What is the best way to handle cleaning my dad after a bowel movement?

Hi Jessica,

You are not alone with being perplexed by this new situation of dealing with cleaning and caring for an incontinent parent. I was there also and did not know what to do until a few aides showed me the process. In addition, I did my own research to learn both the best products and the ideal methods for caring for my mom as she moved from urine incontinent to both bowel & urine incontinent and from walking to being wheelchair bound. I’ll share this:

Adult disposable Underwear (aka “diapers” as some say) is a must, but the key is buying the hospital grade kind as they are better made than store-bought brands like Depends. These you can find on Amazon; two that I use & like are Egosan Maximum Absorbancy and Prevail Breezers.

Couple the underwear with a Poise Overnight pad inserted in the crotch area for added protection, especially for night time. (Don’t remove the paper backing on the pad; just insert & fasten the underwear which will help keep the pad in place. When you do your change of him, sometimes just the Poise is wet and you can remove this, clean him & salvage the underwear. Then just add another Poise pad to finish the job. (Note: These pad are promoted as being for women, so I don’t know if there’s a similar brand made just for men.)

Barrier cream for skin protection: Using A& D ointment &/or Butt Paste (Max Strength) liberally will help protect your dad’s delicate skin from contact with poop & pee. Apply this to his buttocks, backside upper thigh area, and in the folds where the leg meets the pelvic region (just A & D in the folds is fine).

Perineal Cleanser: These no-rinsing needed sprays are ph balanced and is what they use in hospitals and nursing home/care facilities. Spray your wipes, tissues, &/or paper towels with it and then use it to clean the entire area. Amazon, Walmart & medical supply stores sell these.

Underpad protection (aka chuxs): Place a cotton chux under his trunk area. On top of the chux, it’s helpful to put other disposable style chux to make the job of cleaning up spills & leaks easier. I buy a case of the Attends ones (Amazon) and they last a while because I put inexpensive Walgreens puppy pads on top of the Attends chux, and I change those as they get soiled.

A good Bariatric (i.e. sized for larger individuals) commode is ideal. I’d recommend a shower chair/commode combo product with wheels so that you can push him into a bathroom , remove the pan & roll him right over a standard toilet. These cost a bit more than the standard one you get from Medicare. But in my case it has been well worth it in that it’s more comfortable, cleaner and easier for my mom to go sitting upright than in the bed, not to mention it’s a great ease for me too! The one I have can go in the shower too and will not rust. Here are two well-made models as examples: Clean Comfort & Raz

If you are able to get your dad back into the bathroom, a handheld sprayer bidet may help some with cleaning him on the toilet or in a commode chair over the toilet. It’s an Amazon product that you can easily connect to a sink and that you can use to spay water to help with cleaning his backside. I’ve used both this & the Japanese bidet for cleaning my mom, and each one has it’s merits.

Finally, check out videos on how soiled bed changing/bottom cleaning performed by aides for further insights:  Male one:  CNA Skill: Perineal Care Male With Changing A Soiled Brief

These things are all things I’ve used and have been helpful at various points in my mom’s journey. While the costs for equipment/supplies does add up, check out Goodwill and online sites for people selling loved ones’ items for a lot less. I also recommend checking into a house call doctor program for services, calling your local hospice agency for info (and possibly for an evaluation), and for contacting your local support groups/support agencies for other ideas on getting you the assistance/resources you need.

Best of luck to you!

My father has quite a few issues with mobility, sometimes we are able to get him on a portable potty that we have next to his bed, sometimes we can not and have to use a hoyer lift. We were getting up about every 1/2 hour throughout the night for him to urinate. To remedy this issue we now use external male catheters that have made a huge difference. If your loved one is on Medicare or anything similar, they may pay for the catheters and urinal bags, they do for my father. We have had to do some experimenting with them but they have made a BIG difference for us. As far as not making it to a potty for BM's....that is going to be tougher if you do not have help. This is something we also struggle with and we have a man to help us. Sometimes it is not possible even with a male and the two of us women. When this happens, we resort to washing him in his bed the best we can.

