mothers – My Alzheimer's Story

Advocacy, Antipsychotic drugs, Music, Videos

she couldn’t sing because she was sedated

May 26, 2020 amazingsusan

My mother, who lived with dementia, was chemically and physically restrained every day for the forty-five months she lived in a dementia jail (aka a long-term care facility or nursing home).

These restraints could have been avoided if the medical personnel in charge of her care had addressed the root causes of the behaviours they found challenging in her. All they needed to do was to take a closer look at what was going on around Mom. If I could do it, surely they should have been able to.

When Mom was sedated, she was unable to do things she loved to do such as walking and singing. Here she is not singing (because she had been sedated an hour or so before), at some of the weekly sing-alongs conducted by volunteers at the place she resided:

Besides cruelly sedating her with antipsychotic drugs, no one who was involved with my mother’s care listened to my request to provide her with music therapy. So I hired a music therapist myself and the three of us enjoyed many happy afternoons together after the worst sedative effects of the chemical restraints had worn off. Here’s an example of one of those wonderful sessions:

a magical musical alzheimer gift

And this one was just four days before Mom died on August 17, 2016:

one last sing-along: august 13, 2016

I miss you Mom.

50 more pics that prove my mom was neglected and abused in long-term care

four years later is too late for my mom. but it’s not for others.

alzheimer disease didn’t do this. drugs and dementia jail did

10 reasons why neglect and abuse of elders with dementia may be the norm rather than the exception in long-term care facilities

25 practices long-term care workers know are elder neglect and abuse; it’s time to put a stop to it

#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
/* Add your own MailChimp form style overrides in your site stylesheet or in this style block.
We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Advocacy, Care Partnering, Toward better care

50 more pics that prove my mom was neglected and abused in long-term care

May 24, 2020May 27, 2020 amazingsusan

If you don’t have proof, you won’t be believed. Sometimes, even if you DO have proof, you are not believed.

I learned that when I went to court to try to get control of my mother’s care in early 2014. I had lots of proof, but I still lost. I was devastated. But the loss didn’t stop me from documenting the neglect and abuse my mother continued to suffer until her death in August 2016.

The neglect included not having her incontinence pads changed as frequently as they should have been, having the pads put on backwards, not having wounds properly dressed and not having the level of one-on-one care she required.

The abuse consisted primarily of being chemically restrained with antipsychotic drugs (which caused her to stumble, bump into things, fall and sustain a continual stream of injuries), and being physically restrained with recliners, wheelchairs, and various types of alarms.

These fifty photographs (all taken in 2014), show what this neglect and abuse looked like.

This slideshow requires JavaScript.

If you have a family member in long-term care:

learn what constitutes neglect and abuse
visit often at different times of the day
watch how staff treat other residents
document what you see and hear
advocate for proper care

25 pics that prove my mom was neglected and abused in long-term care

four years later is too late for my mom. but it’s not for others.

alzheimer disease didn’t do this. drugs and dementia jail did

10 reasons why neglect and abuse of elders with dementia may be the norm rather than the exception in long-term care facilities

25 practices long-term care workers know are elder neglect and abuse; it’s time to put a stop to it

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Advocacy, Care Partnering, Toward better care

who is responsible when people living with dementia are robbed of their dignity in long-term care?

May 14, 2020May 14, 2020 amazingsusan

Of the roughly seven hundred entries on seventy-five pages of nurses notes I was sent leading up to the court case I had initiated to try to get legal control of my mother’s care, the only one that made me cry was logged at 9 a.m. on June 26, 2013:

The second-floor “dining room” was small, more like a kitchenette really. It had a table in the middle at which six residents could be squeezed at mealtimes, a recliner (of course!) in one corner, and a rocking chair in the other. It had sliding glass doors that opened onto a little balcony where no one was allowed to go, and, at the opposite end, a sideboard with a sink and cupboards above.

I imagined Mom in there, needing to use the bathroom, but not knowing where one was. Maybe she had cramps in her tummy, as she often did in the morning. She suffered with diverticulitis. It flared up when she ate nuts or seeds or corn.

“Where’s the bathroom?” Mom would have asked other residents sitting at the table. “I need to go to the bathroom.”

