Incontinence vs. laziness vs. memory loss.

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My mother had a stroke May 2013 affecting her short term memory and cognition. Rehabbed physically and doing well, however due to congestion heart failure she is on a daily diuretic. I've been the caregiver since the stroke, sibs out, whole other topic we won't address. I lost my business and ran thru all $$ caregiving, am now working 3000 miles away to refill coffers and managing care from a distance. Dad was in great shape but this has taken its toll, I have a of girlfriend who is helping my man of 39 years in the care along with a family friend. Things run pretty smooth except mom started having accidents last summer heavily and has to change several times a day. I have her in depends with poise pads but she just goes so it's not holding and they are getting more and more bound to the house. We don't know if it's incontinence, she doesn't remember the feeling of urgency, she's gotten lazy or something else. I've asked cardiologist if we can reduce diuretic, he is reviewing all blood work. I've sent several types of plastic pants to dad to try but so far moms not happy with any and without being there I can't determine if they are uncomfortable due to fit or if she's adverse to the plastic. Trying to explain to her is difficult due to the memory. I'm hoping someone might have experience with some sort of comfortable leak proof panty that can go over the depends and maybe free them up to go out a bit more which will help dads mental health.
Thanks to all...this site is a godsend and I tell anyone who is dealing with caregiving about it. It's literally saved my mental health and life.
God bless all you awesome caregivers. You are all beautiful!!


Maybe you can ask dad to remind her to go to the bathroom every few hours. AND to change the Poise pad at the same time...wet or not. That worked with my mom. She was dry most days after I started doing that. If I were going to ask dad to do that, I'd let mom know I'd asked him to.

If mom is under medicated with her diuretic, does she put on water weight in her legs? If so, appearance is everything. If her ankles are skinny, ask the doc if you can cut her dose by 25% and watch her closely. That diuretic no doubt contributes to her incontinence.

I hope you can put out of your mind that she's somehow responsible for her plight. It's not her fault. Nobody wants to pee in their pants.
Make sure that you are buying the highest absorbency of Depends and Poise pads. Depends comes in "Moderate" and Maximum" and I made the mistake of grabbing the wrong bag once.
Plastic pants would be extremely uncomfortable, I wouldn't want to wear them either, would you? Why don't you try the pull ups and forget about the pads, the light weight ones are not bulky or uncomfortable. I know they are more $$$ but is the hassle really worth it?
We tried reminding her every hour, but that means HE has to remember and if he gets busy doing something in the house, he forgets as well. He tries to have her go when he goes, but she doesn't think she needs to right then. The stroke left her somewhat like an ALZ patient without the combativeness and total memory loss.
I will look on the Depends bag for absorbancy, didn't know that, I have them auto shipped.
She is in pull ups AND poise pads at this point, we put the pads inside the pull up.
It's so hard because my mother pre-stroke would have been MORTIFIED!!! I keep thinking she'll get tired of having to change so many times in a day, but I just don't think she remembers. We've tried signs, I even got an alarm that I could record my voice reminding her, but if she left the room it was in......
And she can't remember to take it with her. The short memory/cognition is really devastating....
Thanks for all your suggestions...Bless you all:)
It sounds as though you are saying that your mom has been diagnosed with Vascular Dementia as a result of her stroke. It was helpful to us that her doctors used the term dementia and not just Memory Loss and Cognitive loss. I think it helped to keep us from thinking that mom was being manipulative, or lazy. Dementia, at least in the case of my mom means loss of reasoning skilks, loss of the ability to connect a with b. Loss of procedural memory (first do this, then that) Left to her own devices, she would put on her clothes first, underwear last. This all leads to increased anxiety and panic, because she knows she's missing some piece of the picture.
I'm going to start by saying that contrary to the advice given by lots of people I do not find adding a pad to a pull up to be effective. In my experience the pad will overflow down the legs before soaking the pullup unless the waterproof liner is cut open. This allows it to act as a booster pad but is a p-i-t-a. There are booster pads available if you are shopping on line.
I think your best bet will be to try to help them manage her incontinence better. Checking about the lasix is a good first step. It may be helpful to have her use the toilet at regular intervals, and dad will have to start checking her each time she goes. I can understand them not wanting to go out, but the ultra absorbency products do hold a lot and should allow them to leave the house. Encourage them to get out for short periods at least. And it sounds as though you mom's dementia is more of a problem than either of them admit to you, perhaps it is time to explore more ways to give your dad a break.
Could you get your dad a cheap, simple watch and set an alarm for every two hours during the day that would beep or buzz or vibrate to remind him to get her to go? Even if she doesn't feel like it, I'd get her to go and sit down. Once she's "in position" she may go - just like a kid that doesn't want to go but will go if you get them on the toilet.

And see if your dad can notice if there's a particular time of day when she's overflowing. Pay particular attention to that. For example, my mom takes a diuretic with her morning pills. So I know that until noon, she'll be peeing more, until that diuretic has worked its magic. Maybe clue your dad in to mom's medication schedule and when she has to go, so he can set time timer around those times.
All very good advice, some working on and some will introduce.....
As always thank you all, your all angels with wings

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