My mother-in-law has frontal temporal dementia with Parkinsonism. She is also suffering from depression, anxiety, and obsessive compulsory behavior. Her change in behavior happens when she has experienced fecal incontinence. The doctor prescribed lax-a-day, Pms-Docusate Calcium and suggested metamusil. We did everything according to what the Dr. suggested but she still have this faceal incontinence problem. We applied Adult Glycerin suppositories but she just fart it back out or she would use her hand to take it out.
What should I do? Thanks
Pat-galantamine, Apo-Ditiasz, Apo-Atorvastatin, Sandoz-Pantoprazole, Paradaxa, Ramipril (changed to Pms-Memantine 2 weeks ago), Auro-Mirtazapine. However, I was told by the doctor that all these drugs are not effective for frontal-temporal dementia patient.
Her faecal incontinence problem is more related to constipation (hard stool). She had been to the doctor 3 times in the last 2 weeks but the result is minimal. She does not know how to bath and my wife bath her every day. I lost my job last year and became her primary care giver (except bathing, changing clothes, and toilet function which are done by either herself or my wife). She was a socially active person before your FTD condition. She attempted suicide 5 years ago when she realized a change in her physical condition. We, including the doctors, all thought she was suffering from depression at that time. I was only a year after that she was diagnosed as suffering from FTD. She is obsessed with tidiness and cleanliness. She used to be very conscious of her personal image. Her condition just changed drastically a months ago when she had the constipation problem. She would take off her clothes (a new behavior) and go into the washroom trying to take a bath. The problem is she does not know how to bath anymore. My wife bathes her every night when she comes home from work. She turns on the faucet and looks at the water that flows out from the tap. I mentioned her latest condition to the doctor and was told there is nothing they could do. Yes, long term care is a solution for us. If I told the public health care nurse that I can no longer look after my mother-in-law, she would put us in the emergency queue. We could get her into the first available long-term care facility within 50km limit from our home within a few months. However, I would like to put her in a facility that understands my mother-in-law's cultural needs. Hence the long waiting list. I told my wife that my mother-in-law raises her in a comfortable surroundings and it is now our turn to look after her if we are capable. May be my job lost is a sign that we should try to provide for my mother-in-law until when we can no longer capable. I am Catholics and really believe in this. That's why I post my problem here hoping that someone can provide me with some advice on how to get through this difficult time.
Thanks
Please get her in a facility - you and your wife are now doing a lot more than you should be in her care, and its only going to intensify.
My opinion only that is, but from all I've read, seen and am going through, some one has to look to the caregiver(s) at some point. Take care.
I would be cautious in using metamucil, if she doesn't drink enough it will have the opposite effect to what you need. Try giving her the docusate twice a day and add in a stimulant laxative like milk of magnesia every other day. The polyethelene glycol (lax a day) worked for us for a while, but it is essentially doing the same job as the docusate at a much higher price. Make sure she gets a good diet of fruits, veggies and whole grains, and push the fluids!!!
Apo-Ditiasz, Apo-Atorvastatin, Sandoz-Pantoprazole, Paradaxa suggests she has high blood pressure, high cholesterol, stomach issues and clotting problems. Again, be sure she really needs all those meds by reviewing them with the MD. Ask the pharmacy to run a drug interaction check on those combined drugs. If red flags pop up, call the MD and hold him accountable. Too many drugs can actually make things worse. Six different meds all at once would worry me.
This morning, we heard her going into her washroom at 5am. This is not her regular routine because she seldom wakes up at night. My wife and I jumped up to check on her. We are so happy to see that she finally had her faecal incontinence issue eased up a bit. The stool is very hard and not much, but at least it starts coming out by itself without my wife's assistance. It did make a bit of mess in her washroom because she used her hand to find out whether there are stool in her bum and then used her hand to touch quite a few thing in the washroom. I am fine with cleaning the washroom because we are happy for her. I booked an appointment to see the Dr. this afternoon. Tonight, depending on what the Dr. suggests, we may decide on whether to put her in that emergency queue.
Thank you all for providing me with the comments and allow me to share my concerns with all of you.
James
That is why the applesauce with easily digestible chia seeds may work.
I do understand your reluctance to use a facility; it's my understanding that the Chinese and some other ethnicities have for centuries cared for elders in their homes rather than use facility placements. To me, that's very admirable.
As to all the medicines, I'm not familiar with them but just wonder if time-honored Chinese practices and good diet might be helpful for the bowel issues.
I think the reason your MIL feels the need for so many baths is probably because of the discomfort in her rectal area and the sense that things just aren't working properly there.
I understand exactly what you are saying when you talk about your case manager pushing you to put your mom into the queue for care, the same thing happened to me. When my mom first took her turn for the worse i begged for answers, for more help, for a nurse at least to come out and give me some guidance. My case manager looked at me like I was talking crazy and informed me that she WAS a nurse. Her personal belief that I should put mom in a nursing home coloured her judgment, and when I finally broke down and admitted I couldn't do it anymore she found my mom a placement within weeks. After an agonizing night of worry and second guessing myself I declined the placement, and was finally able to get supports in place to keep my mom at home. This website, although American, is a wonderful resource and helped me immensely. I'm glad you were able to get a nurse to come into your home, just keep pushing them to continue to cover your needs. Only you know if you can handle having your mom with you, don't let some bureaucrat talk you into going against your best judgment!!!