I placed hb in an adult care facility mid March of this year. Very nice 12 resident place with very good care, 25 miles from our home. About three weeks ago I got call from owner that I need to find another place. He had had a bowel movement and tore of his diaper, dug in it with hands and was licking hands. Also does not sleep most nights and talks constantly which the girl on night duty couln't stand. He goes on talking binges until he wears himself out and then sleeps, sometimes for couple of nights in a row. The poop thing has happened before with him smearing it around on bed, wall, etc. I am in the process of trying to find a good place that I can afford to pay for but it's hard, compared to where he is they are not in that league. I talked with doctor that comes into the home once a month day before yesterday and asked if he couldn't prescribe medication to get him to sleep at least through most of the night. He will up the night dose of whatever it is they are giving him for agitation and check in week to see if that is helping. Of course this is the office that doesn't seem to return calls(a corporation of doctors that visit care homes) when the home calls for something. We have a farm and son it running it and I don't want to have to jerk it out from under him(hb would never do paper work to get it turned over) Do any of you have experience with this behavior and were you able to find a solution? I suggested putting tape around diaper, they said they tried that. Also because you can't restrain them he has fallen trying to get out of bed. He can't stand, late stage memory loss, all that stuff.
I am sorry to hear you are going through all this. For my H, most of his acting out and expressing (?) himself with poo happened while he was still at home. With the help of divvi and others somehow I got through it.
He was in the ALF for only a brief time but they made it clear that as soon as was legally possible he would be moved at least to their memory unit. His neurologist and later his Hospice doc said he did not need a memory unit because he was not a flight risk and they also thought it would not really do anything for him.
I can't tell you how many times his meds were changed over the years. For soothing agitation the docs always went back to lorazepam (Ativan). I think the dosage was up to 2mgs qid. Specifically for sleep he was rx the generic Ambien ER @ 12.5 mg.
dorie, my husband has always been difficult and still is in mid-late stage 6. He doesn't sleep and always tears off the pull-up because he can't stand wearing them. He is still at home but when he was in the NH this summer for rehab, he was a very difficult resident. I will share with you some of what helped (still does) us.
The dr increased his Neurontin to 800 mgs at night in addition to his Seroquel (100mgs) and clonopin (0.5 mgs) That has helped my husband sleep at night. He still tears off the pull-ups but I have tried putting his regular cotton briefs over them. I am only partially successful with getting him to keep them on. When he digs into the poop in his pants, he has smeared it usually on a counter but knows it is something bad and doesn't do much else with it.
It sounds like your husband needs more meds to calm him down and help control some of his behaviors. I won't sugar coat this-getting my husband to sleep nights was almost a 3 year battle. We tried everything, most of which didn't work. Consider adding 10 mgs of melatonin ( OTC) to his nighttime meds...it could help. Regarding the pull-ups - I'm still fighting this battle too.
dorie try putting on pants with belt loops and put the belt on BACKWARD so the buckle is in the back. he would have to be very crafty to be able to pull it around thru the belt loops. its tricky this stage. poop behaviors are usually lines in the sand for most. and I am not sugarcoating anything here either. its terribly disgusting to deal with. I do believe I have been on my soap box lately about how meds need to be upped or reevaluated if they are non compliant with how we need them to be for difficult issues while in facilities. at home, well we do what we can, but facilities wont tolerate this behavior and have to take measures to ensure other residents are thought of. there are also one piece jumpsuits you may try on of those at buck and bucks who deal with dementia clothing. I think they snap up the back so they cant get it off. if he cant get to the diaper or poop he cant make messes. that's my motto:) yes its a bit more complicated to change them but I would rather change on my terms not theirs and after all everything should still be contained if all goes as planned:) I hope the dr can RX something to help him stay down at night and help deter his poop behavior. I tried these measures above and it worked for me. my DH would pull on his belt trying to get it off and he worked for hrs til exhausted. but in the end the pants were still on and diaper within. good luck to all of you dealing with this very unhappy time. divvi
I haven't reached this stage...and as Divvi said that's my "line in the sand". My heart goes out to you and I hope that you get some resolution very quickly.
Dorie, I am so sorry this is happening. We never had to deal with this so I have no pearls of wisdom to offer you. I hope you can find a better facility that is able to handle these behaviors.
