Touching briefs or smearing can feel shocking, but in dementia it’s usually a sign of discomfort or confusion, not intentional behavior. Start with this quick checklist to troubleshoot the most common causes, then keep reading for the deeper ‘why’ and what to do long-term.
Quick Troubleshooting Checklist (Start Here)
Use this as a fast “why + what to try” reset. If the behavior is new or suddenly worse, jump to When to call the doctor.
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Check comfort first: Is the brief wet/soiled, too tight, sagging, or rubbing?
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Look for skin irritation: Redness, itching, rash, pressure marks, hemorrhoids.
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Rule out bathroom need: Offer the toilet right away (even if they wear briefs).
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Think constipation/diarrhea: Any change in bowel pattern, straining, loose stools, gas?
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Screen for UTI or illness: Sudden confusion change, pain, fever, strong odor, new agitation.
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Simplify the environment: Bright light, clear path, bathroom easy to spot, door open.
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Simplify clothing: Pull-on pants, elastic waist, fewer layers, easy access.
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Keep hands busy: Give a “replacement” item/activity before the usual trigger time.
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Adjust timing: Increase toileting prompts after meals, before naps, before bed.
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Track patterns: When does it happen (evening, nap, overnight, after meals)? What changed?
Why does a person with dementia touch their diaper/brief or reach inside it?
Most often, it’s a sign of discomfort or an unmet need, not “bad behavior.” They may feel wet, itchy, cramped, or need the toilet but can’t interpret the body signal or explain it. Dementia also makes it harder to follow the steps of toileting and cleanup, so touching the brief can be a confused attempt to “fix” what feels wrong.
Is fecal smearing in dementia done on purpose?
Usually no. Dementia can reduce inhibition and make problem-solving harder, so the person may act on an urge (itching, pressure, discomfort) without understanding the result. Smearing can also happen during attempts to clean up after an accident, especially if the steps feel confusing or the bathroom is hard to locate.
What is “scatolia” in dementia?
“Scatolia” is a term used for fecal smearing behavior. You don’t need the term to respond well, but it can help when you’re searching for support or speaking with a clinician or care team about what’s happening.
Why does this happen more at night, after naps, or in the evening?
Evenings and overnight often bring more confusion and restlessness, especially with lower lighting and fatigue. If a brief becomes wet/soiled during sleep, discomfort plus disorientation can trigger touching or removing it. A predictable toileting routine, better lighting, and keeping hands occupied before bedtime can reduce the chances.
Could this be a medical issue like constipation, diarrhea, or a UTI?
Yes, physical discomfort is one of the most common triggers. Constipation, diarrhea, gas, hemorrhoids, rashes, or a urinary tract infection can cause itching, pressure, or pain that leads to repetitive touching. If the behavior is new, rapidly worsening, or paired with other changes (sleep, appetite, mood), it’s worth checking for medical causes.
How do I know if the brief itself is causing the problem?
Fit and fabric matter more than most people realize. A brief that’s too tight, rubbing, sagging, or holding moisture can cause irritation and constant “adjusting” attempts. Try a different size or style, check more frequently, and change promptly after soiling. Many caregivers see improvement just from faster changes and better fit.
What should I do in the moment when it happens?
Treat it like any personal-care moment: calm voice, privacy, neutral tone. Avoid scolding or arguing, it usually increases distress. Use one simple line like, “Let’s get you comfortable,” guide them to the bathroom or changing area, and then reset the mood afterward with something soothing (music, warm drink, quiet activity).
What toileting routine works best for dementia (even if they wear briefs)?
A simple routine can reduce discomfort and accidents. Offer the toilet at predictable times: after meals, before naps, before bed, and whenever you notice restlessness. Keep prompts short and consistent, like “Bathroom time,” and praise cooperation gently without making it a big event.
How can I make the bathroom easier to find and use?
Make the bathroom obvious and low-effort. Keep lighting bright, remove obstacles, and make the door easy to spot (door open or a simple sign). Reduce complicated clothing and layers so pulling down pants is fast. If they hesitate, use a simple cue: “This way,” and walk with them rather than explaining.
What helps reduce skin irritation that triggers picking?
Skin care is prevention. Check frequently, change quickly after soiling, clean gently, and make sure the skin is fully dry. If redness is common, ask a nurse or doctor about a barrier cream. Also double-check fit so the brief isn’t rubbing or trapping moisture.
What can I do to stop repeated picking at briefs during the day?
The most effective approach is often replacement + prevention. Offer a hands-busy activity before the urge starts (especially at known trigger times). Folding towels, sorting cards, holding a soft sensory item, or using a fidget tool can give the hands something safe to do while you address comfort and toileting needs.
What helps when it happens mainly in the evening or overnight?
Start with prevention: toilet before bed, check the brief right before sleep, use a soft nightlight, and keep the bathroom easy to access. Many caregivers also find it helps to offer a calming routine (same soothing songs, a warm drink, or a quiet hand massage) and to use adaptive clothing during high-risk times so the brief is harder to reach.
What clothing helps prevent access to the brief while staying comfortable?
Soft one-piece outfits (jumper/overall style) can make the brief harder to access, especially during naps, evenings, or overnight. Choose breathable fabric with a relaxed fit so it doesn’t feel restrictive. The goal is comfort and dignity—not “locking” someone into clothing—so adjust based on their tolerance and your care setting.
When should I call a doctor about this behavior?
Contact a clinician if it’s new, suddenly worse, or paired with signs of illness or pain (fever, significant discomfort, bleeding, sudden confusion change, dehydration, ongoing constipation/diarrhea). A treatable issue like infection, constipation, or skin breakdown can be driving the behavior, and addressing the cause often improves it.
If you’re dealing with this, you’re not doing anything wrong, and you’re not alone. These situations are hard, but with patience and a few small adjustments, they often become more manageable over time. Be kind to yourself, you’re showing up and doing your best.
