Monday, May 25, 2020

Alzheimer's and Feces

You read it right, it’s poop! Oh yes, we are going to talk about poop! Why? because it’s one of those things that causes a lot of stress and chaos when you are in the midst of it, and we need to be prepared mentally and physically (to clean it up!). It can literally turn into a sh** show very quickly. Where do I start? Well, I don’t know why, but there is a turning point in Alzheimer’s and Dementia patients when they become fearful, not aware of what it is, or where it's coming from. They don’t know what is happening when they are in the process of pooping, they don’t make the connection from the brain to the body where the brain should be communicating to the body what needs to happen next. In a normal situation, it would be going to the bathroom, in an actual toilet. I've witnessed people wanting to go outside, in the lawn, in the trash can, or the bathroom sink. Many times they do make it to the bathroom, and they just stand there, they are lost not knowing what the process is, They have pooped, they know something is not quite right, but they don't know what to do next, this is when the walls can get painted with feces. As they try to "clean up".

Gross! Mega gross! Yuk, OMG I’m going to vomit… I’ve had my share of rivers, artwork, and paths of it! I know, when you walk in you can’t believe your eyes, the hairs in your nose are burning with the smell, you are dumbfounded, you can’t comprehend it and then boom you want to scream, run away, and freak out! NO, no! you need to remain calm! (Remember they react to our emotional states) go find your gear; gloves, mask, hair net, and lots, of wipes and bleach! Let’s not forget the trash(s) bag and about two rolls of paper towels. I hope you are not allergic to bleach because you will need a lot of it. If we want to avoid a bigger mess, you need to remain calm. In a very serene manner, you ask the person to sit down, in your most sweet voice you instruct them on what to do, tell them what will be happening, and reassure them that they are safe and that you are there to help them. Depending on their state of awareness is how they will react, you are familiar with their emotional states figure out how to best communicate and direct them. Do not scold them, argue or try to reason with them, this will only complicate the situation. Trust me you don’t want to aggravate them when there is plenty of feces around, you might end up taking thirty showers to take the smell away.

My mom has developed this habit of hiding her soiled (pooped)
undergarments. It has become a problem since she insists on doing her own housework and doesn’t let her caregiver come into her house. Can you imagine the smell that brews! Oh my! My sister has become the designated one to go clean her house.
And she has found several surprises. Of course my mom’s reaction is not a good one; she usually locks herself in her room (not literally, her room doesn't lock)and has a huge meltdown. Her bad mood usually lasts several days, unfortunately for her caregiver. I don’t know what it is about poop that causes them to be very confused about it. I remember one time I was on one of those walks we use to take with our group of patients, when suddenly I see, from the leg of the trousers of one of the patients a large piece fall out, the patient was oblivious to this and continued walking like nothing happened. I couldn't believe that he hadn't noticed. I had to radio to bring something to clean it up.
There are a few steps that you may want to take to prevent/limit the incidents that may occur. Be vigilant of their diet; you would want to avoid feeding them something new if you are thinking of being out of the house. Medication may also be the culprit, especially if it’s a new medication it may cause major havoc in the bathroom. Be aware of dairy! and dairy products; believe me when I tell you they can become your enemy!

Be prepared – when going out have a “clean up bag” ready. What should be in the bag? wipes, lots of wipes, antibacterial, rubbing alcohol or hydrogen peroxide( can be used as a disinfectant use with caution it can cause stains like bleach), several black trash bags (you don’t want to advertise the mess you are in), gloves, hair net, a small bottle of a mixture of bleach and water, if you can find a gown like the ones that the ER nurses use a disposable one preferably, goggles and if you are like me a face mask, and finally very important, a change of clothes for the individual. I always carry a nice smelly lotion with me, which in this situation I use a little dab of it right between my lip and nose, I find that this neutralizes smells whatever they may be. In my car you will find a laundry soap container the ones that have the stopper, filled with a mixture of foamy soap and bleach. I use that as my hand washing station along with a roll of paper towels. Please remember to remain calm like the sea before the storm. Mind your tone of voice and body language for a pleasant cleanup.
It's not an easy road, it's full of bumps along the way. we will travel it together.

Be Prepared, Be Informed, Be Empowered.
I send you lots of positive virtual energy.

With gratitude-