Is this remotely fixable?

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I asked this in "Questions" but perhaps I need to explain more. I have a wonderful aunt in assisted living because of Parkinson's. She got it pretty young (50's) and is now in her late 70's. My cousin lives nearby and is there every day. The latest difficulty is that for the last six months, or so, my aunt has been taking her diaper off in the living area of her room and doesn't make it to the actual bathroom. So, she just pees where she is - which is often all over the couch, rugs, clothing, mattress! She can't seem to remember that she needs to go into the bathroom BEFORE she starts to urinate! She knows that she needs to remove her pants and diaper, but doesn't make it to the actual toilet. Although almost saintly in her personality, she gets furious if anyone tries to suggest that she has a bathroom and that she needs to pull her pants down after she's IN the bathroom. We don't want to shame her as she is incredibly dignified and sensitive to criticism. BUT, my cousin ends up doing about three loads of urine-soaked laundry per day. The mattress is a real challenge, and sometimes the assisted living workers don't put the mattress pad on, especially if my aunt has already peed on it! This disease is so cruel. She can't remember to enter the bathroom before taking off a diaper, but she can remember the prosecuting attorneys in the OJ Simpson trial! If anyone has suggestions as to re-training her or at least helping her cut down on these numerous "accidents" I'd be so grateful. I'm going there in two weeks for a visit, so I'd like some wisdom to share with my dear overworked cousin. Thanks


First of all, can you or your cousin request that the staff at your aunt's AL facility help her to use the toilet on a regular schedule, like every two or three hours? They may charge extra for this, but it may be cheaper than all those loads of laundry! By keeping her bladder more empty, she may not have the urge to "go", and may not remove her clothing and diaper.

Also, put water proof covers on the mattress and couch. You can buy vinyl zippered covers for mattresses that you use under the mattress pad. You can also buy rubber sheets that feel like flannel on the outside that can be cut to whatever size you need to cover the couch. The covers won't help the problem, but will make clean up more manageable.

You should also discuss this with her doctor to see if there is any medication that would help, or if any of her current meds might be contributing to the problem.
It sounds like your aunt needs more care than assisted living can really provide and your cousin is wearing herself down trying to make up the difference. Is there a particular reason an NH isn't being considered at this point?
This is a very cruel disease! Helping her to use the toilet on a regular schedule may help, as akdaughter suggests. Is she really using a diaper? Disposable undies ("pull ups") might be easier since they don't have to be removed but simply pulled down, like she used to do with regular underwear.

If this is her only difficulty I certainly hope it can be addressed and she can stay where she is. But I'd also talk to the staff about another level of care. Do they think she is ready for NH?
Thanks for the comments so far. I know that after a long time of wanting her in assisted living and her resisting it, she is fully acclimated to her present situation and is relatively happy after some years there. AND, because she is so so sweet and kind, the staff loves her too. So, maybe requesting that she go on a schedule, with assistance from staff members, would help some. I actually read that not drinking enough (which my aunt doesn't) adds to the problem, as the urine is highly concentrated and actually irritating, causing more urgency. It's just so hard to get in the head of someone who cannot remember the sequence of events - go in bathroom, go to toilet, pull down pants, pee! Yet, she can remember other things that I CAN'T remember at all! The brain is so strange.

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