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M
mitzijh Asked January 2020

Incontinence? Agitation? What stage? AND "I want to go home."

Mom is wetting the bed about twice weekly. Tonight she urinated on the couch (like completely soaked it) and didn't even realize it. I found it a half hour later when I put my hand in it.


Early this evening she became combative about the fact I didn't feed the sitter supper when she left at 4:00 pm. Then Mom accused me of not feeding herself for days. She said she would fast supper and then asked why didn't I pick it up earlier.


What stage of dementia is this? Could she have another UTI? She had one about 2 weeks ago.


Also, what are your strategies when they say, "I want to go home?" She's staying with us 6 days a week now and it seems every day I'm dealing with this issue in some form, but she hasn't tried to hit my husband again.

lealonnie1 Jan 2020
I agree with Upstream about getting her retested for a UTI. Unless a culture is taken, the correct antibiotic will be not be prescribed so the infection may not clear up. And even if it does, it can easily come back (unfortunately). Along with a UTI can come quite ugly & combative behavior, too.

When a dementia sufferer says they want to go home, they are expressing anxiety of some sort; an unfulfilled need that you will have to figure out how to soothe. Many times, a baby doll will help a woman A LOT with anxiety issues. They enjoy carrying and swaddling these dolls and caring for them as they did their children long ago. It's worth a try.

Here is some useful information about the problem:

Communicating with a Loved One Who Has Dementia
Adults with Alzheimer’s disease and other forms of dementia often lose some or all of their verbal communications skills fairly early in the disease process. This makes it hard for their loved ones to understand what is wrong or what the senior is trying to say.  
Sometimes a person with dementia is searching for home because of unmet needs or because they are feeling isolated and alone. Here’s what they might really mean:
Undiagnosed pain: Is the senior in pain? Sometimes you can tell by the look on their face that something isn’t right. If they aren’t able to tell you what is wrong, try pointing to different parts of the body and asking them to answer yes or no if it hurts. 
Sad or lonely: The very nature of Alzheimer’s disease is isolating. As memory and abilities slowly decline, the older adult’s world becomes smaller. They might remember faces of loved ones but be unable to recall names. Eventually, they live in a world where no one and nothing looks familiar.  
Confusion: As short-term memories fade, an adult with memory loss might be confused about where home really is. They may try to find their way back to a house that was home many years ago.
Unmet needs: Sometimes the senior wants to “go home” because they are hungry, thirsty, tired, or need to use the bathroom. When the environment they are in doesn’t look familiar, they feel an urgent need to search for home. It can help to offer them something to eat or drink or show them to the bathroom. 
Boredom: Creating meaningful days can be difficult when a loved one you are a caregiver for has memory loss. Their need to find home might be the result of boredom and not enough activity.

Redirecting a Senior with Alzheimer’s Attention
When a senior with Alzheimer’s is frustrated and agitated at not being allowed to search for home, redirecting their attention is often the best solution:
Ask for their assistance. Bring a basket of towels in to the living room and ask for the senior’s help folding them. Or try offering them a dust cloth and asking the senior to clean the dining room or help make dinner. Giving the senior a job may help redirect their thoughts.
Turn on favorite music. Research shows that music has the power to change mood. Uplifting songs can boost mood, while the sounds of nature can soothe agitation. Music an older adult associates with the happiest times in their life might also help calm the senior and make them forgot about searching for home.
Agree to go later: If you aren’t able to redirect your senior loved one’s attention, agree with them that you will go to their house later. Tell them you have to make a cake and clean up the kitchen first. Agreeing with them might help soothe the agitation they feel, while also buying you time. It’s entirely likely a senior with memory loss will forget they were searching for home before long.

**************************
Adult disposable briefs & chux are indeed the right answer for your mom's incontinence now. Depends are good pull ups, and Medline makes great chux that are HUGE and good to sit on top of, or lay on top of while in bed.

Now may be a good time to research Memory Care homes in your area as dementia often reaches a point where in home care becomes impossible.

Riverdale Jan 2020
Has she been seen recently by a urologist to determine what condition her bladder is in? There are medications to help with incontinence. My mother has been on 2 that have helped some. Hopefully your mother is or can start using disposable briefs. She should be told that it is far better to use them rather then ruin furniture,bedding,clothing not to mention the thought that this will cause her to be uncomfortably wet and she will reek of urine which hopefully she might realize does not make her pleasant to be around.

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againx100 Jan 2020
Wow, you've got a lot going on there.

Is she wearing a diaper of some sort? If not, that's got to change. Peeing on your couch is not OK. I would do a diaper then have her sit on a chux. Maybe you can save your couch that way.

Do you have the bed set up for this bedwetting? Rubber sheet? Again, diaper and chux.

Was she like this before the UTI? I would get her retested to make sure it actually went away. Not every antibiotic works for everyone or doesn't work quick enough, etc. Worth checking.

Nice that she hasn't tried to hit your husband again!

Repetitive questions just need a quick and easy "answer". If you think her ALZ is fairly advanced and she can't really understand or remember the answer, a quick "Yes, I know you want to go home mom" might be enough. "Soon", then change the subject or otherwise distract her. Have a response ready.

Good luck.
Riverdale Jan 2020
It has been suggested that it is better to refer to them as disposable briefs or other language rather than diapers. We may regard them as such but I think it could be more difficult for the individual to hear that term. My husband is on the verge of having prostrate surgery which is concerning. He will have to be on a catheter initially and then may need to rely on briefs after. Hopefully it will not be too long. I am just trying to stay positive for him. He has a fairly good sense of humor and might laugh about diapers but I will not refer to them as such as deep down I know there is concern with this issue and his recovery with regaining control of his bladder.
cwillie Jan 2020
If she's mobile and talking and only recently incontinent she is probably middle stage, you have a long haul ahead of you. Have you ever watched Teepa Snow's videos?

https://www.youtube.com/playlist?list=PLVl8vTLjje8ESAEvpjVoVTEK-_6X2jTdl

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