Let's talk toilets!

Personal hygiene becomes more difficult with range of motion limitations. With personal hygiene difficulties come more urinary tract infections (UTIs). With more UTIs come possible UTI-related dementia and/or avoidable pain. Even when a UTI is asymptomatic pain-wise, it can trigger forgetfulness and confusion.

Please forgive this indelicacy, but a woman’s ability to wipe her derrière clean without pushing any stool particles near her urinary opening is critical to prevent UTIs. Some older women simply cannot physically do this. Asking her caregiver to wipe her is likely embarrassing.

So I was wondering how to make this easier, and my one experience with a bidet toilet came to mind. A gentle spray of water washes your behind, and a gentle poof of air dries it. Voilà. No need to twist or reach to wipe with toilet paper. The water duct would have to be aimed properly, of course, or the spray could push stool particles toward the urinary opening.

When I Googled the use of bidet toilets (not freestanding bidets) to prevent UTIs, this New York Times article by Paula Span, “Begin the Bidet,” appeared. Link to it here. This article from 2012 concluded that it’s an interesting idea with possibilities. Tests would need to be conducted. Here’s hoping …

Looking for practical ways to keep your loved one independent longer? Another helpful toilet apparatus is described by Valeri Thelen in “Give Me a Lift,” an article she wrote for Caregiver.com’s newsletter. Read it here. Thelen discusses common causes for difficulties getting up from typical toilets and two types of power-lift toilet seats on the market. The article also suggests adding padding or height to the toilet seat.

Toilet seat risers, with and without arms, have been around for a long time and are relatively inexpensive. Commode chairs typically have arms and the ability to adjust seat height. You might also check your local nurses’ lending closet to see if their inventory and lending policies might allow you to borrow these items for the length of time you might need them.

Living and Laughter with Alzheimer's

 I’ve written a number of previous posts for this blog about my “entertainment” role as my father’s Alzheimer’s progressed. Always such a serious kid, I could not possibly have imagined myself as class clown. Dad was the nutty punster who always made me laugh. But when Dad’s disease progressed to the bleak stage, I instinctively knew my job was to bring him joy. That included making him laugh. I brought him joke books in a tote bag I dubbed my “bag of tricks.” I recalled funny family stories that he enjoyed. I played silly videos for him. It did us both good to laugh together.

Jim Greenwood’s “Living and Laughter with Alzheimer’s” article in Today’s Caregiver’s online newsletter is an excellent reminder of this. And he includes some good jokes! Click on this link to read his article. Greenwood has also authored a book called Alzheimer’s: Medical Science and Families Are Still Asking Why.

How to know when a person with Alzheimer's should no longer drive?

My family and most of my friends instinctively sense when an elderly person becomes a danger to himself and others on the road. Little dents and scrapes accumulate on Mom or Dad's car. When we ride with them, we find ourselves cringing a lot or being relied on to copilot before every turn. "Any cars coming from the right?" Maybe we hear them tell of frequent close calls. Reaction times naturally slow as we age, but additional signs might be present if your parent has dementia. I thought that instead of living with vague worries, it might be helpful to have some concrete signs to look for.

This is verbatim from the Alzheimer's Association's Alzheimer's Update Questions for the 24/7 Helpline column:

Determining when someone can no longer safely drive requires careful observation by family and caregivers. The following list provides warning signs that it's time to stop driving:
Forgetting how to locate familiar places
Failing to observe traffic signs
Making slow or poor decisions in traffic
Confusing the brake and gas pedal
Returning from a routine drive later than usual
Forgetting the destination you are driving to during the trip

For more information on this issue, visit our Dementia & Driving Resource Center at alz.org/driving.

The next obvious question is how to take away the keys. "Let the doctor tell them" is my easy-way-out answer. At the link above, you braver caregivers will find tips under "Having the conversation." Have you had success with other methods of breaking the news? 

Free Respite Opportunities for Caregivers

You love your mom or dad with Alzheimer's. You see their needs. You embrace opportunities to visit, to cook for, to care for them. After a time, however, you may notice the spring in your step toward their door has morphed into foot dragging. Heaviness of heart and physical fatigue are normal for a caregiver. Perhaps you have looked into respite and/or counseling support, but found it outside your budget. Take heart!

If you feel tired from any aspect of parental caregiving, please read this article at Caregiver.com entitled "Free Respite Opportunities for Caregivers." Allan S. Vann gives live links to seven FREE respite opportunities that I had no clue about during all the years I might have benefited from them.

The one form of support I did find invaluable was the Alzheimer's support group that met at my local library. It was facilitated by a volunteer trained by the Alzheimer's Association. Check your local newspapers for such support groups at your library, hospital, or nursing home. And a few times I called the Alzheimer's Association 24-hour helpline, too. They were great. Don't hesitate to call them at 1-800-272-3900. Or check out their Community Resource Finder at http://www.communityresourcefinder.org/.