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I’m not sure how to even present our situation so I’ll do my best. Our mom has dementia and up until about a month ago she started to have urine accidents. Sometimes we would fine her bed wet or her bed quilt wet and up until recently one of LVN’s at facility found a wet spots near her laundry basket. Mom is still able to walk with her walker and TRY’s to get to the bathroom on her own. But here recently it’s getting harder and harder for her. When she does make it to the restroom she has a very difficult time lifting her pamper and pants up and leaves them half way down her legs causing us to worry about a terrible fall to happen. We are trying to find a solution to try and get her to go on the pamper and a solution to keep her from leaving her pamper and pants half way down her legs. She’s become so weak physically but the dementia just won’t let her mind rest. We appreciate any advice or suggestions you can share. Looking to help

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I wish I could present a better answer, but we have just resorted to keeping watch outside the door when my grandmother is in the bathroom and stepping in to help her get her pants pulled up when she has trouble doing that herself. My grandmother is the same way, weak but can walk with the walker and tries her best to get to the bathroom in time but she does not always make it. She will also try to walk with her pants halfway down her legs because shes in a hurry to be finished with the bathroom task and we are very worried about her falling because of that.

Best Ideas I have for getting her to wear incontinence products?
-Be positive and talk them up. Act like its a great invention that really helps and is discreet and comfortable. Avoid calling them diapers or pointing out her problem too much.
-Try the pad style that will stick right into her underwear. Perhaps prepare her underwear with one ahead of time. Then she still wears her own underwear but has protection.
-Try the underwear-looking pull-up style. Most of those are thin and comfortable and flexible and easily tear off at the seams. You can even place these inside regular underwear to make them seem more discreet and less "diaper-like."
-Suggest simply "trying them out" rather than making her feel she must commit to wearing a diaper for the rest of her life
-Place some in her drawers or bathroom so that she can see them and she may try them out on her own?
-Be on her team in joining in a solution to help her and avoid coming off as telling her what to do
My grandma is pretty good about this, but those are some of the things we've had to do occasionally. It's pretty rare that she doesn't wear anything as she was wearing incontinence underwear for a few years before dementia really set in. Occasionally she will believe shes in her 20s or 30s and go looking for regular underwear, but we make these incontinence underwear very visible and she will reach for them herself most of the time.
Another thing we had made sure that there is grab bars and supports to hold on to so that my grandma can use one hand to hold and the other to pull up one side and then switch until the pants are all the way up. Honestly, it still means being at least on standby assist to help out when necessary. She is in a facility, yes? Perhaps the staff there needs to be aware that she may need some assistance getting her pants up after using the restroom.
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Even in dementia it's difficult to urinate in one's pants. It goes against a lifetime of using the toilet. Some people will hold it in to the point of making themselves sick because they can't seem to let go and let the Depends do the work.

If your mom is in a facility shouldn't they be helping her in the bathroom? I agree that trying to walk with her pants not pulled up all the way is a huge fall risk. Plus, she should have her pants up anyway. I wouldn't want my mom walking around like that fall risk or not.

With her dementia, your mom probably isn't able to learn a new routine but if you think she can I have a suggestion: we all have our habits when we go to the bathroom and most of us pull our pants down to at least the knee if not lower. If you can get your mom to pull her pants down to just below the toilet bowl (low enough so she won't urinate on her clothes) she won't have as difficult a time getting them back up again.