This is one of the hardest things I have had to do personally. My sister, her husband, and myself all live with my mom and dad to take care of them. My dad has dementia/ALZ and my mother has been diagnosed with UIP, which is a type of pneumonia that has no cure. She is on oxygen 24/7 and gets out of breath just eating so we do not allow her to do much as far as helping with dad.

We are now looking into getting some outside help and are going to use respite care once a month to give us all a break.

Please take care of yourself.......use any and all help that is offered to you, if no help is being offered........you have made a good first step in asking for ideas on this forum.

Take it one day at a time.......you only have to get through this day today.......I know it can be VERY overwhelming.

You can also go on YouTube and search for videos that are used to train nurses and CNA’s on how to’s on many subjects such as this. Sometimes seeing visual demonstrations can be better teaching guides. 
Good luck!

Thanks for the update. Best wishes as you handle a tough job!!

UPDATE.... I have contacted home health care and hospice. They came out for the past few days and it's getting easier. I took as much advice from y'all as I could, and THANK YOU ALL so much. I think with some time and patience I will get the hang of this.

Why did you remove him from the nursing home? Check to see if he has lost his olfactory sense.

2 things:
1 - a person can't smell themselves that is why people with bad breathe don't know it or when someone uses too much perfume [explains much doesn't it!]
2 - I used to double & triple make my kids cribs - when they are out make it with pad then sheet then pad then sheet then pad then sheet - just make sure the pads are large - bed change is only taking off the top layers [so much easier at 3:00 a.m.]

Local Area on Aging can help. They can help determine if you/he needs more help.
Is your Dad a Veteran? If so he may qualify for a bit of help or a LOT of help if he has ANY condition that may be classified as "service connected" . Contact your local Veterans Commission Office they will help you and their service is FREE. There are others that will help but you pay for the service.
Also (and here I go again) Is he or might he be Hospice eligible? It was AMAZING what I was able to accomplish with the help of "my" Hospice and the VA. We had a CNA that came in several times a week and she taught me how to do a lot of things and easier way to do things. The Nurse was an angel as was the Social Worker. I/we got Hospital bed, wheel chair then a Broda Chair, that is a more adjustable/adaptable wheelchair. I got supplies and medications delivered to my door. Granted not everyone qualifies for Hospice but it is worth a call and have an evaluation done. Do not be afraid of Hospice" my Husband was on Hospice for almost 4 years. The qualifications are "life limiting disease", no cure and no longer seeking treatment. And there must be a continued, documented decline. The person on Hospice will be reevaluated at various times to determine they still qualify.

Now...
To clean your Dad.
If he is using the toilet you clean the best you can once he stands up.
If he is in bed pull off the tabs on the briefs, this way the sticky tape does not get stuck to the skin where it may cause a skin tear. Roll or bring the front of the brief down to the bed.
Then the easiest way is to roll him to one side, place the leg that is on top over and in front of the leg with contact with the bed. This will enable you to clean easier.
Using wipes clean as best you can. Placing the soiled wipes on the absorbent pad.
Once he is clean roll up the pad with the brief and soiled wipes. Toss that away.
Roll up a clean absorbent pad about half way and place the rolled portion near the center of his back. The flat, unrolled part lays flat on the bed.
Roll your Dad to his other side then unroll the clean pad.
Place a clean brief under him as far as you can again with the center of the brief lined up with the center of his back.
Roll him onto his back and you should be able to pull the clean brief up and attach the sticky tabs to the front of the brief.
I guarantee that this will not look pretty the first dozen times you do it but you will get better at it.
And I also guarantee that at least once you will have to do it all over again because he will pee again or the BM you thought was done wasn't! Not to mention the times you will have to do it again because the tab broke, or you tore the brief, or you got it backwards! I could go on but you get the idea.
Not looking for perfection here just a way to keep someone dry and clean as best as you can.
Changing the sheets on the bed is pretty much done the same way, roll up half the sheet place it by the center of the back, roll the person over the clean sheet then unroll the sheet. Try to get out as many wrinkles as you can as wrinkles in any material will cause red marks due to uneven pressure. While not a big deal normally when a person is bed bound and the circulation is not good there can be skin breakdown. (another good reason for Hospice they also keep a close eye on things like this)
Good luck.

