PWD refusing to pee with aide, instead ends up going on floor, help!

blues · September 11

Looking for tips to improve a situation! My husband is not incontinent but sometimes needs help in the bathroom, either verbal cueing, or sometimes a bit of physical guidance, to either stand close enough to the bowl to aim or to sit down and pee that way. The problem is that now I'm back at work, the aide (who's in her 3rd week) cannot get him to pee in the bathroom. He shows very obvious signs of having to go, walking repeatedly back and forth between his comfy chair and the bathroom. But he rejects both her verbal encouragement and her gentle physical guidance (which she doesn't try first). She will stay outside the bathroom invisible to him to give him privacy, but he just turns around and leaves the bathroom without accomplishing anything. He sometimes pushes her away or verbally protests ("I don't want to"), even tho he generally doesn't talk much anymore. In the end, 3 days in a row now, he ends up peeing in his pants about halfway between his chair and the bathroom. And after all that, he may resist her efforts to clean him up. In short, he's resistant to this aide's help in the toileting department.

She is not inexperienced with dementia patients, and she is kind and patient, but he just seems to reject her efforts to help. There are other ways in which he allows her to care for him, e.g. putting on shoes and going for a walk outside, eating the meals she prepares.

I'm wondering if this aide is just not going to work out (mainly because of him), or if we're missing some obvious way of making this situation better. I don't have the same problems with him at all, but she's not his wife so it's a completely different relationship. I have told him (kindly) that when she's here, she's in charge and that he needs to let her help him, even in the bathroom. He agrees in those moments, but obviously he may well forget later in the day. Possibly he just needs more time to get used to her? How long does it normally take? Any thoughts about what to do? I just have no idea.

Lgb35 · September 12

I wonder if he would be more cooperative with a male caregiver. You could also try the briefs that fit like underwear as a back up plan. That way if he has an accident and is reluctant to get cleaned up it’s not as urgent.

SDianeL · September 12

I don’t think the aide is the problem but you never know. The problem is that the PWD forgets how to use the toilet. They may also have visual problems. I put an LED battery operated light on the back of the toilet tank. They also recommend that you get a bright toilet seat. They make red ones. I also put toilet bowl cleaner in the tank that turned the water blue. He might also pee if she can get him to sit. They make male splash guards for that purpose. You might also try a red urinal. I remember a dementia caregiver video about toileting but don’t remember who made it. You could try searching for it. I’ll also see if I can find it. To get him to wear male depends, replace his underwear with them and say there the new thing or another fiblet that might work. This is a tough one!

SDianeL · September 12

https://www.alzheimersblog.org/2016/09/06/toileting-tips-tricks/

SDianeL · September 12

Search for this video: “Time with Teepa: How to Help Males Living with Brain Change Manage Incontinence” by Teepa Snow.

JDancer · September 12

https://alzconnected.org/discussion/comment/253321#Comment_253321

My spouse wears incontinence briefs, but still pulls his penis out and goes on the floor

blues · September 12

Thanks very much for all these replies. I do actually think the issue is the aide, being unfamiliar and perhaps being female (It is so much work to swap out aides!) I say this because tho it's a given my husband needs some assistance using the toilet (despite motion sensitive lights around and in the toilet bowl), I myself have no problem coaxing him into the bathroom to either sit on or stand before the seat and even at time he doesn't really have to go.

So I think my question is very particular about getting him used to a newish aide doing the same — is it just a matter of time (and how long to expect)? should I have her in the room a few times while I lead the process, or me be in the room when she leads the process? are there words she could say that have worked with others? Just seeking some tips from the collective expertise. I can't imagine we're the first people to have this issue.

Metta · September 12

Could you try to be more present in the beginning during the transition to help DH over what may be some anxiety with someone new? Maybe just for a week? I feel for you!

Timmyd · September 14

I have no expertise in this subject. I am only communicating my own experience. With matters of personal care, DW is more comfortable with our female paid companion than she is with me. I get the feeling that with certain types of help for DW, gender matters to her. It is just a guess. I have read it is not uncommon that PWD react much differently when offered help with personal care depending upon the person offering.

Most of the available aides for hire were female applicants so I never had to consider using someone of a different gender. It would have been very hard for me have to hire a male caregiver to help DW with personal hygiene matters.

PWD refusing to pee with aide, instead ends up going on floor, help!

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Search for this video: “Time with Teepa: How to Help Males Living with Brain Change Manage Incontinence” by Teepa Snow.

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