This was originally written 12/7/08. I was remiss in not posting this here earlier.
We need to back up a bit for this story. The days of yester-year when I took Grandpa to the bathroom are now mostly behind us. He uses the toilet for maybe 1/3 of his bowel movements, and rarely when he pees. Not only is his limited mobility a problem, but his awareness is also failing. Maybe half of the time (or more) he doesn’t even realize he needs to go pee. I have a set schedule for changing his diaper and usually it is soused (Grandpa’s preferred word for his wet condition) without him having complained earlier about a need to go. Sometimes he is cognizant of needing to go, but the increasing failure of getting him to the bathroom in time to urinate means I have abandoned the attempt unless he makes a specific request. There is no point in dragging him to the toilet if he has already peed himself by the time we get there. Typically, if he does realize he needs to go pee, he realizes it for one minute, starts to head “somewhere,” forgets what he was doing, pees himself, forgets he did it, and life goes on. It’s not ideal, but at this point in Grandpa’s deterioration, we’re far beyond ideal. It was something of an effort to give up dragging Grandpa to the bathroom–after all, not wetting yourself seems like a fundamental issue of decency–but it came to the point that the bathroom failures were so many that it began to feel pointless, and I discovered that there was actually more peace in the house if I stopped trying to fight that lost battle.
Since I’ve surrendered to the diaper for Grandpa’s urinary incontinence life has been pretty peaceful on that front. He rarely gets his clothes, or anything else, wet. Life is much more simple and less frustrating. The last time we had a pee disaster was a few weeks ago, and that was the first in many weeks. Grandpa had woken up in the morning needing to go to the bathroom (nothing unusual) and had sat up and promptly started to go (nothing unusual again). But somehow his diaper was badly arranged and so the pee leaked out the side and started getting his bed wet. Grandpa stood up, and the pee promptly started gushing down his leg to the carpeted floor.
I woke up to the sound of splish-splatter-splish-splish. My internal disaster alarm went off and I leaped out of bed with the exclamation of “Ah! Ahhhh! Ah! Ah! Ah!” Rushing around Grandpa’s bed I quickly adjusted his diaper to stem the tide.
“What’s the matter?” Grandpa asked, a bit perturbed by my exclamations. “Did I get some in your eye?”
“No,” I said, still kneeling in front of him and holding the diaper in place. “I just don’t want anymore more mess to clean up than I have to.”
I was laughing to myself to rest of the day over the question, “What’s the matter? Did I get some in your eye?” It was the most peculiar concern given the situation, and yet in an absurd way, there was a certain logic about it.
Anyhow, the issue of pee problems has largely receded. Poop has been a slightly different matter. It is more work (and more unpleasant) to clean up Grandpa’s soiled bottom than to get him to the toilet to do his bowel movement and simply wipe his bottom afterward. The problem is that Grandpa has maybe a 50% ability to recognize that he needs to do a bowel movement. Some of the time he is simply agitated over something, and he doesn’t realize the “something” is his need to go to the bathroom. Of course, there are plenty of times when he is agitated over something else, or nothing at all, so guessing when Grandpa’s agitation is over the need to do a bowel movement is something of a fine art. The last thing you want to do is drag him down to the bathroom and sit him on the toilet only to have him do nothing. Of course, the last thing you want to do is not take him to the bathroom and end up with a dirty diaper to change. One could get obsessive about the whole thing, but I try to not spend too much time on it. I try to keep an ear tuned for Grandpa’ agitation and if there seems a good chance it is from a need to go poop, I will make the suggestion.
A couple of weeks ago around breakfast time Grandpa was wildly agitated. I sort of suspected he might need to use the toilet, but his agitation consisted in him bellowing at the top of his lungs for “Ma!” and wrestling with the kitchen table. He was in such a fit that I wasn’t going to man-handle him down the hall to the bathroom unless he agreed that was where he need to go. Finally he stood up and declared, “My a**hole hurts so bad!”
I said, “Well, maybe we should go to the bathroom then.”
He looked at me questioningly and said, “You think so?”
“Yeah,” I said. “I think we should.”
So we started to trundle toward the bathroom and after maybe two steps Grandpa says, “Oh, shoot! I just did something! I don’t know what it was, but I did it!” At which pointed I propelled him–pronto–into the bathroom and got him onto the toilet. He had done a portion in his diaper, but he did a lot more in the toilet.