I remember when Lynn was first placed they called an emergency meeting and in shocked tones expressed that Lynn was peeing all over the place! One lady said he is even urinating out the window! They then asked what I thought we should do about it. I couldn't help it I had to laugh. Hello! YOU are the experts! If he wasn't having issues like that, he wouldn't have needed placement. At home he was doing this and much much worse. I told them to be grateful he wasn't pooping in the drawers too!
It just baffles me that facilities are not better able to handle these issues. We place our loved one when we can no longer do it alone and trust that with 24/7 trained staff thay can and will deal with these behavioral problems.
I am so sorry for all of you going thru this, I just hope my dh doesn't go there. I would try the backward clothes. My X also ended up with ad, he would poop in the trash can, his sister would go to her bedroom door and squat. His son ask about this at the nh. He was asked if they grew up using an outhouse. The answer was yes. They had reverted back. I know that isn't always the reason, but a thought. I guess paint a moon on the bathroom door. Love, Bonnie
Nikki, I've wondered the same thing about why NH staff isn't better prepared/trained in dealing with the peeing/pooping issues. Surely they've had hundreds of residents who are incontinent and men in particular can pee just about anywhere. When Rich was in NH this summer for rehab and peed on the floor the staff was also shocked and told me the behavior had to stop. Well you deal with this every day and have a dr who visits 2-3 times a week, surely you know how to manage this? I too am amazed this is such a problem for a 24/7 staff.
Thank you for all the support and I've looked at some of the dementia clothes on the internet. I will discuss the clothes with the staff to see if they would actually use them before I invest. He wears sweat pants so would have to change to some with belt loops to do the backward belt. Going today to a support group meeting with human development commission so may get ideas there, the meeting speaker is elder care lawyer though so subject will be on finances. I haven't gone to these meetings before but desperately need financial help too. Friend who asked me to go says the lawyer will give 1 hour free consultation which may help me get a few answers to questions about how to proceed. I have questions about trust for spousal support. Do any of you have one? This is just such a mentally draining situation to be in. Wouldn't it be nice if all alz patients were like the ones in the excelon patch ads, so quiet and calm and smiling?
dorie--it sounds to me like your husband may need a stay in a geripsych unit to get his meds regulated. See if the doctor who is treating him can make a referral. Medication adjustments for a dementia patient who has difficult behaviors are hard to do in a regular facility, especially when you have an unresponsive team of doctors treating him.
http://www.buckandbuck.com/mens-adaptive/jumpsuits/back-zip-jumpsuits/mens-solid-sweat-jumpsuit.html you can find these jumpsuits that zip up the back. they look like a regular pair of sweats! nice. one as an investment may be the way to go. $42 dol per jumpsuit. I think this would best deter them getting into the diaper, but the belt turned around is also a working idea. you can find regular pants with belt loops at discount centers for very cheap. if they are really with it, this jumpsuit over the depend covered with a plastic sani pant on top of that will work! :) and its not a question of if they would use the clothing if its in his best interest. good luck dorie.
Dorie I am so sorry that have something else to face. However, I think that if I had poop in my pants, I would want it out also. How long do they let him go with it before they change him. I know that some places only change the diapers at certain time intervals, not when they need changing. It would seem that professional staff would recognize when he is usually dirty and try to stay ahead of it.
Yes LFL, it boggles the mind that behavior issues would be considered a problem. It's an Alzheimer's unit! What did they expect?
One thing that would worry me about a belt in the back and perhaps even a zipper if it is larger, would be could it cause skin breakdown? Lynn has reached the point that even with an excellent turn select bed if he has clothes on in bed it can damage his skin. For this reason he now only sleeps in hospital gowns and I bought him super soft sheets. He hasn't had any breakdown in the 3 years since we have done this. Just a thought....
I know where Lynn is they have had residents who do "poo art". I am not sure what they did to try to resolve it, I will ask some of the aides today. I hope your meeting goes well Dorie.
divvi - what would we all do without your expertise in almost everything. You are certainly the "go-to" gal. I truly appreciate you, my friend. Yes, that "poo" art would be very disgusting to me. However, I never thought I'd be cleaning a grown man in a public restroom after a "blowout", either.