The others, if there were any there, wouldn’t have answered because they wouldn’t have known. They would have forgotten, just as she had. If there were no other residents, Mom might have asked one of the care workers. If there had been any there, they might have noticed the telltale signs that Mom needed to got to the toilet. The signs were obvious, as I had explained to the Director of Nursing (DoN) four months earlier when she had asked me in a phone call whether Mom was in the habit of squatting and peeing on the floor. “No,” I said, surprised by her question. I wrote her an email the following day (February 5, 2013); it read in part:

“After I hung up the phone with you yesterday, I knew immediately why mom did this “squatting” behaviour in the living room at [the Dementia Jail]…she was desperate to “go to the peeps,” she didn’t know where to find a toilet, there was no caregiver…to help her, so she decided the best solution was to go on the spot rather than ‘in her pants.’

Even in her own room, she needs to be guided to where the bathroom is. For example, she may be sitting on her bed, facing the bathroom door, she will say: ‘ need to go to the peeps’, stand up, turn right, and head towards the closet.

It’s easy to see the signs when [Mom] needs to go to “the peeps;” she starts to look distracted, she fiddles with the front of her pants, she may stand up, she may put her hand on her lower belly or between her legs, just like little kids do.”

The DoN replied saying she would share the information with the staff. It seemed strange to me that she hadn’t figured out for herself what lay behind the “squatting,” given that she was meant to be an expert in caring for people living with Alzheimer disease. Mom’s behaviour was basically Dementia Care 101, or at least it seemed so to me.

Had the DoN conveyed the information to the staff (who also should have known without having to be told), and had there been one of them in the dining room that morning, they might have wondered what my mother was doing when she went over to sideboard and took a piece of paper towel from the roll that was sitting there.

They may have kept watching when she laid the paper towel on the floor in whatever space she could find. But when she stepped in front of the paper on the floor, unbuttoned and unzipped her trousers and started to pull them down, surely they would have intervened and taken her to the toilet. Or one would hope they would have intervened…

But no one took my mom to the toilet, so it seems there weren’t any care staff there to help her preserve her dignity. Where were they? Around the corner at the nursing station, which was no more than twenty feet away, having a chin wag as I had observed them do on many occasions? Or maybe they were busy with other residents? Who knows?

What can be understood from the notes, which were written from the perspective of the charge nurse and not my mother of course, is that Mom had a bowel movement on the dining room floor and then tried to clean herself. How must she have felt throughout this episode? Confused? Scared? Embarrassed? Ashamed? Agitated? Upset? Surely she was robbed of her dignity, and that’s what made me cry when I read the entry. When I flipped the page to find the same thing happened the following week, I saw red.

I remembered the incident of the dirty pull-up. The week after, Mom was without a pull-up under her trousers, which were wet, two nights running. The next Saturday morning, I found her walking naked in the hallway; her bed was soaked and the room reeked of urine. Then there were the times her incontinence pad was so full it had leaked, and created crescent-shaped wet spots on her pants.

None of these had been mentioned in the eight months’ worth of nurses’ notes I was sent in advance of the court hearing. But fourteen other incontinence incidents had been recorded. They all implied the fault lay with my mother, when in reality it was the DoN’s responsibility to ensure her staff met my mother’s basic hygiene needs. Had the Director of Nursing done her job, my mother wouldn’t have suffered the indignities she did.

Likewise, my mother wouldn’t have been chemically restrained with antipsychotic drugs, physically restrained using recliners and other means, hospitalized with thrombosis in her leg, forced into incontinence, forced into a wheelchair, denied the right of seeing me, her daughter, during the last eighteen months of her life, and left in the bathroom alone to fall, break her arm and as a result of the trauma, die three weeks later.

Robbing someone of her or his dignity is tragic. Neglect and abuse are criminal. Those who are responsible should be held accountable.

