Thursday, June 24, 2010

THE 2 Ps (Warning! Unpleasant Reading!)

 The 2 Ps

The following is a post from by Denise Brown, on Incontinence.  It is a good intro to what I want to share on the topic.

How Do You Deal With Incontinence?

About 18 years ago (wow!), I helped friends care for an 81-year-old woman named Evie.
I can remember managing her incontinence like it was yesterday. Incontinence has a way of staying with you. She wore Depends during the day, which she hated. The dressing-for-the-day ritual included her throwing the Depends against the wall and stating, “I hate that thing.”
Getting her to wear the Depends was nothing compared to changing the Depends. I remember one unfortunate episode when she began disrobing because of an incontinence episode that, unfortunately, was still occurring. As she walked across the bathroom and left, well, a trail of incontinence, I followed behind with paper towels and wash cloth.
Evie was a very proud woman. But, the Depends and incontinence humbled her. It humbled me, as well.
Managing the incontinence is not for the faint of heart or for those with the sensitive stomach. It’s kinda smelly, pretty gross and awfully embarrassing.
It’s also not something that you can really speak about. So, you go about your day, doing what needs to be done.

"It's not something you can really speak about."  Why not?  This is a very real very normal, very "crappy" part of caregiving.  Of course not everyone has to deal with the 2 Ps, but I say statistically speaking, the greater percentage of caregivers do.

"Managing the incontinence is not for the faint of heart or for those with the sensitive stomach. It’s kinda smelly, pretty gross and awfully embarrassing."  Yeah, my son said to me one day after I was going over some of the P issues I had been dealing with,  "Mom, you have got to have a strong stomach."  Well, I probably do, but that is not what enables me to be elbow deep in poop at times past. It was the decision, the realization, the knowing I was the only one to get it done, which began back in 2006 basically.  In my early blogs I write about "If I Don't Do It, Who Will?"  Making the transition from daughter to caregiver, changing into my caregiver coat, and each day checking a pocket to see what new or continuing task must be done that day.

BM, or bowel movement, stool, elimination, incontinence, I don't have time for such "clinically correct" terms.  They are cover ups of a immensely unpleasant reality, my mom has no control over when she pees and poops!
Am I being disrespectful towards her in discussing such personal things like  Cleaning up after our parent when they pee or poop is one of the hardest and worst thing that we have to go through.  Can I get an Amen here?!

When I became mom's caregiver, she was still using her potty chair in her room, and she could still use the regular bathroom.  But things were changing, and I was not accepting or acknowledging them.

I have not listened to my intuition at times which would result in more then a "Cleanup in aisle 2!" (thanks DR, lol)  But a cleanup from the carpeted living room into the kitchen and into her room where plastic was then layed down.  I am very cautious now, and listen to that maybe yes or maybe no little voice!

There is a method I came up with called Excavation, when mom would get too constipated and her stool softener was not helping.  I won't detail it out here, but it works and if you have the stomach for it, I can fill you in, just email me.  But here is what I use, a potty chair, plastic bowl, large sheet of plastic, dry and wet wipes, Vaseline, latex gloves, small lamp and 1 or 2 towels.  Like I said this works, and it is work, but gets the job done.  Room spray......

In November of 08, mom came down with the flu and had severe diarrhea.  It was so much work changing her and everything else in the bed, and the smell after a few days was enough to make me pack and go far away!  I wrote about it briefly,

I know it is hard to accept what is going on, and make the changes needed, but we have to and the sooner we do, the easier it will be for us, for our caree and cleanup will be easier too.  Protect all the areas that your caree will be sitting or laying, use sheets of plastic, towels, sheets, whatever it takes.  Designate one seating area for him or her, limiting their places to sit will cut down on how many pieces of furniture, or places on the floor that you might have to clean up.  Don't forget to protect the bed in the same manner!  I started doing all this I think in 2008, and increased the protection early part of 2009.  Now since using hospice, along with mom's decrease in eating and eliminating (I know, there is one of those clinically correct words),  I don't have plastic or towels or extra draw sheets on her bed.  She uses a electric bed with electric air mattress, which has a cover that is removable, then I just use a regular mattress pad and sheets, on those I use the blue/green pads from hospice.  In her wheel chair is a gel cushion with a blanket or towel and a blue pad on that for protection.

Yesterday was the day, that company shouldn't come over, as I began this post, she began her business lol.  She hadn't pooped since last Monday.  It is almost a celebration when she does because of how being so backed up affects her moods and physical functions.

What else can I say here, I don't think I mentioned the diapers did I, well I began using those on mom last year when so many things were changing and she was declining in so many areas.  It was not a welcome expense, but they were a necessity for sure as nothing was staying dry or clean.  The diapers do not guarantee no mess that is for sure, still protect where ever your caree will be sitting or laying because these pants leak as much or more then kids diapers!  A blessing was, once we got hospice help, all the diapers and all other supplies were provided.  Only her nutritional drinks are not covered, and it is medicare that covers these costs.  Oh yes, with the diapers, I would for awhile, cut one down and use it as an insert inside the one mom was wearing to give some extra protection at night.  Sometimes it worked, aannnddd sometimes it didn't!  I don't do that anymore because she doesn't drink anymore, have to mix any liquids in her nutritional pudding, so she doesn't pee as much as she used to.

