My Alzheimer's father stays on the toilet all the time for fear of soiling himself!

A fellow caregiver asked...

My Dad is 87. I help my Mom care for him in their home. My Dad has alzheimer's and has had small strokes. He has hearing loss and is legally blind. My question is... How can I keep my Dad from spending so much time on the toilet. He is determined to stay on there because he is afraid of having an accident. He even refuses to release gas unless he is on the toilet. He has a small sore on his behind from sitting so long. We purchased a padded seat and because he wipes so much we had to remove all but a few squares of toilet paper. I realize this is a strange situation but is very real and frustrating. I am grateful for any information on the subject. Thanks

Expert Answer

Helene Bergman, LMSW, is a certified geriatric care manager (C-ASWCM) and owner of Elder Care Alternatives, a professional geriatric care management business in New York City. She consults with nursing homes and daycare programs to develop specialized programs for Alzheimer's patients.

Quite an issue. This happens often with Alzheimer patients who run to the bathroom every three minutes with a sense of urgency, get there, forgot why they went and then go back three minutes later. Or, like your dad, go and stay forever until someone entices them off the toilet. I have had some situations where spouse caregivers had to call 911 to get their spouse off of the toilet because they were stuck! You are right that it is a dangerous situation in terms of skin integrity.

You do have some options. Firstly, you could put a lock on the bathroom door and tell your dad they are fixing the pipes. You could put a sign on the bathroom door that says "Out of Order". This, of course, would only work if his dementia is at a moderate or later stage; you could have to get a commode placed in a private spot for him to use in emergencies. You could remove all the toilet paper to address his overuse. You could begin using incontinence wear (i.e Depends pullups) to help his anxiety that he will have an accident. What works best is probably identifying a distraction- an activity in or out of the house- that might redirect him from toileting. Might a sweet entice him? music? a story? a puzzle?

You and your mom need to believe that this is a passing phase in your dad's dementia and will cease with the progression.