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My 98 year old father has his mental faculties but due to spinal stenosis has lost his ability to stand, walk and therefore manage his toileting on his own. My 98 year old father has his mental faculties The LTC facility has become reluctant to help him on/off the toilet which frustrates him to no end.


How do I get him to accept this situation and the humility of a dirty diaper?

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I would work with the facility to see if they can help him with more trips to the bathroom. Advocate fiercely.

He shouldn’t have to sit and wait in a dirty diaper. If this is happening for more than a few minutes, become a squeaky wheel. Healthcare professionals understand that beyond unsanitary and humiliating, this can be dangerous.

Most of us will probably have toileting problems someday. Talk to your dad with gentle kindness.
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Candyapple Sep 2021
good answer. your correct the caregivers, facilities understand. they may not like it but that's what they signed up for. dad is still independent and should be encouraged and treated with kindness as u stated.
(3)
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My mom will be 90 on 10/26 she has dementia she wears
adult pampers we call them underwear and she doesn't think it's a pamper try that and see what happens Do you have a portable toilet for him to use in his room? My mom can't walk very well she shacks when she standup we have one in her room we put it right beside her bed when we get her up to use the bathroom . Yesterday I talked to my Dr she told me to get some pads that she can lay on at night and leave the dipper off of her at night and just check it ever so often and if it's wet remove it and put a dry one down under her
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My dad had his mental facilities up to his passing. He was incontinent. Mom used some type of urine collector that was put on every day and secured with the absorbent adult diapers for any leaks. He didn’t move without help. That meant the only time she needed to assist him to the toilet was for his bowl movements. He slept with the urine collector. I never saw it but I was told it gave him the ability to not use the bathroom multiple times a day. He drank at least 5 12oz containers of water a day to keep UTI at bay. As far as the LTC, that is an issue to bring up to the nurse in charge (the top nurse responsible for the facility). Find out what she/he recommends and the commitment. Then, I would get a Alexa Show and use the drop-in to see your dad. He can also call you by telling Alexa to call. When you get the call from him that he needs help, call the facility to get your dad the help he needs. I would also get fax numbers/emails and give feedback to the staff and the administration on how his care is doing and not doing. I do that now with my mom thanking them for their care of my mom and the current situation that I need to talk to them about including details. This process of conversations, emails and faxes have been helpful to me since my mom is now in Assisted Living. I am actively involved. I have found improved relations with the facility and they know my advocacy for my mom and my sensitivity to their care and compassion for my mom. I also pray before every call and conversation for wisdom and receptiveness for both the staff and myself. My mom has mild/medium cognitive disorder and needs help with showering and dressing but refuses because she “is not a baby”. So I hired a friend who comes over once a week to shower her and get her into her clothes. This solution of hiring a 1/time a week for my mom will not help your dad with incontinence. However, your question helped me prepare for the inevitable future. Thank you.
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my opinion i would try getting a counselor, i also would sign him up for yoga, exercises to bill strength and get an nutritionist. try that i think it will work. instead of telling him to pretty much give up. try encouraging him. tell him he can do it. all things are possible with GOD. i think this will turn out GREAT!
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Midkid58 avatar
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Midkid58 Sep 2021
Candy--
Spinal stenosis is a life changer that cannot be made 'better' by good nutrition, exercises or yoga.

Besides which, this gentleman is 98. His family is working to make his EOL experience have some dignity.

All things ARE possible with God. I think this OP is just trying to keep that dignity for her dad.
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I am concerned that the LTC will not help him as much on and off the toilet. Your father should be placed on a toileting schedule - being offered and helped onto and off toilet every 2 hours while he is awake. This is a routine well within the abilities of all LTC facilities. Talk to administration about this.
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I am shocked at this. When I worked as a professional carer in a care-home I had to help the elderly residents with their toileting. It's obviously not their fault. It's hard for them to lose their dignity. I am in England so we have different healthcare. I don't know what LTC is.
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craftslady1 Sep 2021
LTC is an abbreviation for "long-term care." I am often confused by the abbreviations that people use on this site, but I do know this one!
(4)
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You don't.
No Adult with their mental faculties likes having to wear an Adult Diaper and your Dad will never like the idea.

He shouldn't have to soil a Diaper as someone should take him to the toilet if he can get there with help from his walker and or wheelchair..

He should never have to stay in a soiled Diaper.

You should have a talk with the Care Home he is in and if he knows he has to go, they should take him.

But know, that most care Facilities are Understaffed and they do what is easiest for them.
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Will he use a condom catheter? Stand beside the bed and use a urinal. A urinal is not the best solution but you got to find something that he's okay with. Don't call them diapers call them underwear and you can put a woman's pad inside that we used for our periods to catch more urine so it doesn't leak
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How do you get him to accept the situation...