Enlist the help of the staff. That's what they're there for.
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To answer your original question - no one wants to go in their pants, it's a taboo that has been established in very early childhood, the incontinence products are there to catch the results of unexpected loss of control. If she is too weak to pull up her own pants then she needs to be supervised. If she can't remember to pull up her pants then she needs to be supervised. If her pants and/or pull up are wet or soiled and she can't figure out what to do about it then... she needs to be supervised.
If she is in a facility that only offers minimal help with bathing, meals and medication management it is probably time to seek out a place that offers closer supervision, if her current facility says they can still handle her needs then ask them how they plan to do that, for example toileting her on a schedule might help.
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Thank you all so much for your advice. She is in a facility and they try to do the best they can keeping an eye on her. We're always there with her in the afternoon (1-7) to help out as much we can. I'm sure it's one of the stages of this horrible disease. I'll keep everyone updated on this change. We have continue to help each other and support each other.
God bless.
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My question is, why, if she is in a facility, are they not taking her every 2 hours? That is what I did with my mom when she was at that point. Then you are there to assist with anything she needs.
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Thank you for sharing your experience Grammyteacher. This is what I'm looking for responses like yours "why the facility should be checking her every two hours". I will be SURE to discuss this with the social worker and ADON.
Thank you again.
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I wonder if Mom might do better with a toilet chair close-by. That way she’d have more time to get everything situated. It doesn’t have to be right in front of the door, but in a secluded corner close to her chair or bed. 

