[Advice needed] My father in law goes to the toilet several times a night. Sometimes, after flushing, he gets confused and just sits there for a long time, almost catatonic, until someone comes and talks to him.

[Gary88]

He’s in his 70s and has middle stage-dementia (I think Frontal Dementia is what he is suffering from, although it’s hard to know for sure since it’s tied to a brain surgery he had about 15 years ago and the doctors have been hesitant to put a definitive diagnosis).

For over a decade now he would go to the toilet several times per night. His surgery left seriously affected his mobility, but he is still able to walk on his own, albeit slowly. There is a night light near the entrance to the bathroom and he never really misses the way or has any issues actually getting there.

Yet in the last few weeks we are facing this new issue: about once every 2 or 3 nights, immediately after flushing the toilet he would get confused. (He usually turns on the light, but sometimes he uses the toilet in the dark. Regardless, this does not appear to make a difference ). So he just sits there, sometimes silently repeating to himself stuff like “What do I do now”, while others blankly staring at the wall. The moment someone comes and talks to him he makes eye contact and snaps out of it. He then heads back to bed.

Did anyone ever face anything similar? I read a lot all over the internet about old people not being able to find the way to the toilet, but almost nothing about finding the way back. Someone suggested getting a commode. But there is an issue with this as well: he has a night pot that he uses sometimes, but then he decides to go to the bathroom empty it. And once there he might get confused, like I described above.

This is taking a toll on the family, as every time this happens someone has to wake up and bring him back. He is never violent or aggressive and the issue only happens at night. During the day he is still jovial and aware of his surroundings. But he doesn’t seem to remember that these things are happening to him during the night.

So I guess this is a double question: a) Have you been faced with something like this before b) Is there a way to convince a person with dementia to start using a night pot or commode every time if for years their routine has been to go to the toilet?

Looking forward to your answers.

Yes!

My mum had this issue of going to the loo in the night, and then struggling to go back. DB was staying with her and virtually picked her off the floor and said she was conscious but unresponsive to him. Tucked her back into bed and after short while she started talking normally. Other episodes of zoning out/near catatonia. Sleeping most of the day.

this was the trigger for us to seek medical help for her. Long story short, diagnosed with dementia - possibly vascular, possibly Lewie Body, possibly Parkinson’s. She has been prescribed Parkinson’s meds (Levodopa), and these have made a huge difference. Her personality came back and she no longer zones out now her brain is getting the dopamine. Her cognitive abilities continue to decline but nothing anyone can do about that. She gets herself to and from the toilet all times of the day ok now.

that answers a), I’m sure others more experienced will be able to help on b).

Has he had a prostate check recently?

I've literally no clue about this and no experience but what about leaving a radio on or a recording playing in the bathroom quietly or putting some signs up telling him what to do. Something that will help him stay present ( sorry if wrong word)

Sounds like he's hardly waking up when he goes to the toilet and is just falling back to sleep sitting there. Does he take any meds that might make him very sleepy at night?

So to answer your ?

In fronto temporal dementia confusion in familiar environments is common. I would guess that your DF goes to the loo on "autopilot" but then properly wakes up when he flushes. Paradoxically recognising his surroundings is impairing his reasoning. This is particularly common when the frontal lobe is more affected.

He will be having difficulty ordering his actions ie 1) stand up, 2) walk forward, 3) find bedroom 4) lie down

Things that are automatic for us are actually a complex series of decisions that have to be done in the right order.

Awww, poor guy.

How about a sign to prompt him?

'Now Wash Your Hands
And
Back to Bed'

Lighting may help but it is probably the reasoning that he is having trouble with.

Can he still read and understand prompts?

If so "back to bed" won't help.....
would need to be "stand up and walk forward"
then another note...open bedroom door...(label the bedroom door)..... lie down on the bed.

However there is a possibility that his verbal reasoning and fluency are also impaired if his spacial reasoning is.

I'm really sorry OP it's so hard to see your Dad go through this and for your Mum and all of you to cope.

Get outside help if you can (Dementia UK has amazing resources and volunteers and although majors on Alzeimers does help with other forms of dementia).

Dementia UK: Specialist support to families facing dementia

You could set up Alexa or similar to prompt him. Use a motion sensor and an echo.