Well, I finally got Old Navy to be still long enough for me to get a really, really good look at his bum/bottom. Not only is the sking red, but it is beginning to develop sores where the urine and poop tends to sit against it.

ON was not at all happy with my nosing with him so personally, but when I told him it was either me cleaning his bum and putting ointment on to keep his skin from getting worse, or we could start arrangements for him to live in the NH, and let them do it. When given that choice, he gave in and let me clean him.

I worked as a Nurses Aide many years ago and I know how difficult it is to heal up such skin problems on the elderly.Now my question is this: I purchased some OTC ointment that states that it's for both babies and adults with incontinence issues in protecting and healing skin due to diaper rash and skin ulcers. Will this do until such time as I can either talk to the doctor on the phone or into the office? How often should I be checking his bum (as this is a major problem in getting him to use the toilet every 2 hours). Should I make him lay on his bed to let me clean him? or let him attempt to stand up holding onto furniture while I clean him?

I'm wanting to change him from wearing the Depends briefs and start using the actual adult diapers as it's so much easier for me during the day to get them on and off without having to remove every stitch of clothing from the waist down. Should I insist that we have to change them every 2 hours regardless of his need to 'go?'

Any and all suggestions would be appreciated. Thank you all ahead of time.

Dear Debra,
Wow! Your method of encouraging cooperation was on spot!
I haven't reached this point with my Dad, so I don't have direct
experience, but one thing popped into my mind.
When you mention trying to get ON to shift from the pullups
to the diaper-type of Depends, would it make sense to keep
some pullups on hand for when he insists on them, but when
it is time to change, don't remove all the clothing below the
waist--just cut the pullups down the sides so you can easily
remove them--do the clean up--then put on a diaper-type
garment. If he protests, then the consequence is he has to
remove all the garments from the waist down in order to
put on the pull-up. Don't know if I made any sense. Just
trying to pursue an incremental, "low-impact" approach.
I wish you luck. You are one of my heros!
Carol

Debra,
I did exactly what Carol said today. Bill wants to go to the bathroom but he cannot sit on the toilet and ends up pooping on the seat and himself. I had to clean both four times today. I started with briefs and then just rip them down the side and put the diaper on. He didn't even know what I was doing.
Since he is able to stand by holding on to something, I find it easier to have him stand instead of laying down.
Last but most important. I bought an ointment called Bag Balm it reminds me of vaseline but it is actually used on cows.
There was only once that Bill got red and after just one time the red was gone.

By accident I found out that it works to soften his toe nails, too. Put it on the nails and then put his socks on. When I removed the socks that night, all the built up dead skin around the nails came right off. His nails look better than they have in years.

His Butt looks pretty good to, for someone his age.
I had to add the last part of that sentence because that's what Bill would tell me. "You look good, for someone your age"

Try the Bag Balm, I think you'll like it.

Debra,

When mom first began developing reddened skin and small ulcers I used good old Desitin (the diaper rash cream) and then covered that with baby powder to keep it from wearing off so quickly. I also used sterile guaze pads over the cream/powdered area to provide even more of a barrier from bodily fluids (and solids.....) -- but I did NOT tape it in place because the tape pulled off her skin when it was removed. So I would think that any ointment barrier you are able to get on him will prove effective until you can have it looked at by the doc or a visiting nurse. The ulcers might even possibly be enough reason to get a visiting nurse -- and combined with the swallowing problems you shouldn't have a problem. You could run that by the doc and see what s/he says.

As you remember from your previous training (back in the dark ages like when I had mine) the key to successful healing is to keep the as dry as possible and keep pressure away from the area so you don't compound the problem. It sounds to me like you are on top of this and are attacking it the correct way.

As far as pull-ups or diapers -- I found it to be more a matter of convenience for me. I did not switch over to the diapers until mom was more incontinent than not, and it did involve stripping her from the waist down to get her changed. But with most pull-ups there is no need to cut them off -- there is a seam on both sides which rips easily for removal. So, I think it all comes down to how much effort you want to put into it and how much ON will allow.

As long as the diaper/pull-up remains clean and dry I see no need to change it. And I would suggest checking him at least 3 times a day and every time he has an accident to make sure he is clean and to reapply the ointment. And if he is able to stand by holding onto the sink I think letting him stand will help preserve his dignity a little longer without compromising your level of care. You might try for at least once a day a really good look with him in bed. But if the sores are responding to treatment I would minimize inspection as much as possible.

I was very lucky that mom did not develop any major decubiti until very near the end when she was already bedridden, and they caused her a lot of discomfort. You may want to appeal to that aspect when insisting on checking his bum.

Hope this helps you out some.

I second the bag balm!!!

MIL doesn't have bedsores but we've used bag balm in my family for years. It works on just about anything. I use it for stubborn zits, boils (fun there lol, trust me), skin infections, as a salve, etc. One of those big green tins lasts for years. Also if you get hemmroids it's handy too.

That was probably too much info LOL!

Kat

Thanks for the good ideas, everyone! I never thought of using Bag Balm. At least if I apply it (whichever I use) after every time to the toilet, I'll be able to keep an eye on the sores.

I really do try to preserve his dignity... I try not to discuss the situation with my local friends... you never know if it will turn up as gossip fodder. But I know that everyone here understands and wants to help instead of hurt. I think the sad part about this whole ALZ is that he's still fairly sharp in the mind, and it absolutely embarrasses him to no end that he's not capable mindwise to realize he's soiled himself and even when he does, he can't make it to the bathroom in time.

