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Why Do Dementia Patients Play with Poop and How to Manage It
Kristina Lopez

Fact Checked And Medically Reviewed By Sophia Deschler, RN, BSN | Expert Medical & Wellness Writer

By Kristina Lopez, Writer | Mental Wellness, Lifestyle, Travel

Last Updated on December 29th, 2023

Senior Care

Why Do Dementia Patients Play with Poop and How to Manage It

Dementia, a complex and often misinterpreted condition, affects millions of people worldwide and their families. One of the many challenges that families face is a perplexing behavior known as fecal interaction, where the person living with dementia plays with their feces. It’s a difficult behavior to understand and manage, both physically and emotionally. But why do dementia patients play with poop, and how can caregivers and family members handle it compassionately and effectively? Let’s unravel this intricate issue and shed some light on practical solutions.

Key Takeaways

  • Fecal interaction in dementia is caused by cognitive decline and confusion resulting from medical and psychological factors.
  • Caregivers can create a safe environment, establish a routine, and provide sensory alternatives to manage fecal interaction.
  • Family members should provide emotional support while navigating professional care for the best outcomes for those with dementia.

Decoding the Behavior: Fecal Interaction in Dementia

Old Man suffering from Dementia

Fecal interaction, or engaging with feces, is a behavior observed in individuals with dementia. This situation can pose a significant challenge for caregivers and can cause distress for both the person with dementia and their relatives. But what triggers this behavior? Let’s empathize with a dementia patient and examine the cognitive decline, confusion, and loss of social norms that may result in fecal interaction.

Alzheimer's flow chart

Cognitive decline and confusion can hinder a person with dementia from understanding and performing basic hygiene tasks, such as managing bowel movements. Straightforward tasks like using toilet paper or reaching the bathroom in time may become daunting. Fecal smearing actions, sometimes referred to as poop smearing or smearing feces, may arise from this confusion or as a reaction to physical discomfort such as constipation or a full bladder.

Cognitive Decline and Confusion

As dementia progresses, cognitive function deteriorates, leading to confusion and often, behavioral changes. Imagine finding yourself in a world where familiar tasks become foreign and simple actions, like going to the bathroom, become complex puzzles. How would you react? For some people with dementia, fecal interaction can be a manifestation of this struggle, a response to the confusion that clouds their understanding.

Routine tasks that we often overlook, such as identifying the need to use the toilet or maintaining personal hygiene, may pose difficulties in the early stages of dementia. This struggle can give rise to fecal interaction. Fecal smearing, including fecal smearing behaviors, may arise due to confusion, sensory stimulation, or behavioral concerns.

Loss of Social Norms

Imagine yourself in a world where the norms and rules you once understood no longer hold any significance. This is the reality for many people living with Alzheimer’s disease and other forms of dementia as the disease progresses. Social norms and inhibitions that once dictated behavior can disappear, resulting in unusual behaviors such as disrobing in public, potentially due to feeling uncomfortable in restrictive clothing, or other actions like:

  • fecal interaction
  • inappropriate sexual behavior
  • hoarding objects
  • wandering or getting lost

It is important to approach these behaviors with understanding and compassion, and to provide a safe and supportive environment for individuals living with dementia.

Impaired judgment, coupled with the loss of social norms, can lead to the person with dementia handling fecal matter without understanding the hygiene implications or social inappropriateness of the act. They may not recognize the need to use the toilet or may not identify the toilet itself, causing accidents. In such circumstances, the empathy and understanding of caregivers and family members are essential in handling the situation and preserving the dignity of the person with dementia.

The Underlying Factors: Medical and Psychological Causes

Old man and brain on display

To comprehend fecal interaction in dementia, it’s necessary to contemplate the underlying factors that may influence this behavior. Medical conditions, mental disorders, trauma, and other psychological aspects can have a substantial impact. By pinpointing these possible causes, we can gain a better understanding of why fecal interaction happens and how to manage it effectively.

Medical conditions such as urinary tract infections and constipation can result in discomfort and behavioral changes in individuals with dementia. For instance, a urinary tract infection can induce confusion and agitation, which can alter behavior and lead to fecal incontinence. Chronic constipation, conversely, can result in fecal impaction, a medical emergency that can trigger fecal seepage and incontinence, potentially causing fecal interaction.