You can find your local Area Agency on Aging by putting in your zip code at eldercare.acl.gov/Public/Index.aspx. They should be able to answer your questions, link you to community resources and see if you qualify for any assistance with in-home help.

Can his doctor help advise? Also eat a good diet and cleanliness.

My husband can not tell me when he has to go so I started taking him and sitting him on the toilet on a schedule, and he stopped going in his pants and goes when he is in the bathroom. There is an occasional accident but not many. He is getting less mobile so when I can't get him to the bathroom I have a commode already so I can bring it to him and hopefully he'll continue to go on schedule.
I can't imagine how uncomfortable it is to have to do this with your father, and same for him. You can get home care that will come in to shower/bath him a couple times a week, but if they consider there to be a risk of hurting anyone they will only do sponge baths...that's what happened with me.
Good luck to you, this is a horrible thing we have to do but it's even worse for the LO.

If your father is strong enough to stand, and you can wheel him to the bathroom, use an extend shower hose that can double as a bidet and don't be afraid or disgusted about sticking your hand down there and getting your hands dirty. It all washes off including a good rag that can save you from buying wipes. You wipe, wash the same rag and wipe again until he is completely clean. This is what true love is about. Also, if he's immobile, get a plastic mattress or place a plastic sheet of material between the sheets and mattress to protect the fabric. You don't have to use a whole diaper to collect the mess. I take one Depends or any generic brand and cut them up in four pieces with a scissors, then place them inside his briefs for support and clean him accordingly. I hope this information helps. Good luck.

Call HomeHealth and or Hospice. They will bring you some supplies. If Dad is a veteran, the VA will also help furnish supplies.

You need to us Aloe Vesta Cleansing Foam - it's Perineal (body fluids) and needs no rinsing. Also, you could use some Pre-Surgical Scrub (Hibiclens) and the VA will furnish both if asked. Limited amounts, but they will supply them. I mix them together and it not only cuts smell but kills all germs. Vital to your own health. I even use a little when I wash his bedding.

HomeHealh will supply gloves and barrier cream to help prevent bed sores.
You need a waterproof mattress cover and still use incontinence mats. I bought mine from Vitality Medical online. (the pads, not the mattress cover)

I'm no expert, my DH is 96 but not yet bedridden. But my guess is your dad needs to be changed more often. Since I haven't had to do this yet, I can't advise. But HomeHealth and/or Hospice can teach you a lot!

No, it's not easy - but we all gotta poop daily.

You mentioned that you tried putting him in the shower. So that must mean you can at least get him into the bathroom. If so, get a Japanese style bidet for your toilet. While some are really fancy and really expensive. The cheap ones are only about $20 and very easy to install. Instead of using the shower to wash him off, use the bidet. Get one with an adjustable nozzle so you can swing it around to wash various areas. Otherwise you'll have to get him to move himself over the seat which is much harder. A dual nozzle one will also have a nozzle to wash the front.

Here's what I do with grandma.

1) Maneuver her so that she's standing right in front of the toilet.
2) Pull her pants and diaper down. Not all the way, but enough that she can sit on the toilet without the garments being caught.
3) Pull off the pants which go into the hamper for washing. Pull off the diaper which goes into the trash. Done carefully, there is no smearing. Takes experience. I kind of wrap the diaper upon itself on the way down.
4) Use the bidet to wash everything off.
5) Put a diaper and pants back on pulled up as far as I can with her sitting down.
6) Stand her back up and pull everything back up all the way.

About $200 bidets can also have a drying function so you don't even have to worry about drying. The bidet will take care of that. Otherwise use TP, paper towels or even a regular towel to dry off at some point.

Every one that needs caring for should have a bidet. It's a lifesaver. Even for someone that can be bathed/showered, a bidet prewash makes things more pleasant for everyone involved.