Also, one thing the aides at rehab and the visiting nurse both told me was to NOT call them “diapers” or “Pampers”. I was told to call them that to the wearer’s face is insulting and demeaning. Even in the throes of Dementia, a person is able to associate “diapers” with “They’re treating me like a little baby!” I always say “underwear” to hubby even though he doesn’t have dementia.
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Thank you Ahmijoy. I will start using the word “underwear”, when discussing her pampers. The only concern the staff at the facility have is that she may try to walk with the toilet chair thinking that it’s her walker. Maybe I could try it while I’m there and see how she does with it.
Thank you again.
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A toileting schedule will help as long as your mom doesn’t try to “go” in between monitored trips, but I think it’s definitely a great place to start. You don’t say what kind of facility your Mom is in but just be aware that in the ALs in my area the toileting schedules were an additional cost due to Level increase. In Moms NH she is on a toileting schedule to reduce the frequency of UTIs.
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Oh okay. She is in Alzheimer's memory care unit. I will definitely check with them on their toileting schedule.
Thank you for your advice.
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Besides a structured toileting schedule, I think it might be another tactic to try to have her use her call bell if she can, or vocalize if she needs to use the bathroom, instead of encouraging her to go in her pants. My Mom also with dementia in a NH on good days can vocalize “I need to peepee” or whatever. Accidents are one thing but the staff there would never actually encourage a resident to use the pampers, instead of using the toilet if they are physical capable. Mom is a 2 assist but they want her use the toilet as much as possible as they evacuate more and can get cleaned up better. So when Mom says she needs to go, I call the aides.
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Thank you Rocketjcat.
What you stress does make sense. We want her to use the potty as much as possible but we’re just afraid she’ll fall with not being able to lift her pants. We have tried getting her to use the call button but she doesn’t comprehend. The staff have started a scheduling toilet ting system with her. They check her through the night but for the most part she sleeps the entire night. Then they change her first thing in the mornIng. Thank you for your advice.
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In the NH my wife is in they call diapers "briefs" and the pull up's are called "panties" The words pull ups, diapers, or pampers are not used at all. With our health care system, the CNAs in most facilities are overworked, underpaid, and looked down on by the nurses instead of being seen as an asset. The "bathroom program" looks good on paper but in reality does not work. With 75% of the staff pulled away during meals, that leaves little help on the units to deal with all the call buttons being used . They cannot mix passing out or picking up trays with bathroom duty. The system is broken.
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We call the depends "briefs". Made Mom look at it differently. Throw away Lady pants, lol We also have a bedside commode when problems arise. Also those bed chucks to lay on the mattress
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My dad is on a toileting schedule, wears Depends and has a toilet chair and a toilet riser at his assisted living residence.
He has incontinance at night but also sleeps on a chucks pad. I try to have him dressed in sweatpants va pants as it’s quicker for the aides as he waits for the last minute to signal that he has to go to the bathroom. When he was still walking he would urinate in inappropriate locations at his AL. More embarrassing to me than to him.
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When Mom started having this problem, she was mortified that she couldn't hold her water. I purchased some depends and told her they would give her a little added protection in case she "leaked a little". She gradually accepted the depend although I know she would have preferred to just have panties. At one point, the aides told me to take away her regular panties because Mom wanted to wear those instead. In short, tell her whatever you have to, do whatever you have to... and change those depends often making sure she (or an aide) has cleaned herself properly. If the aides aren't doing it often enough, complain until they do. It makes all the difference in the world and cuts down on the UTI's.
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Yes the underwear word, a porta poddy and commode and lots of help. We had to cath it was becoming so impossible by then life was no longer stable. I'm sorry. But try different methods and always have a smoothy friday or treat day. They love that. And if they ask why tell them it's because they are the best. Muvh love and luck. Jo home health aid
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Also double the underpad in bed to help with leakage facilities have a hard time doing checks exactly on time. Hence why I'm a home health aid, facilities are understaffed and patients need more care at different times, which can't be known all the time. Eventually in my area I'll be volunteering for these reasons and hopefully 3xs a week to help the nurses. I am disabled can still be of help but I know how hard it is to make everyone comfortable. Your doing great asking is #1 to success! Your a wonderful person. Stay strong.
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Have your dr. ok a portable commode or you can buy from craigslist, local goodwill etc. Its the timing, not the fact she can use a walker to talk to the bathroom. With the portable commode, all Mom has to do is stand and pivot. I rearranged my Mom's bedroom so not only is commode next to her bed, but commode is behind her door. I use a shoe rack hanging behind her door for all her supplies, pull-ups are way better than pampers. See if her ins. co. will pay for them. I use an extra large kotex at night just for extra absorbancy. Baby wipes are great. Small can bags, like Dollar Tree. Hand Sanitizer, Baby powder, vasceline, diaper rash ointment... all these go into the shoe rack at a hand's touch. Mom has privacy, all paper products go into her can, she can tear off the pull-up as the sides are made for easy removal. It gives her a sense of independence and I set her cell phone alarm to ring every hour to signal her to check herself. I hope this helps. Good Luck
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Garylee- you are so right. My mom is in a NH also and it's a great one so glad she is there. But they too have times the CNA's can't get to them. My mom's call light can be on for an hour or more. Most of the CNA's are fantastic & the student help during the week is so nice to have. Weekends are slow staff is minimal & no students. My mom can't walk she wears briefs as they call them. 91 years old. Fell last year in her home going to bathroom broke ankle rest is history. Even if I'd been at her house wouldn't have kept her from falling knees just buckled. Bathroom schedule sounds great on paper & maybe would help sometimes. But like you said not during the times of passing & collecting food trays. Then it's staff changing time another delay. CNA's are overworked & underpaid for what they do. Some are better than others. Just something you deal with & pick your battles. Gloriacoco- check places like thrift stores for comodes I have found them there so cheap but your right she may think it's her walker. The washable bed pads are great. It's a process & it's hard. Hugs to you.
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Most of my thoughts have been covered here, not using the term "diapers" or even Depends, briefs, special panties or simply "your underwear" (make them the only ones available to her). Trying to put her on a regular toileting schedule of some sort, if it isn't every 2 hrs exactly no big deal but making every attempt at getting her on the toilet before she "needs" to go can help a great deal. My mom has been loosing the sensation of needing to go and the muscle control of being able to hold it in for many years, she was supposed to have surgery years ago but kept putting it off so she has been using disposables for a long time and it was more recently after a hospital stay that a VNA nurse suggested hitting the bathroom every couple hours to get ahead of it, makes so much sense! Eliminates the rush to the bathroom didn't make it mistakes. You will know when the time comes but my instinct is to put off the bedside commode for as long as possible because getting up and walking over to the bathroom forces exercise as well as let's them feel more normal, less like an invalid longer. Just my 2 cents, I know there will come a time of course. Bathroom bars and toilet chairs I would guess are already in place since she is in a facility but if not they should be. Same with the bed protection pads.