Such is an example of the very confused and disconnected relationship Grandpa now has with his own body. Sometimes he understands his body is telling him something, but can’t make sense of what it is saying. As I mentioned, we only have about 1/3 success, but I don’t sweat it. Sometimes he doesn’t even agitate before pooping himself, so there would be no way I could have known. Sometimes he poops himself too quickly to have got him to the toilet in time, and sometimes I simply mis-guess the source of his agitation. In the end you have to realize there are bigger problems in life and not get consumed by the whole bathroom issue.
Not only does Grandpa sometimes have difficulty understanding what his body is telling him, but the problem is made worse by the fact that I am giving him (doctor proscribed) laxatives to even make him go. By this past summer he was retaining so badly that he kept becoming completely impacted which resulted in several very messy enema incidents on the bathroom floor. Bad as changing a stinky diaper is, and as much as it isn’t fun to clean poop from someone’s bottom, it is a veritable walk in the park compared to an “Alzheimer’s and enemas” incident which ends up with poop and enema liquid all over the bathroom floor. Yes, that makes changing a diaper filled with diarrhea seem a very good idea indeed.
Of course, the idea is not to give Grandpa diarrhea. The ideal is to simply make his stool loose enough, and regular enough, that there are no disasters. But how much laxative Grandpa needs depends on how much he has eaten and drunk, and that is a moving target from day to day which means that if I want the perfect poop I will have to continually adjust the laxative dosage. The doctor was quite frank when she proscribed the laxative, and said I would have to adjust the dosage as needed and it would be “messy.” So in the whole laxative dosage game, failing to give enough means impaction, and giving too much means dealing with a watery soup of diarrhea. Rather than attempting to adjust the laxative dosage on the fly and ending up in some situation where I am too clever by half, I have settled on giving him a dosage every other day. This is not perfect, but seems to end up with the best average. Some poops are a little on the hard side, some are soup, and some are just right (sounds a bit like a Goldilocks story–ha ha). But at least we haven’t had any more impaction, and a regular schedule and dosage means I won’t forget when I am supposed to give him laxative, and how much, two things which are a big problem if you are constantly adjusting things on the fly.
Whatever the exact consistency of the bowel movement, the laxative means that usually when Grandpa has to go, he has to go now–Which is a good thing because it means he won’t be able to hold it in and become impacted. But it can be a bad thing, too. Two or so weeks ago Grandpa had to go to the bathroom. I was working on supper, and it was a rare very good day for Grandpa–which meant he was tottering about all by himself. He wasn’t agitating or anything, so I simply kept an eye on him as I went about my own business. I saw him totter off down the hall and enter the bathroom. I thought that slightly odd, since it’s been a long time since he’s entered the bathroom by himself. Since he had made no agitation I figured he was simply wandering about, and so continued on with what I was doing. But not to leave him unobserved for too long, I went back to check on him a little later. The sight that met my eyes was Grandpa standing in the middle of the bathroom floor halfway through pulling down his pants and simultaneously in the middle of going poop (I will spare you the graphic precision).
Zing! The bag of kale in my hand went flying as I lunged to intercede before the situation became any more disastrous. My quick work meant that event did not turn out too badly. But it is an example of how thin the line between disaster and success can be. Sometimes the only difference is a few minutes. And while sometimes you manage that last minute save, sometimes you aren’t there to do it.
Two days before Thanksgiving, the latter happened.
I was preoccupied working on my computer, and did not register anything unusual coming from Grandpa in the living room. My first hint that something was wrong was the exclamation from Grandma. It was the “big disaster” sort of gasp so I was out of my chair and down the hall immediately.
Then I saw it. Apparently Grandpa had walked to the middle of the living room, dropped his pants (much like he had done a few weeks ago, in the slightly more appropriately location of the bathroom) and went poop in the middle of the living room floor. By the state of the evidence, he had then walked back and forth through the poop, smearing it across a ten foot stretch of the living room carpet before setting his bare soiled bottom on the couch. On first sighting the disaster area, there was the strong desire to run around in a circle screaming. Not just because it was gross, but because I am thinking, “How on earth am I going to get that cleaned out of the carpet?”
