loss of social grace

grandmamary_gaJanuary 23, 2009

My MIL is in an assisted living facility. She is soon to be 88 years old. She has mild dementia. On medication for that. Has had many bouts of uti's. Her most recent problem has been brochitis which she has been treated with several antibiotics. Still has the coughing and problem with coughing up phlem.I'm sure I have spelled that wrong. Anyway she has taken to just spitting whereever she is, in her room on the walls, on the floor, in the dining room, in cloth napkins in glasses and on and on. My dh has asked her why she does this and her statement I guess I'm going crazy or the staff are liars. The director of the assit. living home has said that they have seen this in some patients and its called loss of social graces. Is this another step in the dementia or something else. Can it be treated. Will it stop. Will we have to put her somewhere else. She also has had a problem with not making it to the bathroom at night. Then everything has to be laundered and the carpet shampooed. sometimes daily. Its getting very frustrating for Dh who is her caregiver. Any suggestions will be welcome.


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It's very unlikely that she will get better. As far as treatment, that's probably not going to happen either. It's like she is regressing to a point in childhood when such things were not worried about. Children learn not to spit just anywhere. They get old enough to make it to the bathroom in plenty of time. Sadly, the dementia patient goes in the opposite direction. It's a common thing with some types of dementia.

Now, see if this present home has a dementia unit. There may come a time when she needs a more secure area. If they won't be able to handle her, then, if and when she gets worse, you will have to move her. So, start looking for a suitable place. You don't want to have to move her in a hurry. Look at what's available and pick the one that is will work the best. If they have a waiting list, try to get her name on it. You may not have to move her, but you need to know what's available.

Since she is having problems getting to the bathroom in time, you can expect that will probably going to get worse too. She doesn't need to be a place with carpets.

Good Luck and take care of the DH.

    Bookmark   January 23, 2009 at 7:39PM
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Mary, your MIL's story sounds all too familiar. My mom started the spitting about two years ago. She complained that food particles got stuck in her teeth. For years & years she used toothpicks to take care of the problem. But once dementia started setting in, she got into the spitting habit. She picks out food from between her teeth & gums and then spits into her napkin or her plate. She's been living in an assisted living facility for over a year now, and her spitting routine follows every meal and takes close to 10 minutes -- all done at the table in the dining room.

I think the AL director is correct. The dementia gets to the point where the elderly person no longer has social graces. I don't think it can be stopped. Unfortunately, it's part of the disease progression. I think it's best for you to just ignore it, if you can. Trying to correct your MIL will just frustrate & confuse her. As a word of warning, it may get worse. I won't describe what my mom now does when her nose drips or her disgusting toileting behaviors. I don't want to make you sick!

Many ALs now have memory care wings and your MIL may eventually have to be transferred to one. Most ALs & memory care facilities are used to dealing with the strange behaviors of persons with dementia.

Regarding the night time accidents, it may be time for overnight Depends. You can purchase them online for a better price, and you might even find a better quality product. You also might want to consider putting a commode near her bed. That might help with the dribbles. I realize that the commode would have to be emptied & cleaned daily, but it still might be easier than cleaning the carpet.

As far as laundering goes, you could purchase a quilted waterproof mattress and a vinyl mattress protector. In addition there are disposable and reusable/washable underpads that can also be used. My mom uses all three items along with the Depends. It has helped keep the laundering down.

Here are some web sites to give you an idea of what's available:



Here is a link that might be useful: Waterproof Matress Covers

    Bookmark   January 23, 2009 at 8:00PM
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Agnespuffin and Shambo, Thank you for your comments. We realize that it will probably get worse than better. The assisted living facility does have a memory care unit. Most of the residents who are there are alzheimers patients. We are not sure she is ready for that at this time. Nor has the staff recommended that we think about moving her there. But i'm sure it is coming. We have thought of looking into another place for her. She is fully aware of what is going on around her and will remember things like doctors appointments and outings. We have the mattress covers in place and the pads for the bed etc. She refuses to wear depends at any time of the day or at night. We even took all of her underwear out of her drawers so that she would only have the depends to use and she just wore nothing. The staff does empty the beside commode in the mornings. Of course we are paying extra for all of that. DH is coping very well. Thank you again for your comments.

    Bookmark   January 24, 2009 at 9:25AM
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Mary, if you're still around... If your MIL refuses the pull ups like Depends, do you think she'd try pads? They're similar to the menstrual pads she might have worn when younger, and, therefore, might be more acceptable to her. They come in a variety of thicknesses & absorbency levels.


Also, she could use washable incontinent underwear. They're just like regular ladies briefs but with a thicker built-in pad in the crotch area. Not a perfect solution but maybe better than over soaking clothing & bedding.

Here is a link that might be useful: Eversures Incontience Underwear

    Bookmark   January 24, 2009 at 10:31AM
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Shambo, Yes we tried pads but she would flush those resulting in stopped up commodes. Never thought of using something like a washable underwear with pads built in. Thank you for sending the website. Will definetly check it out.

    Bookmark   January 24, 2009 at 2:12PM
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Mary, it's always something, isn't' it? Sometimes trying to help our elderly loved ones gets so very frustrating.

Regarding the website I posted, I bought my mother about three sets of the pretty light blue printed briefs. Her vision is poor, but she can distinguish the blue print from other items in her dresser.

My mom wears Depends but also insists on wearing the incontinence briefs over her disposable pull ups. She's as padded on the bottom as a toddler.

With all that padding, getting her elastic waist pants on was a problem. Taking them down to use the bathroom was even worse. Eventually I found some pants online that are slit at both sides and fastened with Velcro. They're much easier for her to get on & off. Just perfect for someone dealing with arthritic hands and incontinence.

    Bookmark   January 24, 2009 at 11:12PM
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my Mom has dementia and she has hygiene problems I won't go into details, yuck!!!!! Nothing we say or do changes it. She gets angry at my Sis when she tries to correct the situation. Mom is 96 and still lives at home.

I was so lucky in caring for my husband. I cared for him for 4 years before I put him in a home. He trusted me, he did every thing I suggested without a problem. When I put him in the care home he was excited about being in a new place.

He thought the care home was his home,

    Bookmark   January 25, 2009 at 12:23PM
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