If you are having a hard time getting her to wear disposables and be comfortable with "accidents" being contained in her underwear I have a couple suggestions, first try the more expensive brands, they are far more comfortable and acceptable than the ones the hospital has and probably the facility she is in supplies (if they supply them) and some have easier rip away sides without attaching like diapers (that type exists too) making some bathroom situations easier including maybe helping with safety since they should rip off before tripping her when she doesn't get them up properly. It may be a slow adjustment since she isn't used to disposable underwear and has memory challenges so in that vane they do make reusable incontinent underwear as well as pads to use in them so one isn't replacing the whole panty each time. They are cotton so look and feel more like sensible underwear rather than disposable and might help ease her into disposables (PIA to keep laundering I imagine & likely something you would have to do) then the more expensive disposables might ease her into the more generic brands. Just an idea. I saw the cotton versions on Amazon which is how I learned about them and I purchase the disposables, my mom is more active still and the better quality brands make a big difference to her, on-line or at Costco in the bulk cases depending on what is offering the best price. I find there are often coupons on the cases, otherwise I have her set up for regular monthly deliveries from Amazon. She also uses the incontinence pads inside the briefs at night which I also buy that way but she is comfortable with that, I think the pads must be harder to get used to.

Back to the redressing after using the toilet, does she wear easy to pull up pants? Might she wear a skirt so she can just lift the skirt and it's never a danger around her ankles/legs? Then with the underwear that will rip off at the sides when pulled hard enough it might be a little safer? Finally while you may have to go over the reasons for it the rest of her life from time to time, it can all be in the presentation. Maybe presenting the idea of wearing a special new undergarment could be related to you or someone else, "Ever since having children I have had these annoying little leaks when I laugh but they seem to be happening more now, I just can't hold my urine the way I used to! I found these great new panties though that absorb my leaks and don't feel wet next to my skin or show it by going through onto my pants. It occurred to me you might like them too. The things they come up with these days!" or "I was reading about incontinence, I had no idea it was such a common problem. Guess that's why they have so many things available to help live with it, just like using makeup for laugh lines!" I'm sure there are better approaches and it's the kind of thing that seems like the kind of thing that's best geared to the individual and perhaps the timing but you get the idea, it's all in the approach which includes tone of voice and demeanor. If it's upbeat and positive as well as somewhat nonchalant it's likely to be better for everyone and perhaps retained longer?

This is such a tough subject and why is it that the accidents seem to get worse and more frequent as their sense of smell goes too? It's the overwhelming scent of urine when you walk in certain rooms that she doesn't seem to smell that's hardest for both me and my brother (bless his soul, he get's the worst of it more). Good luck and I hope I have people who care as much around me when the time comes as you do about your mom.
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My mom has dementia and living with me. She was getting up on her own to go to the bathroom during the night if she needed to. I put a nightlight in her room and left the bathroom light on across the hall.

One night she had a bad bout of diarrhea and must have laid in it all night without getting up or calling for me (we have a baby monitor in her room).

Ever since then, for some reason, she started wetting the bed at night and not even trying to get up. Doctor ruled out a UTI.

So now she wears the overnight diapers and also daytime ones as she also started having occasional accidents during the day.

What will save you from daily laundry is a waterproof mattress pad and a waterproof disposable pad to put over the bottom sheet. You can find the disposables ones on Amazon. They are actually made for kids who have trouble with bed wetting. I like them because they are large enough and they have large adhesive strips on the back to keep the pad in place.

