I need help with controlling my sister's bowel movement issues!

My sister has down syndrome and now Alzheimer's.
She will not wear a pamper and poops all over the place. We use pads, take her to the r.r., and have given her pampers. She will remove the pampers and stay naked. She'll walk over to the r.r. and then just stop and poop all over the floor. We are trying to keep her out of a nursing home as long as we can, but we are struggling.