My mother-in-law has dementia and has 24/7 home health aides. The aides identified that she had chronic constipation and would regularly digitally disimpact her rectum. Now she is on a good medication plan so that constipation is not a problem. But still, on confused days, she will dig stool out of her rectum with her finger, smearing it on her bed, or putting it in cups. She gets mad at the aides when they try to stop her. What motivates this kind of behavior? How can we understand it?