Jessica, you haven’t told us why you removed him from the nursing home. There should be a local Council on Aging that you could call for help and advice on taking care of your father. It sounds as if he is ambulatory as you say you have tried to get him to use the potty. That is a big plus, but your father may not be able to tell when he needs to use it. My father seems to have lost the ability to tell when he needs to go. He uses a urinal sporadically, and while he was still home we just accepted that he was going to poop in his diaper and took it from there as he was too heavy to place on the toilet. He is by no means overweight; he is just a big man. It was easier to just hoist him in bed to clean him up using the hoyer lift.
As to bathing him.... is your bathroom set up for a handicapped person? Trying to bathe him by yourself without training or grab bars or a bathing bench could be dangerous for the both of you. Does your father have the funds to pay for a professional to come in several hours a day to help? You could watch how she does things. For several years prior to my father going into a nursing home, we had a former female Marine caregiver who was able to bathe him as we could not do it.
There is a lot of learning and on-the-job training involved with taking care of someone needing the care that your father needs. We had 15 years of learning as both my parents became more and more debilitated. It sounds as if you are experiencing a crash course.
Don’t use baby wipes. They make adult wipes which are twice the size. Please call some agencies (Adult Protective Services or the Council on Aging that I mentioned earlier). You need a lot of help and guidance as your father’s needs are many, and it sounds as if you were not prepared for the reality of it all. Maybe some more people on this forum can point you in the right direction. You sound like a person with a big heart, who really wants to help her father, but as I read on this forum “It takes a village to care for an elderly person”.

Jessica: does your father still have his sense of smell? Perhaps he can't smell it because he can't smell. Is he able to go to another nursing facility? This sounds like an impossible task for one person to care for a large person. Thank you for trying so hard to care for your dad!

Sorry Treeartist I am new at this asking for help thing to. My dad is in adult diapers, and he has to have help doing everything but feeding himself. It is allot to handle and I am doing the best I can. The nursing home that I removed him from didn't help us at all. So it's been a learning process. I tried putting him in the shower but he's a big guy and so ended up on my walls and everywhere else. I have tried baby wipes, but it's too much. So now I'm using warm wet towels and sliding him from side to side and that seems to be doing better. I can't get him to use the potty That is beside his bed, or the one in the bathroom, or even the pee jug for that matter. So it's ending up in my floor because he's soaking to the diapers at least twice a day. I can't get into shower or take a bath. Since he's not using the toilet at all he smells really bad. I understand being incontinent and not knowing when you pee or poop, but I don't understand not being able to smell it. I'm starting to get resentful and then I get mad at myself. I just don't know what to do. Thank you guys for trying to help.

I used Huggies baby wipes. They r thick and big. I also bought a trash can with a foot that opened it. Lined it with a plastic garbage bag and put the soiled diapers and wipes in it.

Use disposable gloves! And wipes are a life saver. Plastic grocery bags are a must to put dirty content in!

Good luck!

Dear Jessica,

I know this is delicate situation and we all need our privacy. Treeartist gave a lot of good information.

For my own dad after his stroke, he used Men's Depends products. Depending on the situation he needed to have a shower to clean up the mess and to ensure his comfort. While he was in rehab the attendants used large wipes to help clean him.

I'm so sorry, I know its hard to reach this stage in our parents' lives. I know others will offer more good suggestions.

Jessica, we need a little more information. Is he completely incontinent? Does he wear adult diapers? Is he bedridden? In a wheelchair? We found that it was easier to lay my father in bed (we had to use a hoyer lift), turn him on his side, and clean him from behind. This position afforded him some dignity and privacy as we were not face to face as he was being cleaned. Hang a plastic grocery bag off the bed to hold the dirty diaper. Use toilet paper to clean off most of the stool, and large wet wipes to clean the rest. This may take several. 2We bought them from Sam’s. I would always give my father a wet wipe for him to clean his front as he was able to do this. Tie up the grocery bag. Mission accomplished! My dad never needed any kind of ointment applied because the wipes we used had aloe in it.
I know there are people on this forum with a lot more experience and tips than I know. I hope they respond. I kept up a conversation with my dad during this procedure as I think it helped to distract both of us from this unpleasant but necessary part of life.