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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  1. I remember this well Donna when my mother was past looking after her personal hygiene many years ago. You didn't mention suppositories; that was the thing that upset Mum most- the fact that I - her beloved daughter should have to do something like that. She felt she had no pride left and yet as you said at the beginning if I didn't do it who would??
    Hang on in there...........

  2. Oh Donna.... this is a topic that's very near to my ..... thoughts and whatever.... David has managed to pee at church twice on the lovely burgundy cushions, then a neighbors new car, our best friends car, and numerous other places..... the poop hasn't started yet...... but .... I know it will. I'm not looking forward to that part...., but realistically....I know it's coming..

  3. Yep, I'd have to say it's the hardest and least-liked part of care-giving. And I totally get you on the celebrating because it's been how long since they last went...well, Mom celebrates. :) Ah, life. Odd, sweet, hard.

  4. OhhhhhNooooo! I sense my day is coming with Chrissy. I'll probably be emailing you all!

  5. We do rally around the oddest of topics don't we?? lol

    Oh A.C., I did post about using suppositories and giving enemas, but I lost some of my writing twice in the process of doing that post! Anyhow, both of those methods failed...

    Ah Dolores, fortunately mom was still able to use the toilet, with help when we were still taking her to church, that would have been a problem for sure! Eventually, we had to stop taking her because it was too hard to get her up and down the stairs and in and out of the car. What will you do with David concerning these things?

    beka, beka, your mom is so blessed to have so many "helpers" with Granny! Most of us have maybe one if even that! Oh, tell your mom to send me that info she was telling me about, I want to see it and send it and post it where it will benefit others. Thanks!

    Judy, I read your post on Chrissy, looks like you are starting to see some issues in this area, and you had some good solutions too!