavily enough asleep. Yes, he uses the bathroom and tries hard to make it most of the time because it's only about 10 feet from where he sits generally during the day.

Other times, I believe he concentrates so hard on what he's reading that the urge rises and is ignored and then it's too late. Our Youngest told me that he was visiting and talking to his dad about something serious and he heard Spouse voiding into the Depends rather than break up their rapport. There is no way a brief is engineered to hold a full strength mess like that from someone on diuretics without it needing to be changed straightaway.

Aw, the first aide was male and worked wonderfully for 3 weeks, helping with bathing, exercising and changing the Depends! Then there have been 2 females since then and he only allows them to draw the bath, not stay in there with him, although the exercising works well. He's a very social person and tries to befriend the aides, which is his custom with anyone he meets, professional person or not. He gets intensely involved in their lives, takes everything personally, and so forth.

Thanks for responding.

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pronker,

Geeeeez, You have your hands full. I personally like the suggestion of male aides. It might be worth trying. Some men are old fashioned and can have a sexist attitude towards women. They aren’t going to listen to a woman. He very well may gel better with a man.

Can you block the ID channel and tell him that it is discontinued or that it is no longer covered in your area or plan?

Can you start running out for short errands when the aide arrives so he becomes more accustomed to your leaving? Let the aide guide him. They are trained in dealing with separation anxiety. Don’t talk over the aide.

You deserve a break!

Best wishes to you.

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Thanks for the reply - yes, it's a tough part of life. I do leave when the aide gets here for awhile that is a tremendous break in the week for 9 hours. Good idea re blocking the ID channel. Male aides seem scarce, but this is also a good idea since he has gotten belligerent on the phone and in personal meetings with women in authority, such as doctors and bankers.

What concerned me about this latest female aide is that she gets along very well with Spouse and when I was ten minutes late returning last Friday, he persuaded her to help him into the car so they could "drive around the neighborhood to look for me in case I had gone missing and then call the police." I believe she was placating him to de-escalate the anxiety and do not know what would have happened if I had not walked up into the driveway at that moment.

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ask for palliative care or hospice evaluation from doctor.

Calmoseptin is good for skin barrier.

ABri Form is a heavier diaper.. Might leak less.

A & D Ointment is good too for skin

Spouse agreed to wear Depends. He does not change them often enough, not even daily unless there is a bowel accident. Any suggestions?

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