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Patient refuses to go to the bathroom
mwdobrow posted:
My father-in-law is late in his disease and refuses to go to the bathroom and refuses to allow us to put depends on him as well. We have tried every type of coaxing but he gets very determined and refuses. He may go all day without urinating and days without a bowel movement. Does anyone have any suggestions? Of course the nurses are aware of this problem (Hospice care) and try to guide us but I wondered if there were any real life caretakers out there that have experience with this problem. Enemas are the usual course of action for no bowel movement (after 4 days).

He no longer communcaites at all just random words we do not understand. We try to understand but have had no luck. This makes it very difficult. He fell the other day and really scared us...he is OK but he is very unstable. Without the ability to communicate we are at a loss as to how to deal with this new behavior.

cjh1203 responded:
Hi Mitchell.

If he goes all day without urinating, and days without a bowel movement, that sounds more like a physical problem than one of being stubborn. What do the nurses say? Have you spoken to his doctor about it?

One thing I know is that coaxing doesn't work with Alzheimer's patients.

When my uncle became totally incontinent and refused to let my aunt put Depends on him, the nurse just said, "You have to wear these. It will be much better for you and for your wife", and he didn't put up a struggle after that. Maybe the nurse could tell him that the doctor has prescribed them.

It does sound, though, like something is going on physically and he may need to be checked out by his doctor.

Good luck. I hope you will let us know if there's any improvement.

Judith L London, PhD responded:
Hi Mitchell,

What a dilemma. If your father is OK physically, approach him by not asking a question but stating that it is time.Imagine how he might feel about this issue, and verbalize your guess.

Make the bathroom inviting- if he likes music, have it playing. Does he fight the administering of an enema? The caregiver could try a urinal, and make a point to respect his need for privacy. Using Depends is demeaning for most people, so he might be reacting to that.

Again, make a guess about what he might be experiencing and verbalize it to him. Understanding can go a long way toward cooperation.

If he is not eating then he might be entering the last phase of this disease. Comfort care is usually the credo of hospice, so maybe that's what is called for.

Take care of yourself too, You've been a good son.


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