Note: To add insult to injury, there were no “public toilets” on the second floor where Mom did not have a room of her own (her room was on the third floor). So when she was “toiletted,” she was taken into one of the second floor residents’ rooms too use their bathroom. But if she “wandered” into one of the second floor residents’ rooms on her own, she was admonished for doing so, dragged out into the hallway and made to sit in a chair in the corner by the elevator. Naturally she protested by striking out, and was then written up in the nurses’ notes as being aggressive and uncooperative.

which way to the bathroom?

hail mary i need to pee

5 ways we rob people with dementia of their dignity

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Advocacy, Care Partnering, Death & Dying, Love

hilda zlataroff should have died of old age

May 10, 2020May 10, 2020 amazingsusan

Family care partner Nicole Jaouich visited her 102-year-old mother Hilda Zlatoroff in a Quebec long-term care facility every day for 6 years to help her eat and drink; her mother’s eyesight was failing, and she lived with dementia. When COVID-19 struck, no visitors were permitted from March 14, 2020, onward. Over the next 5 weeks, Jaouich watched her mother’s condition deteriorate via a video camera. Her mother died of dehydration on April 27,2020.

~~~~~~~~~~~~~~~~

At 102, it wouldn’t have been surprising if Hilda Zlataroff had died of old age.

Tragically, she did not.

Hilda Zlatoroff died of dehydration in the Saint-Joseph-de-la-Providence long-term care facility in Quebec, Canada, at 5:35 am on April 27, 2020. Ms. Zlatoroff had been a resident there for nine years. She didn’t die of COVID-19. She died as a result of COVID-19, and the massive cracks in long-term care that became canyons with the onset of the pandemic.

“I guarantee that if I had been able to be with my mother, she would not have died of dehydration,” says Nicole Jaouich, Hilda Zlataroff’s daughter.

Jaouich had visited her mother every day for six years to help her eat and drink because Hilda Zlatoroff’s eyesight was failing and she lived with dementia.

“Maman needed encouragement to eat and drink. It was important not to rush her. ‘Do you want to drink a little juice?’ I would say to her, and then help her to lift the glass to her mouth,” Jaouich says.

“When I couldn’t be there or needed a break, I hired someone to go to the residence and be with her. She had someone with her eight hours a day every day for six years. She was my mother, she deserved to be cared for,” Jaouich has tears in her eyes.

Then COVID-19 struck, and from March 14 onward, no visitors were permitted at the residence in an effort to limit the spread of the disease. Over the next five weeks, Jaouich watched her mother’s condition deteriorate via a video camera she’d had installed in her mother’s room. It was painful.

“Sometimes they put the meal tray in front of her, but she didn’t touch the food because she couldn’t see it. Then they would come back and pick it up, even though she hadn’t eaten a thing. And how could she drink? They didn’t help her,” Jaouich says.

“I will never forgive the government for banning family caregivers from visiting and helping to care for our family members. The government knew very well the facilities were understaffed. This has been an issue for years,” Jaouich says.

“Family care partners were needed every day to help give basic care. When family members were banned, it made things even worse than they already were. Family care partners should have been integrated into the caregiving, not forbidden from coming to help,” Jaouich says.

“Of course I knew my mother would die, she was 102. But to have her die from dehydration, alone, without me by her side, was criminal and cruel. I will never get over it,” says Jaouich, who, ironically, is an advocate for better long-term care in Quebec, and a board member of Handicap Vie Dignité, an organization that has been fighting for reform for years.

Jaouich wasn’t able to be with her mother when she died, but she was able to visit twice for ten minutes in the week before her death, and then for forty-five minutes each time during the last few days before she passed.

“She was so beautiful,” Jaouich smiles slightly. “The last time I went she was breathing peacefully and her face was relaxed. She squeezed my hand slightly when I held hers. She knew it was me. She knew I was there. I only wish I could have been with her when she died.”

dying with my mom

it’s taken a pandemic and tens of thousands of deaths for people to get what long-term care advocates have known for decades: the system sucks

5 Raw Emotions Alzheimers Dementia Caregivers Feel Every Day

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Care Partnering, Hope, Inspiration, Joy, Love

5 powerful dementia care lessons i learned being my mom’s care partner

February 12, 2020November 22, 2021 amazingsusan

Being my mother’s primary care partner in various ways for ten years was one of the hardest things I’ve ever done. It was ultimately also one of the most rewarding in that it provided me with countless learning opportunities. I’ve blogged before about the joys, the difficult emotions and the lessons I and other dementia care partners have learned; here are five more:

