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?

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Although it’s not the nicest way to handle the situation, your mother-in-law is just trying to alleviate her constipation. She probably feels uncomfortable, and, thanks to her dementia, she does not have the ability to realize that what she’s doing is not socially appropriate. She’s just doing what she needs to do to feel better! 

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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