Alzheimer`s Disease/bathroom habits


My step father (age 92) will be visiting soon. He is an old farmer who wants to stand up to use the toilet. Unfortunately he does not have any aim any longer and frequently hits the wall as well as the floor as well as the front of his clothing at times. My Mom has requested he sit to use the toilet and his response is that he will go outside instead. Afraid the neighbors will not understand the new bush watering technique and call the police for indecent exposure. Pops has moderate Alzheimers and can think through some things but is becoming more reliant on my Mom to do everything for him. He can no longer shower or shave himself and even carrying a cup of coffee from the counter to the chair/table is not reasonable due to some knee issues and stability on his feet. They live in a small town and it is time to either put him in a home or get some in-home care as my Mom is 87 and not able to care for him day in and day out. His children do not visit or offer to help care for him so the full burden is falling on my Mom.
Do you have suggestions for coaxing him to change bathroom habits and any thoughts about getting some relief for my mom. I live about 1100 miles away from her but was there for 10 days this summer and am appalled that his children are not helpful in his care. They have been married 11 years and both had spouses previously that died after more than 50 years of marriage.

Hello Carol:  I'm sorry to hear of your Mom's burden of caring for your step-father.  I know very well how difficult it is to be so far away at a time like this.  
There are changes in the eyes as Alzheimer's progresses so you have to assume he cannot adequately see where's he's aiming for the toilet.  He truly cannot see a white toilet against a white or light colored wall and floor.  To help him hit the mark, purchase a toilet set of a dark color so it stands out.  Provide lots of lighting in the bathroom, and remove all rugs so if he does miss the toilet, it's not so difficult to clean up.  There is little likelihood that you or your mother can "train" him to do something different now that he has dementia.  You must learn to work with him at this level, and get into his reality. Another option would be to have a disposable urinal in the bathroom, and your Mom could accompany him each time he goes in.  He can stand at the toilet, but she could then hold the urinal to catch the urine.  She could tell him that it's the rule of your house, or make up some other reason for it.   
I agree that your Mom should have some in-home help.  Even if it's to clean and do laundry for her, or be a companion for your step-father while she gets out of the house for a couple of hours--it really is important and could save her life.  
It's very sad that his children are not involved in his care in any way, but there is probably not a thing you can do about that.  Make sure he has a designated healthcare power of attorney, and if that person is one of his children, then they MUST make decisions for him or surrender the POA.  Your Mom would be the most likely person to be the POA, but what if something happens to her?  Try to get that all nailed down so that his children won't be coming back to you and your Mom in anger when you make a decision they don't like.  
I recommend you and your Mom read my book "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" because it will give you many, many tips on how to interact with him in ways that won't upset him or frustrate you.  It will also give your Mom tips for how to better care for herself.  
I wish you and your Mom much luck Carol as you continue this journey with your step-father.  Cindy

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner


As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.


I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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