1 ) People are people, not furniture

A changing brain does not suddenly make someone less than human, less what they were before their brain started to change, or less deserving than anyone else. People are people, no matter the condition of their brain, or their body. They have rights, needs and wants, just like the rest of us do. Recognizing and fulfilling those rights, needs and wants are societal and communal responsibilities.

2 ) Stigma destroys the stigmatized

Stigma can be more destructive and devastating to a person’s well being than a terminal illness. Stigma causes many people who live with dementia and the people who care for them to become isolated, sometimes even shunned by family and friends. This isolation is often more damaging to people who live with dementia and their care partners than the condition itself. Changing the way we see dementia and the people who live with it is one of the most powerful ways we can positively impact the well being of those who live with the condition.

3 ) Life is challenging

The challenges we face in life provide opportunities for us to learn, grow and become better people. The challenges of living with dementia and/or being the care partner to someone who lives with dementia are like other life challenges in the sense that they also provide opportunities for us to learn, grow and become the best we can be. It’s up to us to find the opportunities in the challenges we face.

4 ) We are not dead until we die

This seems obvious. Nevertheless, others treat many people who live with dementia as if they are already gone. I believe that treating someone as if they are not here when they still are increases the chances that they will decline at a faster rate. People need attention (via words, deeds and touch) to know they are loved and appreciated. Treating people with love, compassion, understanding and tender care will improve their well-being and boost their ability to thrive, even as they near the end of life.

5 ) Not needing to be recognized increases the chances you will be

When friends and family let go of the need to be recognized by a loved one who lives with dementia, I believe the chances that the person living with dementia will recognize them increases. My theory is unproven and based on my own experience, but I feel strongly that it’s true. When we let go of the need to be recognized, we become more relaxed, more loving, and more open to possibility, all of which impacts those around in a positive way and creates an environment in which positive interactions are more likely to occur.

What lessons have you learned?

top 15 things dementia care partners say they’ve learned

5 Uplifting Emotions Felt by Alzheimers Dementia Care Partners

5 Raw Emotions Alzheimers Dementia Caregivers Feel Every Day

17 links to the “other side” of dementia

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Copyright: number168 / 123RF Stock Photo

Death & Dying, Life & Living, Poetry

eternal anguish

April 27, 2019 amazingsusan

At some point in most dementia care partners’ experience they will find themselves on this battleground: wishing for their loved one the peace that comes with death, while feeling immense grief at the prospect of losing them. The resulting mix of emotions — compassion, guilt, longing, regret, sorrow and more — is exceedingly difficult to cope with.

This poem is about the heart-wrenching conversations one has with self and the powers that be at those times. It’s the second version of a poem i called “a daughter’s prayer to god,” which I first wrote in 2014, after Mom came “this close” to dying.

eternal anguish

please take her lord,
oh no not yet!
i’m afraid
i might forget

how she smiles
and laughs and cries,
it’s not the time
to say goodbye

but I can’t bear
to see her so
perhaps today
is when she should go

is it selfish
when i wonder
how long before
she’s six feet under?

oh my god
don’t take her now
no, this can’t be
her final bow

let us play
another scene
in which she doesn’t
lay serene

a corpse upon
a broken bed
that’s not my mom
she can’t be dead

she’s the one
who gave me life
who saw me through
both joy and strife

don’t take her god
i need her here,
by my side
forever near

i promise lord
that I’ll be good
and do exactly
as I should

i won’t lie
or kill or loot
or disrespect
an older coot

i’ll love my neighbour
guaranteed
if only you will
set her free

to dance and sing
like we once did
when I was no more
than a kid

please don’t take her
oh no please don’t
i wish you would,
and that you won’t

i know deep down
it’s peace she seeks,
every day
week after week

she craves her home
amidst the stars
her life beyond
these prison bars

but when she breathes
in fits and starts
who will call
the funeral cart?

in this game
where life’s at stake
we’re helpless
to decisions make

it’s in your hands, god,
you call the shots:
undo this heart
tied up in knots

around the rosie
we will sing
lord have mercy
you are the king

a daughter’s prayer to god

don’t mourn me long

dying with my mom

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Advocacy, Life & Living, Poetry