Psychological factors also have a significant part in fecal interaction. Conditions such as:

  • obsessive-compulsive disorder
  • anxiety
  • schizophrenia
  • depression
  • bipolar disorder
  • attention deficit disorder
  • autism
  • post-traumatic stress

can all potentially contribute to fecal interaction in dementia patients. Each of these conditions can affect behavior in various ways, emphasizing the need for a comprehensive approach in understanding and managing fecal interaction.

Urinary Tract Infections and Constipation

Urinary tract infections, constipation, and urinary incontinence are prevalent medical conditions that can affect the behavior of individuals with dementia. Uneasiness from a urinary tract infection can incite agitation and restlessness, inducing behavioral changes, including fecal interaction. It is akin to an unscratchable itch, creating an unsettled urge that may exhibit in various forms, including fecal interaction.

Similarly, constipation can lead to discomfort and changes in behavior. Chronic constipation can cause fecal impaction, a painful condition that can lead to incontinence and potentially fecal interaction. Addressing these medical issues promptly can help manage behavioral changes and improve the overall comfort and well-being of the person with dementia.

Trauma and Mental Illness

Life is a tapestry interwoven with strands of diverse experiences. Some strands are vivid and lively, signifying joyous moments, while others are dark and heavy, indicating hardships and trauma. For a person living with dementia, these strands can become entangled, resulting in confusion and behavioral changes. Whether physical or psychological, trauma-related influences can complexly affect behavior in one’s own life.

Mental disorders, such as depression and anxiety, can also lead to fecal interaction. The internal chaos and emotional distress induced by these conditions can be displayed in different forms, including fecal interaction. Comprehending the part of trauma and mental illness in fecal interaction can help caregivers and family members approach the situation with empathy and provide suitable support and care.

Sensory Processing and Dementia

Old woman in a hazy surrounding

Our senses are like a window to the world, helping us experience and interact with our surroundings. But what happens when this window becomes cloudy or distorted? People with dementia often face sensory processing issues, which can lead to altered sensory perception and a need for comfort or stimulation through unusual means, such as fecal interaction.

Changes in sensory perception can make the world seem strange and unfamiliar. The fragrance of a favorite meal might go unnoticed, or the softness of a beloved pet’s fur might feel coarse and uninviting. These changes can be distressing and may lead to behaviors such as fecal interaction as the person with dementia seeks comfort or stimulation.

Altered Sensory Perception

Our senses help us navigate and interact with the world around us. But for people with dementia, these senses can become skewed or altered, leading to changes in how they perceive the world. For instance, a soft fabric might feel scratchy, or a gentle sound might seem deafening. This alteration in perception can cause confusion and discomfort, potentially leading to behaviors like fecal interaction.

Altered sensory perception can make the world difficult to navigate for individuals with dementia. They may struggle to interpret sensory stimuli accurately, resulting in confusion and possibly, fecal interaction. It’s akin to trying to navigate a familiar route in dense fog. The familiar becomes unfamiliar, and the person may resort to behaviors like fecal interaction as a way to navigate through this fog.

Seeking Comfort or Stimulation

Imagine being in a world that feels strange and unfamiliar, where the familiar comforts no longer bring solace. This is the reality that many people with dementia face due to altered sensory perception. In such a situation, they may seek comfort or stimulation in unusual ways, including through fecal interaction.

Amid sensory processing difficulties, fecal interaction can provide a form of tactile stimulation that the person with dementia finds comforting or soothing. It’s comparable to a child who finds solace in holding a familiar blanket or toy. The act of smearing or engaging with feces might offer a sense of control or familiarity in a world that feels increasingly strange and unfamiliar.

Practical Interventions for Caregivers

Lady sitting with an elderly lady

While understanding the reasons behind fecal interaction in dementia is significant, knowing how to manage this behavior effectively is equally important. Caregivers have an essential role in this process, and they can employ several practical interventions to help manage fecal interaction in dementia patients.

