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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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Just seeing a new TV ad for diapers that are called 'boutique'. Can't remember the brand name. They appear to be a light pinkish/orange color and they look like soft and natural under clothes. They have some flowers too. They come up to the waist and are truly pretty. Just their existence gives me hope if my potential leaking worsens. I wonder if other brands exist that are similar. This is the first time I have seen 'girly' feminine panties; these I would feel comfortable even wearing them around my husband!
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I had the same experience with my mom and grandmother. we finally just took away all her regular panties and replaced them with adult pull ups. they never said a word. if we asked them to wear them, they refused. but by replacing them in her drawer, they were ok with it. then comes the problem of getting them changed when wet or soiled
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The pumpkin seed, as suggested by another poster will work.

Withholding fluids at night is not a good idea as it can cause dehydration and create other problems.

If she wants to drink, she needs to drink. By the time someone feels thirsty, they are already slightly dehydrated.

Dehydration can cause dizziness and lead to falls. It can also cause irregular heartbeats, as well as adversely effect liver and kidney health.
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I have recently started wearing Icon panties which have the pad directly in the panties. They feel comfortable to me, have a silky finish and look stylish. Unfortunately, they are a little pricey and I bought them online from New York. They come in two styles, two different absorbencies and several different colours. As they are well made I have been able to wash them many times in cold water and hang to dry. I understand there is a company in Quebec province which makes another type and the company claims these are sold at many pharmacies. Perhaps you have to ask for your pharmacy to stock them. Unfortunately, all this doesn't solve the problem of her not pushing the panties down far enough. My own mother has had similar problems in the last couple of months. I was able to convince her that she would be able to sleep much better with the 'special' panties (adult diapers) knowing that she could just let go and wouldn't wet the bed. I even took a sample one and poured a glass of water into it to prove they would absorb the urine and wouldn't feel damp on the skin. Good luck with your mum.
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I'm not sure how much toileting assistance the facility that your mom is in will provide. I think it varies by state. In my state, the regular AL would attend to toileting support, but, not double incontinence. I'd be confirming their policy, so you can make plans for the future.

Once my LO started with urine issues, the other came quickly and she was not able to handle her own toileting at that point. That's about the time she also needed Memory Care. They handled it all and do that by having a toileting schedule for bathroom and/or changing of her Depends. If the person with dementia can't get their depends and clothes up and down, they must be accompanied to the bathroom each time for complete care.
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My late mother had underwear (pants) with a pad within the fabric. She also used a Poise pad. She became incontinent rather early on in life (age 60) and had one "accident" whereby younger co-workers saw her distress. She even helped me to wear a mini pad when I was hitting every bathroom on my route of errands!
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My mom actually seemed to prefer the disposables because they did absorb more
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OMG, thank you so much for all the "GREAT" recommendations. We are trying diapers at night and the depend briefs during the day. We are going to give the house gowns and house robes a try in hopes she doesn't wet those to. This stage seems to be quit challenging, we can only do the best we can and keep praying. Thank you again every one for your support.
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Fergie my mom likes Depends best. She doesn't need the fancy ones but she adds a Poise Ultra pad, Long at night inside the Depends. They also have a night time Depends and we tried those, she liked them well enough but couldn't remember the difference between the two so would wear the nighttime during the day as well when she doesn't really need the extra protection and that get's more expensive. Since shes fine with adding the overnight pad and that works pretty well (and is more affordable) that's the set up we use. I get both the Depends and the Poise pads at Costco when they are on sale, mail order sometimes and the warehouse sometimes depending on a few variables or from Amazon through their auto delivery and just move it or skip a delivery when I pick them up cheaper elsewhere. I find Amazon auto ship is the best deal when there isn't a coupon or sale elsewhere but I shop them regularly because it changes. Amazon quantity is smaller at a good price too which has both an upside and a down side (It's kind of nice having a gross of them).
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My mother-in-law hated any diapers. We have recently switched to giving her pads. They seem to be working better and she likes them because her underpants don't cause her the problems that the plastic ones did. For incontinence, we also have put her on Pumpkin Seed capsules which are ingredients in AZO and a lot cheaper. These are two things that have helped us through the dementia.
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I would suggest getting her a box of depends that look like underware and they also come in colors, three different colors in a box. Also, I think it is a good idea to have to go to the bathroom every two to three hours to sit on the commode even if she does not feel the need to go. I would limit the amount of fluids before bedtime. A tip for getting those wet diapers off is to have a pair of round tip scissors near the commode and to cut them on each side and dispose of them small garbage lined waste can beneath the toilet paper. I really like the raised toilet seat with grab bars on each side. It goes over the commode and will allow her to get up to a standing position better! I would point out that most seniors are now using these briefs especially at night. They have extra long incontinency pads that stick inside the underpants, make sure you get the maximum absorbency and put them in her underware ahead of time. So, when she reaches for a pair on underpants, its already done for her. Switching to a decaf. tea or coffee helps too as caffeine causes more bladder contractions. I hope this helps and the very best to you and your mom.
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I recommend calling them "comfort briefs" to distinguish them from regular underwear and give them a positive spin. After all, they will make her more comfy. I agree with the 2-hour toileting schedule.
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I am a 69 yo woman and want to share the positioning trick that helped me with my mild, intermittent urinary incontinence. This tip is for women only. I have never tried it with men who have urinary incontinence but wonder if it would help men to?

What I have learned thru the last several years is a way of body positioning to prevent that leakage that comes out after I feel finished voiding sitting on the commode. The leak it prevents is that 1-2 tablespoons that comes after you feel empty. After you stand, you then get resoaked a small amount as you pull up your panties.

So there you are, standing with your folded arms moved from your waist to your knees and lifting your bottom high into the air your position change may output some more urine. It feels to me that I have 2 bladders. So great to avoid soiling 2 pair of panties for 1 void!

how:
Sit on the commode and void all you can. The position for this first voiding is sitting with you arms crossed hugging your waist and slightly leaning forward.

After you wipe, you cross your arms over your knees now. Then you stand and lift high your bottom so that the residual amount of urine can be emptied right there after standing you push/strain to get more urine out.

CAUTION Straining to void or pass stool using these tips should never be be attempted alone. Caregivers must be aware that one could easily fall head first when leaning over and straining. It could lead to disaster. If you have hand bars to hold on to is ideal.

The 'pushing/straining/grunting to void or stool is called the val salva maneuver. It is a dangerous movement and can cause the patient to faint and fall!!! Someone or even a second one is needed to protect by CONSTANT HANDS ON, no exceptions. If a doctor is involved it would help to get his order regarding this positioning. Nursing assistants and new home caregivers should all know that this is dangerous and something not to do without guidance and training. Please do not go try it on your own.

best regards
a fellow leaker
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My late grandmother had incontinence and dementia I had a hard time keeping the diapers on her. Just be sure to be patient when our loved ones have dementia it is difficult to manage. we are their children yet know they are children so just stay calm and patient .
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Try a portable potty to put near her bed or where she would be sitting so she wouldn't have walk so far.
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My DH is home and has a urinal on his walker at all times. Sometimes in his haste to reach "the throne" he forgets to use the urinal first.

The way I deal with it is, 'it's kind of like housebreaking a puppy' - sometimes it's all how you can deal. No, it's not pleasant, especially when diarrhea in included in the mix - but at least he's still alive and with me. That's why God invented Clorox Wipes!
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I have not read the rest of the thread, so if I am repeating other advice, I apologize in advance.

Some incontinence products are very stylish and look like underwear. Maybe those will help.
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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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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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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 has always called them "her pads".
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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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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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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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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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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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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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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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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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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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