a daughter’s rendering and remembering

November 16, 2018November 17, 2018 amazingsusan

November 16, 2018: I doubt I will ever get over the deep grief I feel each November 16, the day my mother was relocated to #DementiaJail in 2012. All I can do is try to process it in whatever way I can. This year, once again, it’s with poetry.

the rendering

nothing more
could be done
all fault lay with
the setting sun

whose will it was
to force imprison
the one from whom
we’d both arisen

a deal had been struck
the year before
when no one knew
what lay in store

then came time
to pay the piper
fate took aim
fired like a sniper

shot her, then me
but not to death
left us bleeding
drained of breath

we struggled hard
for four more years
held hands amidst
the joys and tears

until the day that
she surrendered
with untold truth
for me to render

now i fight on
to right the wrong
of stolen voices
and silent songs

November 16, 2017:

when you’re put behind bars

November 16, 2016:

the day our best wasn’t good enough

November 16, 2015:

joys and tears throughout the years

November 16, 2012:

moving day

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Advocacy, Life & Living, Poetry

ascendants: awakening to where and whom we came from

September 17, 2018March 4, 2021 amazingsusan

Some days I miss my home and my mom more than others. I think about her, and my grandmothers, and my grandmothers’ mothers and grandmothers, and their grandmothers and so on.

Ascendants: those from whom a person is descended, or from whom she derives her birth, however remote they may be. Everyone has two ascendants at the first level, her mother and father; four at the second level, her maternal grandmother and grandfather, and her paternal grandmother and grandfather; eight at the third etc. Thus, as we ascend the various lines of our ancestry which fork at every generation, sixteen ascendants are found at the fourth level; thirty-two at the fifth; sixty-four at the six; one hundred and twenty-eight at the seventh; and so on. By this progressive increase, we have, at the twenty-fifth generation, 33,554,432 ascendants.

And, ascendant:

“Thus, astrologers believe that the ascendant signifies a person’s awakening consciousness, in the same way that the sun’s appearance on the eastern horizon signifies the dawn of a new day“

ascendants

This poem is dedicated to all those who went before us.

ascendants

the memory of you
sits by my side
like my own shadow
from which i can’t hide

you whisper in morning
sing soft through the night
everywhere, all the time,
and yet just out of sight

it’s strange how we leave
our flesh in the dust
while our essence lives on
in those whom we trust

each one of us comes
from the millions before us
ancestors who lived
on the plains, in the forests

they sailed on the seas
and travelled on trains,
to find a home in the wild
and give it a name

they carved livings from nothing
cried tears in the rain,
prayed for more sunshine,
sang life’s dark refrain

there’s no letting go
of those in the past
i’ll join them at sunrise
when i leave here at last

then we’ll be one
as we were once before
together in peace
in the vast evermore

i see you, i love you, i miss you

dying with my mom

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Care Partnering, Death & Dying, Life & Living, Love

7-part palliative care plan works (for people AND cats)

May 25, 2018May 26, 2018 amazingsusan

About a month after Mom died in August 2016, her little kitty cat Pia Roma, who had lived with me since late February 2013, began to behave strangely. Coquetishly cute Pia, with her big yellow eyes, had always been a little odd, but this was different. She wasn’t herself at all. There were continence issues, a lot of meowing and more vomiting than usual.

“She has chronic kidney disease,” the vet told me after some blood tests and an overnight stay at the clinic. “And probably a bit of feline dementia too.”

The vet gave me medication for the CKD, and put Pia on a special diet. Pia continued to enjoy an active life for an older cat, despite her dementia. When I took her back for a check-up in 2017, Pia’s kidneys had actually improved. In the four years we’d been together, we’d grown really close, and I was delighted she continued to be so well. I was equally devastated, however, with the results of this year’s check-up, which took place last week. I wrote about it on my personal FB page:

“I took Pia to the vet yesterday afternoon. Unfortunately, the news isn’t good. The vet was impressed with the great shape she’s in for a cat her age, which I think is 16. The vet said her heart is in fabulous condition; she was surprised and impressed when I told her that Pia still runs around, plays, and jumps up and down from my desk to the floor and onto my very high bed.

The blood tests, however, told a different story. The results showed that, while her thyroid is fine, her kidney disease has progressed from stage I, which is was two years ago, to stage III, which it is now. The vet reckons she only has about six months more in this world.

The only thing that can be done for her now is palliative care to keep her comfortable. Of course I feel desperately sad, and I can’t stop crying, but what to do? This is life. And death.”