I had dearly wished to avoid such an incident, but given that I have stopped him from dropping his pants in various other inappropriate places in the house I did realize this possibility was a continuing danger. I suppose part of me suspected it was somehow inevitable, eventually, given the fact of Murphy’s Law. Nonetheless, poop smeared over a ten foot stretch of the living room carpet is one of the worst house-keeping nightmares in my book.
And if it is two days before Thanksgiving and you’re having the entire extended family over on Thanksgiving . . . well, that doesn’t help, either. Grandma later admitted that she felt like she wanted to faint at the sight. Thankfully, she did the best thing she could under the circumstances–she hid away in her bedroom, leaving me to deal with the situation as I found best.
The first thing to do was limit the extent of the damage. Grandpa was seated on the couch, poop smeared over the bottom of both of his bare feet, excrement squished up between his toes. Every movement of his feet meant more poop on the carpet. I quickly decide my first step was to get him where any further mess he made wouldn’t be difficult to clean up. So I scooped him up in my arms and deposited him on the toilet. Next step was to get a very large putty scraper and scrap off as much poop from the carpet that I could. The third step was to call my Mom and sister and request that someone send me some written electronic directions for cleaning poop out of the carpet, pronto. Then I wet down a bunch of paper towels and laid them over the long trail of poop stain so as to hopefully keep everything from drying into a hard crust before I could finish cleaning.
Then it was back to the bathroom to clean up Grandpa, who by this time was loudly hollering for someone to come and rescue him. You don’t really think about how many folds and crevices there are around, beneath, and between your toes until you’ve had to clean poop out from every one of them. Finally, with Grandpa changed and cleaned, I deposited him in the bedroom, where he wouldn’t be in the way, and turned my attention back to cleanup.
For those interested, the directions I was sent, and which I followed for the cleanup, were these:
1. Mix one tablespoon of liquid hand dishwashing detergent and one tablespoon of white vinegar with two cups of warm water.
2. Using a clean white cloth, sponge the stain with the detergent/vinegar solution.
3. Blot until the liquid is absorbed.
4. Repeat Steps 2 and 3 until the stain disappears or is no longer absorbed into the cloth.
5. If the stain remains, use an eye dropper to apply hydrogen peroxide, and then apply a drop or two of ammonia.
6. Sponge with cold water and blot dry.
Except, I didn’t follow the directions exactly. The whole blotting procedure was a good start, but I judged that “blotting” was not going to lift the offending stain out from where it had sunk down into the carpet fibers, so as the cleaning progressed I moved into a scrubbing motion with the cloth when applying the cleaning solution. Then I moved on to using a stiff scrubbing brush which I applied with such furious scrubbing that I began taking out carpet fiber. Also, the size of my disaster was such that the idea of using an eye dropper to apply hydrogen peroxide or ammonia was laughable. I took a bottle of hydrogen peroxide and made repeated pouring passes over the offending spots. Same with the ammonia.
I spent about two hours cleaning on the day of the disaster. I did not apply any hydrogen peroxide or ammonia the first day, and I ended the cleaning session by liberally sprinkling baking soda all over the carpet and briefly working it in. This was suggested to help eliminate odors, and it did seem to help a lot. The next morning after the carpet had dried somewhat, and with fresh daylight, I saw the stain was still quite visible. So I vacuumed up the baking soda and moved on to hydrogen peroxide.
It is very important to soak as much liquid as possible out of the carpet with fresh paper towels after every cleaning pass. This is how you actually lift away the offending material/stain. It does little good to work in the cleaning solution and just leave it to evaporate. If you do that, all of the detritus will remain in the carpet after evaporation. Basically, you want to keep cleaning until the paper towels used for mop up don’t come away discolored.
After another approximately two hours of cleaning the day before Thanksgiving it looked pretty good, and I decided it would have to be good enough. On Thanksgiving day when the carpet had again dried I could still see a faint stain, but I had scrubbed so hard and used so much cleaning solution, that the surrounding non-stained carpet was also beginning to look faintly paler in color. Any further cleaning was likely to end up with a noticeable pale strip running through the carpet, even if I managed to remove the last faint traces of stain. Since the stain was faint enough that people not looking for it might not even notice–and since after prodigious amounts of detergent, hydrogen peroxide, and ammonia, it was pretty benign in any case, I decide to let it rest.
Thanksgiving was saved. Grandma wanted to keep the whole disaster hush-hush but I wanted to greet every arriving relative with the salutation, “Who wants to lick the carpet?”
That’s just the way I am.