One of the most common aging in place challenges elderly people and their caregivers will encounter is the daily activity of toileting. Toileting is a naturally private matter and when older people need help with it, it can be a source of embarrassment both for them and their caregivers. For many elderly who strive to age in place for as long as possible, dealing with needing help with this embarrassing daily activity is unavoidable. For many caregivers, it is one they manage the best they can, often needing to overcome that barrier of awkwardness, particularly with aging parents.
Identifying and addressing some common toileting issues, with perhaps some less than orthodox solutions, can make the process easier on everyone and allow dignity its rightful place in aging.
Overcoming Embarrassment when Helping an Older Parent Go the Bathroom
It is uncomfortable to come face to face with helping your parents toilet, but it is a necessity that begs some gracious oversight on the part of caregiving adult children. As challenging as this can be, the payoff can mean a higher quality of life and a greater sense of dignity all the way through to end-of-life decisions.
According to a study published by the National Institutes of Health, being able to accomplish both the activities of daily living (ADLs) and the independent activities of daily living (IADLs) are critical for those who wish to retrain independence. A large portion of elderly cardiovascular disease patients studied had caregivers to assist with ADLs. The patients were also suffering from other geriatric syndromes such as delirium, dementia, frailty, and sensory impairments.
The researchers found that when the elderly had supportive care to achieve ADLs such as toileting, their health outcomes were improved and they experienced fewer setbacks due to their greater sense of independence.
…elderly patients who had the support of family members and thereby felt more in control of their own lives…
A large part of this improvement had to do with the caregiver’s role in helping patients to adhere to a treatment plan while at the same time maintaining a sense of dignity. In short, elderly patients who had the support of family members and thereby felt more in control of their own lives, saw improvement in their health and outlooks on life.
Common Toileting Problems and Solutions
Frailty is a general biological decline that accompanies aging, particularly with dementias and chronic health conditions. It spans a multitude of the body’s organ systems, including elimination, as well as the mobility and gait speed needed to make it to the toilet successfully. Frailer people need greater help. It is harder to make it to the bathroom in time, to recognize when there is a need to go, to remember how to go, and to manage the strength needed to sit and stand up from the toilet.
The Alzheimer’s Association leads the nation in dementia-related research and care tips. They have provided the following recommendations when it comes to providing dignified care to an older person requiring long-term toileting support.
- Remember to be patient and supportive.
- Minimize feelings of embarrassment by cleaning up messes discreetly and promptly
- Offer reminders to go
- Watch for signs such as pacing, agitation, or certain facial expressions that may indicate the person needs to go
- Keep a path to the toilet clear of obstacles
- Make sure clothing can be easily removed
- Make signs to hang on the bathroom to make identifying it easier
- Use incontinence pads to prevent permanent soiling of furniture and beds
- Adult undergarments may be appropriate
Independent Functioning Promotes Long Term Aging in Place
The degree to which a person needs assistance going to the bathroom varies significantly. Some may need physical assistance sitting and standing back up while others may be confined to diapers. However, the greater the sense of dignity, the greater the quality of life, and that is more important to many aging seniors than how long they live. The ability to care for themselves with as little intervention as possible goes a long way to improve a sense of accomplishment, which in turn validates their sense of identity. For many seniors, facing the uncomfortable scenario of receiving toileting help is worth it to avoid being placed in a nursing home and feeling forgotten.
When conditions such as late-stage dementia complicate the natural aging process even more, there are still ways to creatively approach the issue of toileting that will also relieve caregivers of mounting stress (and mess). Some unorthodox solutions you won’t find from a doctor’s office brochure include:
- Keeping a urine bottle at sitting areas and on top of toilet seats
- Line floors with plastic runners where accidents are frequent
- Line areas around toilets with disposable or washable linens
- Keep a generous supply of wipes on hand
- Dab mentholated vapor rub under your nose to block out offensive smells
According to many caregivers, sometimes a sense of humor and laughter helps relieve the tension of some of the more unpredictable predicaments that arise when helping another person to toilet.
Getting older doesn’t always happen gracefully. However, a caregiver can learn to handle whatever comes his or her way with grace.
Bell, S. P., Patel, N., Patel, N., Sonani, R., Badheka, A., Forman, D. E. (January 2016). Care of Older Adults. Journal of Geriatric Cardiology, 13(1):1-7. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753005/. Last Visited March 26, 2016.
Alzheimer’s Association. (2015). Personal Care: Assisting a Person with Moderate or Severe Dementia with Daily Needs. Available at https://www.alz.org/national/documents/brochure_personalcare.pdf. Last Visited March 26, 2016.