As with any terminal illness (e.g. Alzheimer’s disease, kidney disease, etc.), the patient does not suddenly die the minute she or he is diagnosed. People (and animals!) can continued to live relatively well until they die. I believe our job as care partners is to support those we love in living as they go through the process of dying. If I’m not mistaken, that’s what palliative care should be about. Hard as hell in the midst of our own grief, no doubt about that. But I know it’s possible.

So I have a palliative care plan for Pia. It’s essentially the same as what I tried to do for Mom, even though my hands were tied in many ways. Here’s the plan:

1) watch and listen carefully to try to determine what her needs are and do what I can to meet them

2) focus on what she can do each day

3) make her life as joyful as possible

4) maximize comfort

5) minimize pain

6) let her be the driver

7) respect the process and hold space for both of us

I know all these things worked a treat when I was with Mom, and I believe they’ll help Pia as well. Maybe they’ll be a blessing for those you love too.

https://myalzheimersstory.com/2018/02/25/3-wise-thoughts-on-being-with-someone-you-love-as-they-die-which-also-apply-to-being-with-someone-with-dementia-as-they-live/

https://myalzheimersstory.com/2018/04/27/understanding-the-suffering-associated-with-dying/

Subscribe to MAS now & get 5 free PDFs & a page of welcome links:

Email Address

Take my short survey on behaviour here.

Challenges & Solutions, Tips, tools & skills, Videos

20 questions to ask yourself about dementia-related incontinence

April 2, 2018February 27, 2019 amazingsusan

One of the first things we learn to do as toddlers is to eliminate our waste in socially acceptable ways, usually in private. The cultural norms and taboos associated with this normal bodily function are deeply ingrained; they remain with us for our entire lives.

The elderly, and people who live with dementia in the later stages may experience incontinence, and, as a result, have to wear adult incontinence products. Sadly, they may also be forced into incontinence, as my mother was, in understaffed long-term care facilities either because the staff don’t understand incontinence or they don’t have time to properly care for people.

I developed this list of 20 questions to help all of us, particularly care partners and care workers, to reflect on some of the issues surrounding incontinence in dementia care, whether that care is administered at home or in a facility.

How often do you go to the bathroom every day? If somebody told you you couldn’t go when you needed to go, what would you say?
When you need to use the toilet, do you know where to go? What would happen if you didn’t know where to go? How would you feel? What might you do?
What is it like to be in a public place, to be desperate to go to the bathroom and to not be able to find one? How might you feel? What might you do?
What would it be like to be in a strange country, to need to use the toilet, and not know how to ask where to go?
What would it be like to be told you can only go to the bathroom at certain times, according to an arbitrary schedule and not when you need to?
How does it feel when your bladder or bowels are full to bursting?
If somebody told you to urinate or have a bowel movement when you didn’t feel the need to, would you be able to? How would you feel about it?
When was the last time you peed your pants? How did it feel physically and emotionally?
When was the last time you wore a diaper? What would it be like to have to wear a diaper today? If you had to wear a diaper from now on and forever, how would you feel about it?
What would it be like to not be able to take care of your own personal hygiene?
Have you ever been on a long drive, needed to use the toilet and been too far away from the next rest stop to hold it until you got there? What did you do?
Have you ever been so desperate to pee, that you have urinated somewhere that you otherwise might not?
What kinds of signs and signals do people (think children) exhibit when they need to go to the bathroom? What about you?
How would you feel about having to wear a full diaper that weighed more than a kilo (i.e. more than 2 pounds) for several hours? Do you think having to do so would affect your mood and outlook? If yes, how?
How often do you use the toilet with someone else in the room, or in the case of a public washroom in the cubicle with you?
Would you feel comfortable having somebody clean your genitals and behind after you had urinated or had a bowel movement? If not, why not?
How would you feel if, when you needed to urinate or have a bowel movement, you were told to do it in your pants?
What is the relationship between bodily functions and human dignity? What is the relationship between bodily functions and shame?
How would you react if you were told to do things or you started to do things that you had been told all of your life were taboo?
What do you think of people who are incontinent? Do you treat them any differently than you do people who have control over their bladder and bowels? How would you feel about yourself if you were incontinent?