Establishing a safe environment is the initial step in managing this behavior. By eliminating triggers and ensuring cleanliness, caregivers can help decrease the occurrence of fecal interaction. It’s comparable to child-proofing a home when a baby begins to crawl; implementing preventive measures can help avoid potential accidents.

Setting a regular routine can also be beneficial. Regular toileting times, consistent meal times, and a predictable daily routine can provide a sense of security and familiarity for the person with dementia, reducing confusion and potentially helping to manage fecal interaction. It’s akin to establishing a rhythm that the person can follow, providing a sense of control and predictability in a world that often feels chaotic and confusing.

Creating a Safe Environment

Creating a safe environment for a person with dementia is akin to constructing a sanctuary where they can feel secure and comfortable. This becomes even more crucial when the person exhibits behaviors like fecal interaction. Caregivers can create a safe environment by eliminating triggers, ensuring easy access to the toilet, and maintaining cleanliness.

Ensure that the bathroom is clean, well-lit, and free from clutter. Visual cues can help the person with dementia locate the toilet and other necessary items. Regular toileting opportunities can help prevent accidents, and using incontinence products like adult diapers can help manage them when they do occur. This creates a safe and secure environment that can reduce the occurrence of fecal interaction.

Establishing a Regular Routine

Establishing a routine can provide a sense of predictability and control, helping to manage behaviors like fecal interaction in dementia. It’s akin to having a daily roadmap that guides the person with dementia, reducing confusion and providing a sense of security.

Toileting should be scheduled at regular intervals, such as before and after meals and before bed. This can help regulate bowel movements, including the frequency of bowel movements, and reduce the chances of accidents. Using a comfortable toilet seat can also contribute to better-managing incontinence. Regular exercise can help reduce constipation, further helping to manage fecal interaction. By following these steps, managing incontinence becomes more achievable.

A routine provides a consistent rhythm to the day, reducing confusion and potentially helping to manage behaviors like fecal interaction.

Utilizing Sensory Alternatives

While fecal interaction can be distressing for caregivers, it’s crucial to remember that the person with dementia may be engaging in this behavior as a form of sensory stimulation or comfort. Offering sensory alternatives can help meet this need in a more socially acceptable way.

Soft or sticky materials like play dough or putty can provide tactile stimulation similar to what the person may be seeking through fecal interaction. A gentle massage can also provide sensory stimulation and comfort, helping to satisfy the person’s sensory needs soothingly. By offering these sensory alternatives, caregivers can help manage fecal interaction while providing comfort and stimulation more acceptably.

Coping Strategies for Family Members

Old woman hugging

Caring for a loved one with dementia can be challenging, and behaviors like fecal interaction can make it even more so. It’s important for family members to have strategies for coping with these challenges. Some strategies include:

  • Providing emotional support and understanding
  • Using effective communication techniques
  • Seeking professional help and guidance
  • Creating a safe and comfortable environment
  • Establishing a routine and structure
  • Educating yourself about dementia and its symptoms

These strategies can help family members navigate this difficult journey.

Providing emotional support for a loved one with dementia involves:

  • Understanding their experiences
  • Responding with empathy and compassion
  • Being a steady rock in the turbulent sea of dementia, providing a sense of security and comfort amid confusion and change
  • Comprehending the reasons behind behaviors like fecal interaction to respond with patience and empathy, rather than frustration or anger.

Emotional Support and Understanding

A journey through dementia can be an isolated one. Emotional support and understanding from family members can offer a beacon of light in this journey. Being understanding of the confusion, fear, and frustration that a person with dementia might experience can help family members provide the much-needed emotional support.

Understanding the condition, its symptoms, and its impact on the person’s behavior and experiences can help family members provide adequate support. It’s akin to being given a map to navigate an unknown city; understanding the landscape of dementia can assist family members in overcoming challenges and providing effective support. Moreover, providing emotional support can significantly influence the health outcomes of the person with dementia, emphasizing the importance of this aspect of care.

Communication Techniques

Communicating with a person with dementia can be challenging, particularly when they are exhibiting behaviors like fecal interaction. Effective communication techniques can assist family members in addressing the underlying issues and emotions associated with this behavior.

