My dad has dementia and can walk with a frame. In the last few years, he has gotten lazy and will avoid moving or doing things for himself. What can we do?

You need to start by understanding that he is not “lazy,” but it’s the dementia that’s preventing him from knowing what to do when he needs to go to the bathroom.

I have never met a single person who wants to sit in their own feces or get them all over the place.

Perhaps it is time to go with the diapers and be done with it.

Is he alone except for the four times the caregiver comes in during the day? If so, that needs to stop. He’s clearly beyond having someone just drop in to check on him.

Your dad has dementia.
he may not "know" any longer what he is supposed to do.
This has NOTHING to do with laziness.
He may need caregivers more often then 4 times a day.
And if he is living alone he probably should not be.
You need to change your thinking process on dementia.

It would help you to learn more about how dementia changes our LOs so that you will know what to expect and how to better engage with him productively and calmly. Teepa Snow has excellent videos on YouTube geared for caregivers. I have learned a lot from her!

You said Dad has always been like this, then I would say that there was something going on mentally back when he was young and fit. This is not normal. So now he has Dementia it just makes things worse. And he does forget what a toilet is. You will read on this forum how men pee in corners in a plant pot, a closet.

When my Mom was living with me, she had her own bathroom not 10 ft from her recliner. I had a small table right outside the bathroom door. She had hollered she was going to the b/r so I started down the stairs and found her going on the table. She thought it was the toilet.

Peeing in a cup is quite a different kettle of fish than 'trying to have a poop in his coffee mug/plate'. Peeing in a cup is a sign of laziness indeed, confirmed by dad saying, "Well it means getting up and you're here to get rid of it, stop going on at me, it won't take 5 minutes to sort it out." As a younger man, he was lazy, ok, got it. Now, as an old man with dementia & walking with a frame, attempting to defecate into a mug or onto a plate means that he's lost his ability to recognize the fact that he should be using a toilet. That's what dementia is all about. He's not able to 'see wrong' in what he's doing b/c his brain is now damaged. Unless it was his lifetime habit to defecate into coffee mugs and plates, then this isn't an old habit repeating itself, but a new one brought on by his dementia.

Having carers come in 4x a day isn't enough at this level of dementia; he needs 24/7 care, a toileting schedule, incontinent (disposable) briefs, and a regular routine provided to him by a stable person or people coming in every day that he can get used to seeing regularly. Or, he needs placement in a facility where he can get that sort of care daily.

And you need to learn all you can about the mechanisms of dementia. I suggest you read this 33 page booklet which has THE best information ever about dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

Good luck!