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When mom and dad moved into their 2 bedroom/1bath senior apartment we got mom a bedside commode. It seemed necessary for emergencies. Mom has bad knees/also incontinent and using during the night became her routine. Now dad has passed and she walks past her bathroom to use the bedside commode! She uses it all day and rarely cleans it and the smell is indescribable. Mom has mild cognitive decline but understand she needs to do this chore. She is still able to cook and do simple chores. Sister and I live in town plus a good bit of family who visit weekly. She is able to do what she wants. Mom also has a sitter 6 days a week 5p-9p for help with meals, showers and light housekeeping. My sister wants to remove the commode completely but I am concerned about night time falls. Mom does wear a life alert. Any suggestions? It is disgusting.

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Sounds disgusting. Does the caregiver empty it when she is there? Maybe caregiver should start getting mom to the bathroom to try to undo this learned commode behavior.
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Does her toilet have a raised seat and hand rails? Perhaps it is too difficult for her to get on and off the toilet?
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InFamilyService Sep 2020
Yes, her regular toilet has hand rails and a raised handicap seat. She lives in an apartment in a senior community and its standard for her home.
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The caregiver, as part of her job should empty and clean the bedside commode and NOT put it back in the bedroom until she leaves in the evening. Or if mom is able she can put the receptacle back in the commode before she goes to bed.
The other option is to remove it until she really needs it.
Has she fallen? I know you don't wait for a fall but if she is going to fall chances are she is going to fall just as easily getting up and moving to the commode.
I would also put cameras in so you can remotely monitor her for any falls.
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InFamilyService Sep 2020
In the past year mom did have 2 falls. The caregiver starts her shift at 4:00 p.m. If mom truly needed it it would be one thing but her bathroom toilet has a raised seat and hand rails. The cameras are a good idea.
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Perhaps mom is afraid she'll spill it. Maybe she simply doesn't care.

Elderly people can become nose-blind and they don't 'smell' as well as they used to.

My mom's cath bag always has maybe 3 Tbps of old brown urine in it. She either does not see it or doesn't care. It smells so bad, it gags you. I don't clean it and never will, she is capable of doing so, just chooses to not do it very well.

The smell on top of the depends she wears (which are saturated, b/c she does not use the toilet at all) are just folded up in the trash. I used to try to 'fix' things for her until I realized she didn't WANT me there, 'fixing' things. She has the trash taken out once a week, so by Thurs, it's pretty rank in her place. She;s overflowed the bag and depends many times on her recliner and she just puts another blanket on the recliner.

She refuses help in this dept, so we let her place just smell awful. I gag when I walk in, and sometimes, against her will take out the bathroom trash and bleach the garbage can--but that's rare. If I'm staying longer than 15 minutes, I have to in order to stand the smell.

'Old urine' is often very smelly due to dehydration and the meds an elderly patient may be taken-along with general decline in hygiene. In your case, you probably could get the CG to empty the commode. And clean it so that it doesn't smell. It would be hard to work with that 'smell' hanging over you.

Elders will also use 'air fresheners' all over the place in the confused state that covering up the base smell will make it be OK. To me, it just adds to the funk.

In your case, where mom is walking PAST the toilet to use the commode makes me think she's gotten into a habit that could be broken.

Good luck. Toileting issues are so difficult to deal with.
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InFamilyService Sep 2020
Yes, this has become a bad habit for her. She can do plenty but would rather do nothing. The more we do the less she moves. Soon she will not be walking at all.
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Has anyone mentioned placing cat litter in the bottom of a garbage bag, then placing it in the refuse bucket and putting the open end around the frame under the seat?

The bucket doesn’t need to be emptied quite as often, and if tied with a twister at the top it will be less often spilled, odors are somewhat less of a problem and scented or super cat litter can help with that issue, and deodorizer or antiseptic can be sprinkled into the garbage bag during set ups and removals.

Downside is that the bag is heavier to dispose of, but even a small amount of litter may help if your mom is strong enough to manage the weight, and spillage of “liquids” is significantly reduced.
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I would put the commode frame over her toilet. Remove the receptacle. This will give her the arms and height her commode may not have. A lower toilet is hard on the knees.

Leave lights on. Maybe a motion detector light would help keep her safer.
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Does the toilet feel as safe to her as the commode - is the height adjusted to suit her and are there sturdy grab bars to help her get up and down?
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Her sense of smell is shot. I learned that with my dad when I'd walk into the house and find the refrigerator full of rotting meat. He functioned perfectly well otherwise and was horrified when I'd point it out.

If your mom has bad knees and is prone to falls, do you really want her to be walking around carrying a bucket of waste she might spill? I sure wouldn't.

These types of issues are the warning signs none of us recognize until after the fact. They're telling us that our loved one is not as able to handle daily tasks as we think they are. My dad was able to cook, drive, go to his meetings and events, pay the bills, etc. and care for my mother, but he couldn't smell rotting food -- or gas when my mom walked past the stove and turned it on, and walked away when it didn't light.

This is a wake-up call for you to take bigger steps that you think you need to.
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InFamilyService Sep 2020
Thank you for the honest advice. Mom now sleeps most of the day and her sitter comes after work. Her doctor is monitoring her depression.
It just seems she does what she wants to do. Sister, sitter and I are monitoring her food and she doesn't seem to recognize hand written "throw out" dates on the containers.
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If you aren't prepared to do the 24/7 care it is time to consider placement now. If it isn't time, it soon will be. To expect an elder with balance problems, dementia, and other aging factors to do what it takes to empty and clean a commode is not a good thing. There will be an accident. I agree with others that sense of smell decreases and often disappears (Lewy's) with age. The care is, for whatever reason, becoming more now than you want to or can do. That isn't a criticism. That's encouraging you to recognize your limitations. None of this will get better. So sorry, but it won't get better.
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InFamilyService Sep 2020
Thank you for the realistic reply. Its just what I needed to hear.
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I agree with MidKid. She may be afraid of spilling it or dropping it. She may very well be fearful of this task.

I would also question if she is truly capable. Maybe her cognitive decline is worsening. Talk to her doctor.

I had a bedside commode in my mother’s room which I emptied. I almost spilled it on occasion due to gagging.

Some caregivers can tolerate smells easier than others. I cannot. It totally took my appetite away which is not good for a person like myself who doesn’t eat a lot to begin with.

It wouldn’t hurt to start investigating possible facilities for her. Or additional help to assist her if that is in line with your budget.
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