Sometimes a kid with Autism Spectrum Disorders (ASD) will care because they can be fastidious. It varies and sometimes seems paradoxic. If the child also has sensory integration issues this can be a huge factor.
We found we got cooperation as long as we nagged enough. But if you have a kid who WANTS to poop in his pants (maybe he likes the feeling) then you have to make sure the payoff is countered by enough negative consequences. Not easy when we're trying to avoid the ppunishment aspect.
Getting the child to help with the cleaning process was for us the best way. Two things need to be cleaned - the clothing, and the child's body. The body needs to be cleaned enough in order to prevent any skin rashes and irritation. And the clothes need to be cleaned (SOMEONE has to do it; the person responsible, if they are going to keep doing this, need to learn to clean up afterwards in order to take their habit into the realms ofpotential independent living).
To clean up and eliminate smells - it can be done. And 85 year olds actually are not likely to notice the smell as much as you (or maybe even worry that they are to blame, and keep quiet!).
Clean-up procedure -
1) Put on gloves. Either use disposable gloves, or washing up gloves which are kept solely for this purpose.
2) Scrape solids into the toilet.
3) Put a bit of soap onto the soiled area, make sure the clothing is wet. Rub and rinse.
4) Deodorise begins now. Splash on some white vinegar. We keep a big bottle in the laundry, as well as some in a mist spray bottle. Then put the clothing in to soak in WARM water (not hot) and enzyme detergent. Let it soak overnight.
5) Machine-wash as usual - COLD wash. Do not hot wash. A hot wash can cook smells in.
If this isn't enough, repeat from the vinegar stage.
We use this for sweat smells/stains, blood, any protein stain or smell. Boys stink especially teenage boys.
Also important - you don't just change the undies. Even if the stains don't go through the fabric of the undies,s the smell does and EVERYTHING the person was wearing at least on the lower half, has to be washed. Only the stuff that got directly pooed is likely to need full treatment, but it ALL needs to be cold washed. I have tried at times to get away with just changing the undies, but have had to accept defeat when the smell lingered, because it had contaminated the outer clothing too. I user the sniff test after the child has changed and ogten wouldsupervise the changin g to make sureof compliance. I also would supervise the body washing if I felt it was warranted. Any child feeling sensitive about modesty - sorry, that has to be forgone if you poo your pants. I used to insist on physically checking that skin was clean. Generally though, Autism Spectrum Disorders (ASD) kids don't care much about modesty under those circumstances either, when it's a health check.
We made our kids learn to do this washing/soaking procedure. EVERY member of our household is required to splash their clothes with vinegar if they are stained or smelly. The enzyme soak isn't always needed.
I've also had some appalling clean-up jobs, including difficult child 1's socks which would be STIFF even after a machine-wash. I've done a double and triple soak of the socks (in a bucket) plus I have a hand-washing gadget like a hand-pumped washing machine agitaror, I use it in a bucket with difficult child 1's socks. I eventually got the once-white socks rejuvenated back to pale beige. That was an achievment.
My piece de resistance was a suit coat, a black one, which the drama club gave me to have cleaned before I was to wear it in a pantomime (I was playing Prince Charming). The previous wearer had been a middle-aged unfit man who rarely bathed and never wore deodorant. He was also a chainsmoker. The coat stank badly and I was told that if I couldn't get it clean, to put it in the compost heap and charge a new one to the drama group. They expected the bill.
So I did the vinegar soak and then the enzyme soak. Thee water turned brown. So I repeated the soak. The water went brown again, slightly paler this time. Then I did the first machine-wash. The smell was gone but the rinse water was still brown so I ran it through a full cycle again (from vinegar). Finally I declared it clean enough to put on my pristine little body. I'd used essential oil in the final rinse water so it now literally smelt of roses. Rosemary, actually. Lavender is another good choice.
When this is done regularly, you rarely have to repeat the wash cycle. We only did it with a backlog, or when difficult child 1 wore the same clothes literally for months. I had a terrible time getting underwear from him on wash day (I wonder how his wife is managing?). For poo smells/stains, one soak would probably be enough.
We don't have encopresis issues any more, but we DO have some appalling poo stains/smells - manure. difficult child 3 changes the water in the chicken pen and is either very clumsy, or is deliberately making a mess by spilling the water and making puddles, then playing in it. He comes in smelling awful and with clothing soaked in ripe manure. But it washes out easily.
Something important to remember - the degree of difficulty in cleaning up is NOT really related to the severity of the smell or stain. If it were, then TV advertorials would have a harder time making some clean-up tasks look miraculous.
The ultimate way to impose a rule of life - "you either will not or cannot get involved in changing this habit. Therefore you must now become your own primary carer when it comes to cleaning up your clothes. I've been doing it for long enough. One day you will be living away from home and laundromats won't allow poo stains unless they've been pre-treated. So in order for you to eventually live independently, you must now do what I have been doing. We all eventually have to take responsibility for our own care. Your time starts now. I will help you and show you, but you now must do it. And don't even THINK about just living with it - this is a house where others live, and poo smells are NOT acceptable!"
Keep reminding him. And when accidents happen, clean up must begin immediately and HE must take a role in cleaning up.
Pooing his pants is no big deal, if he cleans it up immediately and thoroughly. If he really can't help it - OK. But there are NO excuses for inflicting it on other people sharing the house.
Marg