His poor body is wearing out faster than the dementia at this point of the disease.

Deb,

Well geez, I have nothing left to say. They said it all. Aren't these people wonderful???

But could someone please tell me what the heck Bag Balm is and where to get it? I've heard of Udder Cream, is that the same?

That stuff sounds really good. I could not only use that for Mom for some things, but for myself also.

Let me know when you can.

Jackie

Here you go, Jackie.
Check your local drugstore. they should carry it.
Here's the website:

Bag Balm

Deb,
With BFM I used a 4 in 1 body cleanser made by medline called Remedy (it had
olivamine in it) to claense the area. It is really easy to use, it comes out of the
bottle in a light foam. You rub it on the area you want cleansed and then gently
wipe it off with a damp cloth (I tried to get most of the debris off first with baby wipes
for sensative skin). Then after I made sure her bum was clean and I would use
Dermoplast on the ulcer spots (I would spray it on a gauze square and then put
it against the ulcer. I didn't use tape because I didn't want to create skin tears) then
on the area's that I didn't have covered I would apply a thick coating of Butt Cream
(desitine for adults). The Dermoplast acted as an antibiotic for teh ulcers and it
also has a little bit of pain reliever in it.

I used pull ups for BFM for the most part. When she started getting really bad
and wasn't able to stand up while I cleaned her up, I switched over to the ones
that were one size fits all with the elastic that you buttoned on each side to adjust
the fit. It was as close to a diaper (made it easier for changing while in a prone
position) but enough like a pull up that she didn't feel like she was in a diaper
They were softer and more comfortable than a diaper and they could be pulled
up or unbottoned on the sides. I always got the cheapest ones at Wally World.

I know how hard it is to try to help them stay clean and dry and healthy but
try to help them keep as much diginity as possible. I never called her
pull ups, diapers or pull ups I always called them panties. It was already
hard enough for her to allow someone else take care of all of her bathroom needs
why ad insult by telling her she was wearing a diaper???

I hate it when I lose something I'm writing.

Denise, I never use the word diaper either, I always say underwear.
I've never seen any that buttoned up the side. Do they open all the way up like a diaper to put it on while they are laying down?
I hate to use a diaper because it seems like there is way more diaper than needed.
I only had to use them when Bill was unable to get out of bed or roll over and lift his butt up. Thank goodness this only last for about a week after his hospital stay.
It seemed I always had more diaper on one side than the other.

Kat as slippery as that bag balm is, I bet those hemmoroids just slide right back in. I'll have to remember to try it the next time I have problems.

Bill is still sleeping but I just peeked into his bathroom and there is poop all over the seat. So I know what my first job will be this morning. Just hope it's not all over his bed, too.

Does anyone have any suggestions on how to get him to position himself on the toilet so he hits the hole when he sits instead of the seat itslef. He doesn't let me know when he needs to have a BM and he is always having to go to the bathroom so I don't want to have to follow him in there everytime.
Yesterday after having to clean him and the seat four times, I told him to sit and helped him position, you can guess what happened, nothing, He didn't want to go.

Deb, try the bag balm. I hope it works for you.

Joyce, yes they are open on both sides. You adjust the fit by the elastic
(the little elastic thing has button holes in it that will allow you to adjust the
fit). They look and feel more like a pull up but just as veristle as a diaper
because you can put them on while they are still laying down.

The brand I alway got (at Walmart) was Assure Adult Belted Briefs.
Here is a link to their web site and there is a picture of them.

Assure Site

They sure worked better for our situation than pull ups or
diapers. I paid about teh same about for the belted ones
as I did for the actual Assure pull ups.

Hi Joyce,
Do you think something like this:



or this:



might help?
I wonder if, when Bill feels the hole beneath him, he moves to the solid part of the seat?

Thanks for the reply Denise. The next time I get out I will go to WalMart and pick up some of the belted briefs. They would be easier to change him when he has accidents without having to remove his pants and shoes.

Maybee, I have a bed side commode that I will bring up and try it again. It is similar to the top one and it will fit over the toilet. I tried it once before but Bill was not able to position and sit between the arms of the chair. Maybe he will be able to do it now.

I'll let both of you know how the belted briefs and seat works.

Joyce,
We had a bedside commode that you could take the bucket out of and sit it over the
actual commode. I adjusted the seat level for BFM so that it was easier for her to sit
down properly on. I also left the splash guard on it so that if she did get off kilter
a little it don't run out of the potty seat and onto the floor the splash guard
was sitting ring on the rim of the actual commode. The weird thing was I could
NOT get her to use the bedside commode beside the bed. For some reason she
could not get between the arms and sit down, but I had not problems with her
once I put it over the commode. Don't forget to leave the splash guard on it .
It sure helps with directing anything into the toilet and not into the floor or down the
side of the toilet.

The belted briefs were great when she had an accident it was so much easier to take
them off without making even a bigger mess. When she was having her good days
I would pull them up and down just like panties so that she wouldn't feel like she
was wearing a diaper. You sure can't do that with a diaper!

Good luck with the new "Adventure"!!!! Hope the info has helped you!

I would swear by Bag Balm, which can be purchsed at Wal-Mart (in the pet food section here). It is amazing how quickly it works and how effective it is. My Mom never had skin problems as things progressed, and I fully believe it was because of generous Bag Balm use.

Joyce