Clear and concise instructions, visual aids, a calm and reassuring tone, and a consistent routine can all help manage behaviors like fecal interaction. It’s like speaking in as few words as possible, in a language that the person with dementia can understand, helping them navigate their world with less confusion and anxiety.

By using effective communication techniques, family members can help manage behaviors like fecal interaction and provide a supportive and understanding environment for the person with dementia.

Navigating Professional Care

While family members and caregivers play a critical role in managing behaviors like fecal interaction, professional care can also be invaluable. Medical professionals can assist in ruling out medical causes of fecal interaction, and occupational therapists can provide customized interventions to manage this behavior.

Medical professionals can offer expert advice and recommendations for managing fecal interaction. They can assess potential causes and formulate a care plan that caters to the specific needs of the person with dementia.

Conversely, occupational therapists can offer customized interventions that address sensory processing issues and provide suitable strategies to manage fecal interaction. It’s akin to having a team of experts on your side, equipping you with the necessary tools and strategies to manage the challenges of dementia.

When to Consult Medical Professionals

When confronted with challenging behaviors like fecal interaction, it can be hard to determine when to seek medical advice. Nevertheless, seeking medical advice is essential to rule out any potential medical causes of fecal interaction. It’s comparable to consulting a guide when you’re lost; medical professionals can provide guidance and help you find your way.

Symptoms such as severe constipation, fecal impaction, or fecal incontinence might indicate a need to consult a medical professional. They can provide appropriate treatment options and help manage these conditions, potentially reducing the occurrence of fecal interaction. By consulting medical professionals, caregivers can ensure that they are providing the best possible care for the person with dementia.

Role of Occupational Therapists

Occupational therapists can play a significant role in managing behaviors like fecal interaction in dementia. They can offer customized interventions that address sensory processing issues and provide suitable strategies to manage this behavior.

Occupational therapists can work with the person with dementia and their caregivers to create a care plan that addresses their specific needs. This might include strategies to manage sensory processing difficulties, activities to provide sensory stimulation and guidance on creating a safe and supportive environment.

With their expertise in sensory processing and dementia care, occupational therapists can provide invaluable support in managing fecal interaction in dementia.

Summary

Fecal interaction in dementia can be a challenging behavior to manage, but understanding the reasons behind this behavior can provide a roadmap to effective management. Whether it’s due to cognitive decline, loss of social norms, medical conditions, trauma, or sensory processing difficulties, some strategies can help. From creating a safe environment and establishing a routine to providing emotional support and implementing effective communication techniques, caregivers and family members can provide a supportive and understanding environment for the person with dementia. With the help of medical professionals and occupational therapists, they can address the underlying issues related to fecal interaction and provide tailored interventions to manage this behavior.

Frequently Asked Questions

What are 3 things to never do with your loved one with dementia?

When dealing with someone who has dementia, it is important to never tell them they are wrong, argue with them, ask if they remember something, remind them of a deceased loved one, or bring up topics that may be upsetting.

What is the number one trigger for dementia behavior?

Changes in the environment, having personal space invaded, or emotional overwhelm are the top triggers for dementia behavior. Practicing a response ahead of time can help to manage these triggers.

How do you stop dementia from playing with poop?

Encouraging patients to participate in activities with a variety of options and tactile stimulation can help reduce the desire to play with feces.

What is the smearing of feces in dementia patients?

Scatolia, or smearing of feces, is an uncommon but distressing behavior seen in dementia patients. It is characterized by the presence of feces on the body, furniture, and walls and can be accompanied by other behaviors such as wandering. This behavior causes a significant burden to caregivers, making it important to understand the clinical characteristics of those displaying such symptoms.

Why do some dementia patients engage in fecal interaction?

Dementia patients can engage in fecal interaction due to cognitive decline, medical conditions, trauma, or sensory processing difficulties. Such behavior is usually a response to their changed environment and a way for them to cope.

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Kristina Lopez

Written By

Kristina Lopez

Writer | Mental Wellness, Lifestyle, Travel

Kristina is a freelance writer who specializes in the health and wellness, lifestyle, and travel spaces. She loves all things skin care, hair care and self-care. Kristina is also an editor with experience in copy and book editing. You can find her at KristinaLopezWrites.com.

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