Incontinence - Advice

No advice I'm afraid, but I am elderly, with IBS and I wear incontinence pants every day. I usually have to change them at least once a day but otherwise I couldn't cope with the frequent accidents.
Why not get a few different products to see which will work out for the best?

Right, I think the cognitive decline is quite bad now ( plus obviously people are worse about things they don't want to think about.)

The talking to etc is probably still worth doing but you need to take in that he is probably not remembering individual events, plus he can't reason in the same way. He doesn't see you cleaning and understand the reason for it, or if in the moment he does understand, he forgets - really forgets - he's genuinely not encoding memories into the brain any more.

Tbh I think he needs 24 hour care. Where this happens is another matter. Try not to catastrophise about the future - I understand why after so long dealing with this - but for his own safety I think things have to change.

Oh I am so sorry you are going through this . I cared for an elderly relative who was always continent . But he obliged me by wearing pads just in case he didn't make it on time. We had a long in depth conversation about the issue and I told him I could not and would not cope with having to deal with regular clean ups. Nursing home would be the only option. It was a dealbreaker . He agreed but was also fully aware . Luckily it never came to that for which I am so grateful . Do you think your granddad is completely aware ? And at what point do it kick it that he is no longer competent to make decisions. I feel sorry for your family it must be awful and he is so lucky to have so many concerned people .

It might be worth drawing straws slightly and work out who best to give him a firm talking to.

Rather than the friendly, softly, gently.

It could be a family member, it could be the care service manager, it might be a social worker or an occupational therapist.

Someone who will deliver a few home truths. Along the lines of:
you say you can look after yourself, however you’re clearly not.
Other people are having to daily clear your poo and pee off the floor, because it seems you’re incapable of using appropriate protection. Yes, being incontinent sucks but you have a choice. You can look after yourself, or you can lose your independence and your visitors. At the moment you’re on a fast track to that. Your choice. Now then, to make that choice easier what can we do to make it easier for you to use the continence products. Carees help you put them on? Different colour? Different style? Different bins?

Or do you need a catheter. That’s the next step if you can’t find a way to make pads work.

You said he has some cognitive decline, but has this deteriorated more recently? Any other recent concerns, more confusion, saying odd things etc? He might have a UTI which can send people completely off. If you suspect that, I'd ask the GP to check a sample.

Its SO hard OP. I really do understand after trying to help my own grandparents. Are there any friends or family member he listens to? Could said friend claim to have a similar issue and confide that they have started using X underwear which are very good? Would you GF listen?

I'm sorry about the loss of your nan OP. Does your grandfather know she has passed? What would happen if someone said to him 'GF, nan would have recommended you wear those pants/pulls ups'. 'She was so proud of those lovely carpets etc.' This might not be the right approach at all if he is losing cognition, but can potentially spark something to motivate him.

I’m so sorry, I know how hard it is to cope with incontinence in the elderly. Does he have dementia? Sometimes they are not aware that they need to go, or that they have been. Or they just can’t get to the toilet quickly enough. Often, they will pull the pants off, just because. It’s frustrating, unpleasant for them and you and very upsetting. It’s also hard work. Would a commode help if it’s a question of not getting there in time. If it isn’t dementia then maybe there is a physical cause? It sounds like he needs further assessment by either the gp, adult social care or the continence team. I hope for everyone’s sake a solution can be found asap.

I'm so sorry to hear you're going through this. It sounds exhausting.

I think the only way to get through to him is to insist he wears the pads otherwise it's definately a care home for him and once he's in, there's no coming home EVER and tell him he'll likely die in the care home and not at home in his own bed. (Sorry to be so blunt, but sometimes these elderly need some straightforward talking).

It's either pads in his own comfortable home or pads in the care home and you only get a room. Tell him to choose.

I'm afraid it looks like you're at the point where a home is the only option as he is a danger to himself via poor hygiene. Dealing with poor continence is an absolute nightmare and hats off to you for managing 12 months of this - you've gone above and beyond to get this far.

Hope the social worker can offer some help.
In the meantime I would start making a daily note of exactly what is happening and how much cleaning you are doing. It's not sustainable or safe.

This sounds really hard. Is there a reason he's refusing to use the products? Surely it would be more comfortable and dignified for him.

Could he be refusing because he wants to go into a home? Just a thought since he was happy to wear pads in the previous care setting.

Does he have a social worker? If not I would be asking for a social service review as this is beyond what you as a family can support.

Go visit some care homes

Was just going to say the same.
This is usually the final straw.
Mil seem obvious to her incontinence (and the fact the house stunk to high heaven)

I don't have lots of knowledge but I do believe incontinence is closely related to cognitive decline. Do you think he is genuinely choosing to shit himself on the daily, or is he just optimistic and forgets he needs pads?

A route might be for the carers to escalate this. Are they ever dealing with it, or are you always doing it? Do you know what the nursing team were doing in hospital? My guess would be that they had a regular toileting regime plus skilled nursing to persuade him to wear the pads.

I wonder if you may have to down tools for a day or two. At that point the carers are likely to escalate. But I'm afraid the end point is likely to be respite placement in a nursing home, which is likely to become permanent. That sounds tbh like the most likely outcome in any case.