If she is in a facility, you can talk to the staff and provide these for them.
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My mom had a fall trying to take off her pants while standing. We bought some mumus and “housecoats” for her to wear. She didn’t have any problem with pulling up her briefs, and didn’t have to deal with pants. This might solve part of your problem. You can add a cardigan in cold weather.
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Lymie61you mentioned better quality disposables. Do you have a brand name? I've tried everything the medical supply store has suggested and my husband is still soaked in the mornings. Yes, we've tried the scheduling. Thanks
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wi57twin--Your suggestion about wearing sweatpants is a good one. As soon as I read it the Clorox commercial "Mom, we have a situation" came to mind. Anything that requires less of both physical and mental effort is extremely helpful at this point, whether for a small child or for an elderly person.
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I wonder if she wore a shift in the daytime and a short gown at night if that would help with the extra pull up/down of clothes. I know hospitals don't put underwear on elderly patients they just have those bedpads on the bed instead. I know that could be problematic if they don't change them immediately but it's done.
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My mom has always called them "her pads".
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Gloria, I had the same problem with my Mom. We got her a plastic mattress cover first off. Then we put her in adult pull ups that look like underwear. It helped tremendously. Hope this helps! Good luck...
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My mom likes the Silhouette line of Depends the best. I can usually get a big box online at a more reasonable price than buying them in the store, altho' Costco's prices are good. But I'm 11 hours away so buying thru' Amazon is cheaper for me. I let my Costco membership lapse.
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I second the rich suggestions from commutergirl. I am sorry for your loved one who does sound to need complete safety assistance and observation.

As mostly a night nurse for 40 years, I try real hard to make the toileting a safe and positive activity.(ex multitask doing your shift skin assessment, applying ointments, vital signs and even give meds when patient is naturally awake). Sometimes a patient is too asleep and just won't awaken for a few hours except by an act of God. I try not to fight mother nature.

Words can wound so. I called them 'briefs' and never ever call them 'diapers' or 'pampers'' to anyone. It is important for visitors not to talk or phone talk with others at the bedside like the patient is not there. Confidentiality is so important as a sign of respect.

If the bed side commode is out of sight in day shift (like placed in the bathroom) I explain that night time is for sleep not for exercise walking as I set the commode right by the bed. I always cover the seat with chuxs. I like to have all we staff empty and sanitize the bucket after each voiding.

I like how commutergirl hid the bedside commode behind the door and had the shoe pockets on the door to keep wipes, ointments, chux and pads(and call bell) available where she can see and reach them. (I collect little hand bells from thrift stores/yard sales and place one in each room so the home care patient can easily call me. Laughingly I tell the patient that this bell is different from a hospital bell because someone actually appears!

It is important to place a bedside commode right next to bed (especially on late evening and night shifts). If patient has a stronger side or sleeps facing one side then that is where the commode should be placed. Just stand and pivot!!!! This can save walking fall risk especially if there is some unrecognized night confusion when a patient first wakes up. Also the oldest old are usually very modest and that needs to be considered.

Some previous posts list cheaper cost places for a bedside commode. Some medical equipment stores will rent this equipment. Try googling it . It is typically made of bent pipe for the bedside commode. Unsightly even covered over.


There is also a elegant faux leather winged chair style available which looks lots better. The chair is lovely and so important for the atmosphere of the room which may be the patient's long time home. The seat lifts off revealing a bucket to catch the urine and stool. In catalogs there are plastic bags to catch urine and stool so the emptying is cleaner.

There is a lot of wisdom in the experiences of the nursing assistants. Be sensitive to their unmet often need for respect. There is so much to learn from the bedside caregiver.For example there is an art to cleaning off the large, liquid stool of a bed bound patient. The aides' way maximizes the patient's comfort.

Be free with your praise. Name names. Let it be known that you will show your appreciation when you prepare your evaluation letter at the end of care. The aides are overworked. They will put you on the top of their list to satisfy because they need the positive feedback.Get a book entitled 'Take this book to the hospital with you' from amazon.com/books. Also openly keep a log of each day's tests or events such as falls, pain treatments, doctor's visits.


Each bucket emptying can be cleaned with swishing cheapest and maybe diluted mouthwash. Fighting urine odor is SO very important. I like to also use the generic lysol spray which is associated with germ killing.

Resources are available if you know where to find them. AgingCare.com is a great community and I frequently share it with other caregivers and families. Best wishes.
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