Nursing home will not toilet Mom. What can we do?

Also he always wear Depends just in case of an accident or leaking, but they were having him use the Depends even for #2. That is not ideal esp for someone prone to UTIs.

We had this issue at one of the rehab centers grandpa was at. It was purely a staffing issue since one or two of the really good aides were still getting him up to use the toilet but other shifts weren't. Wewere concerned because they were hardly getting him out of bed so going to the bathroom was his only activity besides OT/PT. My mom talked to several staff members about it and just insisted they take him to the bathroom. I believe written requests might carry more weight. It's been a couple months and he can now transfer from the wheel chair to the toilet with his own strength, though he needs supervision. If they'd have kept him using a bad pan or diapers only, he'd probably be bed ridden now. Plus it was humiliating for him.

Maybe they just want to keep your mother safe rather than handle her too much.
It was the same with my mother, but we understood why eventually they used Depends. At first, when she asked to go, they would take her to the bathroom because she could not walk on her own and would fall every times she stood up. But, sometimes she couldn't hold it until someone was available . It was an ordeal - and it took a strong person to lift her out of the chair and onto the toilet and vice versa. It was also a fall hazard and she was very fragile and weighed about 75 pounds, working in the small space maneuvering someone who was weak and tried to do it on her own. Mom fell in the bathroom even though someone was there with her and broke bones. From then on, she had Depends.

If the nursing home doesn't have enough staff to consistently use the hoyer lifts, maybe you can privately hire someone to do it for your mom. I saw on the YouTube video how the hoyer lift is done. It looks very uncomfortable and high above the floor. My dad has a fear of falling. He prefers the hospital bed's railing be raised 24/7 even when bed bathing, because he might fall off the bed. He would definitely be terrified of the hoyer.

I might discuss their policy with the director and see if it's really feasible to put her on the toilet. My concern would be the lift. That kind of maneuver could be uncomfortable and scary for her. Also, is there risk to her body by using the lift multiple times per day? I'm not familiar with it.

My cousin has severe dementia and is double incontinent. She has no idea when she's urinating or defecating, however, the Memory Care staff still put her on the toilet at certain times of the day, just to see if she will go. She is in a wheelchair, but can transfer to the toilet with assistance. But, even doing that is scary. She gets very scared of getting on an exam table, stepping on scales, getting into car, etc. She seems to feel like she's falling and gets scared, says she's scared, and sometimes cries during these transfers. I can't imagine how she would respond to a lift. I don't think she could handle it and I wouldn't want to put her through that. And as far as her dignity goes. She doesn't seem to have any problem with being changed by the staff. They chat with her and it's perfectly normal.

Have you observed how she responds to the lift?

After she broke her hip it was not feasible to get my mom up at all or even to get a bedpan under her. A catheter was a partial solution. I think that the nursing home was truly trying to provide solutions in her best interest. Come to think of it, she was on hospice at that point, so maybe that was their decision.

In any case, few solutions are dignified once you are totally incontinent.

Even in a hospital they want them to go in a diaper as no one will bother even with a bedside commode as you have to then wait until they're done clean them empty the bucket etc

I've seen folks miserable waiting for someone to come change them which Bly happened twice a day - it's awful

My mom even with a broken back hates to wet a diaper - she says she's not a baby- for years I woke up to a trail of pee on the carpet because she couldn't make it time - I hated mopping it up but looking back it wasn't as bad as what will come our way next....

Jeannegibbs- I get what you mean. Toileting is a hot button with me because of my son. Rainman is completely nonverbal so one has to be familar with his signs that he needs to go or he needs to be kept to a trip schedule to avoid accidents. Throughout his school years it was upsetting the number of people who couldn't be bothered with a schedule even though he had his own one-on-one assistant. For me it was and is a matter of respecting him and allowing him some measure of dignity. I know it's different when it comes to the elderly and total incontinence. I just feel badly for my mom when she ends up in a soiled depends after she did the right thing by calling for help and then holding it as best she could.

grrr ... wish we could edit ... NOT helped to the toilet ...

Rainmom, your mom and my mom still know when they need to get to the bathroom. They may even be able to "hold it" for a limited time while waiting for help. This is NOT total incontinence.

But for someone who is totally incontinent, is there any point to seating them on the toilet at certain times of the day? What purpose would that serve?

As the two required assistants were using the lift machine to transfer my mother to the toilet, they chatted a bit about the "olden days." I commented that there was really not enough room to adequately get that machine around. (The building is 50 years old.) Yes, back when the nursing home was built if the resident could not be helped up by hand (generally by one person, but even with two) then they were simply bed-bound. Even if they were not incontinent they would be brought bedpans and helped to the toilet.

Technology and nursing home attitudes have come a long way. But there are still limitations we haven't figured a way around. I would think that total incontinence is one of them.

This seems to be an unfortunately common problem with nursing homes. My mom needs assist to get to the bathroom - she is somewhat incontenent largely due to not being able to get to the bathroom fast enough. Where she's at, she rings her buzzer when she has to go but by the time someone gets to her it's too late. I would think they'd try to get to her faster as surely it's much more difficult- not to mention unpleasant- to clean up the mess than to assist mom with the transfer to the toilet. This is my only complaint about where moms living - and I understand they don't have a ton of staff on hand or they can be busy with another resident... But still - it does bug me. I agree that helping someone to use the toilet if they are able to use it, certainly is the more decent, respectful and humane way to treat another human being.

Louise210, have you seen your Mom when the hoyer lift was being used?... how did your Mom respond to the lift?.... was she comfortable or was she terrified?

Why I asked was because my own Mom wasn't incontinent, but she couldn't walk or even stand. The only way of getting her to the bathroom was to use a lift, but my Mom was terrified of it. I happened to have walked into the room when the lift was being used to weigh her and I could tell by her voice she was really scared.

Thus, my Mom had to use a depends type item, which she didn't like, but there weren't any opinions. I couldn't imagine my Mom being lifted 3 times a day, why put her through that terrifying ordeal.

How can you tell if they are "totally incontinent ? If you can't get yourself to the toilet & can't vocally tell? How can you put someone to bed for the nigh & not give them a chance to relieve them self. This is how we treat a person?

Using the hoyer lift is only workable if the patient can hold the bladder and bowel until they get to the toilet. Once they are fully incontinent, diapering is the only safe method.

If she's incontinent, it would be difficult to determine what time to toilet her. It's possible too that because she can't stand, it's painful for her to be moved too much. I've gone through this recently with my loved one and as painful as it is, I've had to learn to accept that things have changed and she's no longer able to use the commode. If the nursing home staff is otherwise caring and attentive, I would trust their judgement on this one.

I don't think they have the staff to toilet everybody three times a day. I think that's the Humane thing to do who doesn't need to go at least 3 times a day. So I think they just put them in depends and when they are visibly wet or they smell really bad that's when they deal with it.

Oh dear.

Since I think you are right that toileting your mom would be easier for the staff (if it worked) than cleaning her up, I suspect they are not doing this for their own convenience, but because that is, in their judgment, in your mother's best interest in the current state of her health.

What do you think their motives might be, if they are not in your mother's interests?