Ok, an unpleasant topic as I forewarned.  I had considered making it much more yucky by detailing some of the things I have had to do with mom, like the Excavation...but I decided to be merciful, lol.  But I do not have a problem discussing any of this with anyone who needs help.

Some final words, I hate doing this...I hate cleaning up my mother's pee and poop...It was one of the worse adjustments I have ever had to make in any area of my life, ever...I have some background as a aide and worked in nursing homes about 40 years ago, only helps a little!  It is not the action that has been traumatic, it is that it is my mom I have to clean up.  But, I stepped into that role of caregiver, put on that coat with it's myriads of pockets, and one day I pulled out of a big big pocket that's time to clean up your mom when she pees or poops on herself and anywhere else....I don't think I have too many pockets left to look into, I hope not...


National Association For Continence  Up-coming Webinar on Incontinence
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Wednesday, June 23, 2010


I have written about how even though this is my favorite time of  year, it is also my worst time.  This is the season of picnics and parades and outdoor parties.  We do get invites, but often the work involved to for both of us to attend is just to much.  Setting up one or more sitters for mom so that we can go to a gathering, and not watch the time to rush back home.  It is no fun at all when we have to go by our self, and one stay home, so most of the time, we just don't go anywhere. 

As I thought about this, I went back to my being invisible post, where I had talked about how I had wanted someone to bring me free pancakes at a local spot was offering.  What if family/friends considered bringing a dish or even more then one from a picnic, cookout or party, to a home where they knew a caregiver was, who couldn't get out and enjoy these functions?  Does anyone think about something like that?  I am not just referring to myself and my husband, but any caregiver who cannot go and enjoy these good times in the summer.  Of course this can apply to any holiday or function where food is involved, and these individuals would be there if it was not for their caregiving responsibilities.

The 4th of July is coming up, it will be a quiet and lonely day, watching all the cars driving by going to the parade and then back home to get ready for their picnics and cookouts.  Then at night driving downtown to watch the fireworks.  Some of these things, we pretty much stopped doing long ago when the kids didn't want to anymore.  But to have a choice to do them, that we really don't have anymore.  

It is not just missing out on all the wonderful summer foods, some of which we could fix, but it is certainly not the same, it is that someone thought about us, and they took the time to bless us with some picnic goodies.  It is not being invisible, it is someone caring about us here within these 4 walls. 
Does anyone ever think about what good deed they could do for someone?  Well, here you go...go bless a caregiver with some wonderful summer treats!  Little things mean alot believe me!
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Friday, June 11, 2010



The masks we wear...
Comedy and tragedy...
Concealing that which is truth...

Is caregiving like a Greek play...
Do we play multiple roles...
Do we change our masks, as we change our moods...
Humor, not always humorous to those who hear it, sometimes is actually shocking or appalling.  Such humor is needed to vent, to unleash a multitude of negative emotions from inside you, that if allowed to fester and multiply could cause a messy and noisy explosion!
Caregivers need to express and embrace humor.  Some instances of humor may only be funny to the one who is speaking it because it is their way of venting.  Other instances of humor may be able to be shared and understood by many.

Non-caregivers or the general public, are often shocked or appalled at certain humorous statements that might be made by a caregiver.  They may encounter such a statement with, "How can you say that about your mother?!"  At which we might respond with,  "I am not serious, obviously!"  Possibly a few more statements thrown in like, "Ease up!" or "Chill out!"

A few examples from my own personal "joke" files...
"Going to put mother up for sale!"

"Going to put her on the curb!"
"I'll help you pack!"  (After she has informed us she is moving out.)
Now really, am I going to put mom up for sale?  No.
Am I going to put mom on the curb?  No.

Are we going to help her pack?  Welll...I'll have to think about that one.  No, of course not!

These are statements that help to alleviate moments of frustration, blow off some steam.

As my husband said the other day, these kinds of comments, "Soften the blow."

Caregivers who deal with the blow everyday, will understand this.

In her blog, Mothering Mother and More, author/speaker, Carol O'Dell states,  "Laugh whenever you can at whatever you can.  Be irreverent, be snarky, other than downright cruelty, laughter is so good for you that you need to see the humor and craziness of your situation.

Irreverent, snarky, (I like that word!)  That is what caregiver humor is at times, it is not meant to be cruel or disrespectful.

Carol has a funny video on youtube called Humor Caregiving  

Elaine Sanchez, another author/speaker, talks about the need for humor in her article,  How to Stay Positive - Three Tips for Caregivers
"We talked about how we had changed because of the illnesses.  He said he and his wife have developed a greater sense of  humor.  They see things funny that I guess most people wouldn't. I told him I had developed a detached attitude. He calls it creative indifference and he has developed it too.  I like that better, as detached seems cold.  Whatever you call it, it means not allowing yourself to become emotionally ravaged by the progression of events."

This paragraph says many things that pertain to any of us who are caregivers.  We have changed due to the illness of the one we care for.  Some of us have developed that sense of humor, some of us are working on it, some have not found it yet.  We do find things amusing that the average person would not that is for sure.  The term creative indifference if very interesting, it can be used to describe ways in which we turn off the emotions that cause us pain in the carrying out of our caregiving duties. Henny Youngman said for many years,  "Take my wife, please!"  we say, "Take our caree, please!"  He became rich and famous for his irreverent humor, we not so much, but what kind of wealth do we really walk away with when our caregiving journey has reached it's destination?  Guess it might be up to us, but let's hope we can all get there will a smile and a giggle!