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Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 9/16/10
I am caring for my 91-year-old father-in-law and he has Alzheimer's.  In the last three to four weeks, he has become very rude to the people who stay with him while I am at work and he has started to go to the bathroom on my floors. I don't know what to do about this.  Does anyone have any suggestions?


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Name: S. Houghton
Location: san jose ca 95136
Date: 12/30/2012
Time: 05:30 PM


My husband is 74 and has AD for 8 yrs, The AD home he is currently in (6 months)has threatened to throw him out for incontinence on the floors and wherever he has to go. No amount of redirection has helped. He is also angry/agitated and has hit the staff and gets into it with others

Name: C. Fox
Location: Panhandle of Florida
Date: 02/09/2012
Time: 12:55 PM


Dear Caregiver friend, God bless you for staying the course, even though it is very difficult when dealing with dementia and bodily functions, too. My best suggestion is to check for a urinary tract infection (UTI), with a urologist. These can change an elderly patient seemingly overnight. Also, it can be quite hard to get the help they you must persist. He cannot really tell you the symptoms and so put "CHECK FOR UTI", at the top of your list, unless you have already had that checked. Neurologists will tell you that they are often called in to consult for "difficult behavior", when actually the person needs a good urologist who will follow-up with the patient.

Name: Angelika Russell
Location: Tucson, AZ
Date: 09/16/2010
Time: 04:20 PM


The most important thing to remember is to not take your grandfather's behavior personally, it may just be part of his disease process. Is it possible that the people who stay with him during the day are not skilled in Dementia Care and possibly irritate your grandfather? Urinating in inappropriate places is common during the moderate to later stages of Dementia. Try a toileting schedule and look at the physical surroundings. Often places in the home appear 'just like the bathroom' and can be confusing e.g same wallpaper, a wastebasket that looks like a toilet seat etc.

Name: Karen
Date: 09/16/2010
Time: 11:22 AM


As Alzheimer's progresses the rudeness is a normal part of the disease. Regarding your father-in-law going to the bathroom on your floors: What does your bathroom look like? Does the white toilet contrast against darker colored walls and flooring? Is there a contrasting colored seat for your toilet? It may also be a good idea to apply red electrical tape to the inside rim of the toilet so he knows where to aim for urinating. Sometimes older Alzheimer patients cannot see blue tones well (they look gray), so you want to use another color. Do not place a dark colored bathroom mat in front of the toilet. Your father-in-law may see it as a hole and be scared of it and not use the toilet. Alzheimer's can impact one's vision and your father-in-law may not be able to find the toilet. Is he unable to find it when he's in another room? You may neet to put up signs and colored tape up on your walls with arrows to help him find the bathroom. Leave the bathroom door open and paint the door so it's different from the other doors. I hope this helps.

Name: kathy
Location: nh
Date: 09/16/2010
Time: 07:59 AM


This might seem too simple a solution but it helped with my Dad. We made it a point to bring him or suggest he go to the bathroom on a regular schedule rather than let him go whenever. About every hour we'd suggest he go and actually make sure he did at least go to the bathroom. He didn't always go at those specific times but more times than not he did.

Name: Joyce
Location: joliet IL
Date: 09/16/2010
Time: 07:00 AM


My mother had you know, dealing with AD persons is not the same as dealing with someone who has dementia from another disease. As they go through the advancing stages and deteriorate, they engage in behaviors that seem totally out of character for them in the previous years...even with AD. They lose their inhibitions, and toileting in "odd" places becomes normal to makes total sense to urinate wherever they are, whenever they wish. Does he wear Depends? Does he leave them on? Does the person who cares for him toilet him on a regular time schedule? If he has to "go" but cannot express it, the caregiver has to be alert to pick up the cues that the AD person gives off...agitation, starting to move a bit more....these were the clues my Mom gave...she had to go!! After we picked up on those, and toileted her on a regular basis, even if she didn't indicate by her behavior that she had to urinate/have a BM, we continued putting her on the toilet every 90 minutes (or 2 hours, can't remember exactly now...oh oh) The anger is so "normal" in AD....they are in their own reality and anything that is perceived as a threat or forcing them to do something they don't want to do or any of several other triggers, can cause anger. It is important that the all cargivers are trained in how to deal with AD and how to deal with the anger. Any type of agitation on the caregiver's part only will be reflected in the AD person and he may become more belligerent than ever, even lashing out physically. You may know all of this...I could write several more paragraphs but these are just a few things that may help you. God are in a stressful situation and take time out for yourself!



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