Well. How would you go about accepting the situation if you were in his position? Continent, fully aware of events, but denied assistance to transfer to use the toilet? Oh well, just one of those things, eh?

If your father is truly unable to stand, even using a stand-aid or turntable, then what's stopping the LTC using a hoist? I have to say if this were my Dad my energies wouldn't be spent on teaching him humility. I'd need them all to restrain myself from punching the head of whoever's in charge.
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He is not infant having a diaper change. He is wearing disposable underwear or call them by their brand name. He does not need to learn humility. He needs to be treated with respect. Words matter. My uncle's facility does not allow the word diaper when discussing the underwear. My Mom terminated her caregiver when she asked mom if she needed a clean diaper. Talk to the director of nursing about him being assisted when needed. It's their job and what they are paid for.
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Please stop calling them diapers. Call them 'big boy pull ups', 'big girl pull ups', pull ups or even underwear. If they can't be pulled up/down, the facility should have garments that are taped on. The facility nurses here in our town are trained in how to put them on or take them off if the patient cannot get up or use a chair side commode. And yes, I understand that all modesty and dignity are lost during the later stages of life. Keep the patient covered as much as possible. Just change them as quickly and quietly as you can. My 90 yo husband spent time in the hospital and then in a rehab facility. It is most definitely a learning experience for the caregiver.
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Countrymouse Sep 2021
I'm not *completely* sure that calling any item of clothing to be worn by a senior "big boy" anything is much less demeaning than "diaper."
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Why can't he have a bedside toilet just a foot or so from his bed? If you use disposable plastic liners in the bowl, clean-up is usually a breeze because you simply lift out the liner, tie it shut, and throw it in the trash. There is no reason whatsoever for him to have to walk to a bathroom.
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The LTC is "reluctant" to help him toilet??? Seriously??? That is part of their function. Not sure where you are located but I realize that in the US there has always been a bit of a problem getting good staff to due "low level grunt jobs" at healthcare facilities; this has become even worse now thanks partially to the pandemic and partially to the widespread practice of low pay and a very limited career ladder for CNAs. In NJ the Gov recently signed into law the following staff ratios for LTCs:
1 CNA to every eight residents for the day shift
1 direct care staff member (RN, LPN, or CNA) to every 10 residents for the evening shift
1 direct care staff member (RN, LPN, or CNA) to every 14 residents for the night shift

Now if you have ever worked in a busy care center you know this is still stretching it (did I mention that LPNs are hard to come by also? Everyone who can possibly make the attempt is reaching for the higher paid (but still sometimes under appreciated RN title) because of the high number of people who need to be assisted with eating, taken to activities as well as toileted (and some of them may be a 2 person assist; an LTC can get into lots of trouble if a single CNA tries to help a 2 person assist to the toilet). Now add to the fact that on almost any shift you are going to get call outs for any reason (covid positive test, sick kid, no childcare, no transport). LTCs are required to be registered with nursing agencies who can provide coverage in these situations but they will have to find an available staff member within traveling distance (this is going to cost the LTC more than their own staff) who needs time to get to the facility and who is possibly coming in cold (doesn't know the staff on duty or the residents) and has to read charts to find how who is in need of what. Unless a resident is really lucky.... they are going to wait at least 15 min for a trip to the toilet. It's unfortunate but it is the reality of today's industry. Sad really.
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One important aspect of allowing your father to maintain his dignity might be to stop using the word "diaper." He has disposable underwear. Older adults are not babies. It is a bit demeaning to refer to them or their clothing in language used to refer to babies. This may seem like a small thing, but it may mean a lot to him.

I would also question why those who have been hired to care for him are reluctant to assist him with his toileting. Have you addressed this issue with them? Are there factors of which you are unaware?
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I would talk to the facility to see if you buy a bedside toilet, will they help him that far to use it. -- IMO, the don't want to take him to the toilet because it takes too much time. It's a slow process and they don't want to waste that time in his room - they help him get there and then have to stand there to wait on him. I'll also say when they slap that diaper on him, there will still be no speed to come to the room to take it off. So there he sits in his own you-know-what.

Think about it from his perspective - if I put a diaper on you and told you to do your business in it, your brain will go nuts because you've spent all your life since potty training trying to make it to the toilet. Your brain knows it's not right.

I would ask facility to give him the extra time to be able to use the toilet as long as he can without uncontrolled accidents. Just explain it to them as you said about trying to get him to accept it - it's all about being humiliated.
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When caring for patients. I use the word " brief ". I personally would never call them big boy underwear. These are grown adults, and need to be treated as such. I would be pissed if someone was talking to me like I was a child. They are parents, grandparents. Imo they should always be treated with the same respect they received before their illness. Good luck to all caregivers., family members, and patients. Prayers for strength and guidance for all !
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