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We have an alarm that goes off in our bedroom and alerts us when my Father in law gets out of bed.
I make sure to try and keep him awake during the day by putting his favorite music on (on headphones) and also make sure he doesn't have anything to drink after 6:30 pm because he saturates his diaper which leaks through his plastic pants and onesie. We also take him to the bathroom right before bed at 10pm.
Despite this, he's still wide awake and getting up several times at night...and soaking himself through (literally saturating his diaper) by morning when my husband gets up early for work between 4:30 and 5. I've given him melatonin which doesn't seem to help.
And the bed wetting... (to this extreme) is a mystery.
Any suggestions?

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I'm posting here from what's in your profile to give more context to your situation:

Your FIL is only 73 years old.

"I am a 46 year old mother of two adult daughters and a 9 year old son and a full-time caregiver for my father in law for nearly 2 years now. He has end stage dementia.

My husband works from home and my mother in law lives with us too so they both help me with him when needed.

He can walk with assistance, eat with moderate assistance but needs total assistance with everything else (dressing, bathing, bathroom, taking medication etc). "

I'm not sure he's in end-stage dementia, but rather a mod/adv phase. At end stage they tend to sleep more and start having other medical issues that require medical care and trips to the hospital, hospice, etc.

I have a 99-yr old aunt in mod/adv stage. The bed soaking thing is a mystery, no matter what we do to address it. Have you consulted his doctor about it? I think the only other solution is to double or triple up his briefs, and make sure the leg holes aren't too loose. There are many on this forum who can also provide more specific suggestions.

Regarding the night wandering: for the same aunt, we got a hospital bed that has raisable side rails. She sometimes did still breach the rails at night so then we had to address her wakefulness at the wee hours. We began having her do more physical tasks during the day: folding a large pile of kitchen towels, sorting things like plastic utensils or colored poker chips, give her magazines with large pictures (of cats). She pedals for 15-20 min every morning on a motorized leg and arm pedal exerciser and we walk her to the mailbox across her street every day when she sundowns in the afternoon. She was formerly on Melatonin and Tylenol PM and after we introduced the tasks she now takes neither and sleeps through the night every night to date.

Since you still have your own family to tend to I'm wondering if your FIL has the financial means to pay for an in-home aid to come in part of every day to give you a break? We have someone come every day 9:30am-1:30pm and have had this schedule for many years now, ramping up from 3 days, then 4, etc. and now every day. There will come a point where you won't be able to manage his care on your own while making your partner/son a priority (which they are). What are your thoughts on what this will look like in your life at this inevitable point? You don't mention your partner's involvement at all... is there a reason why? I wish you all the best on the journey to help your FIL.
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Also, kindred caregiver, a weighted blanket seems to help with duration of sleep.
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FixItKimmy Nov 2021
Great suggestion, they really do help.
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How much melatonin are you giving him? BIL stage 3 dementia is taking 30mgs of it, we have found that keeps him in bed sleeping because of sundowning and the sisters at a nursing home told us it was safe to give. And we give it to him at his last pills which is at 6pm. The best time to stop water or any kind of liquid is about 4pm or 5pm. If he drinks any kind of caffeine that is a natural dehydrator so they will pee and for my BIL he has his pop at noon.

I would have chucks on the bed besides a plastic bed cover if you haven't already done that. Also look into a different diaper that maybe for nights that may hold more urine than most. People tend to urinate more heavily at night. Looking at some diapers they have night ones that hold up to 34ozs of liquid(Carewell tranquility) which is 4.25 cups of liquid and a bladder hold about 2 cups but it can retain it too. Have you had your father check by a urologist because he maybe retaining the urine where he isn't fully peeing it out. BIL had to go on flomax because he was retaining his urine.

Prayers that you find the answer.
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It's great that he can urinate and giving him plenty of fluid will help to keep him healthy.

You might try thicker Night Time Diapers and also put a pad under him.
Sometimes they just get their days and nights reversed.
Maybe you can try leaving a TV on for him to watch so it might occupy him and he won't leave his bed.
You should check with his Dr to let them know.
Dob't think about catherizing him because that is very painful and causes UTI's

You can also try letting him listen to stories on his headphone
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FixItKimmy Nov 2021
Urinary- An external Texas catheter might help, once he is in bed. it's a condom-like cap that drains into a hose and bag unit. Never opt for internal catheter if you can avoid it, they cause kidney and urinary tract infections.

Staying in bed- Good Luck with that. When I worked as a nurse in a Alzhemers unit, we had residentss that would not stay in their rooms no matter what. Tying them to the bed was of course not an option, as it is dehumanizing, and unsafe. We had one guy who insisted upon scooting with his feet in his wheelchair around the ward, we could time him, he'd gat tired of doing his NASCAR Wheelchair run, then go to bed. He later needed help sitting in his chair, so we tried using a lap belt, but on one of his NASCAR rounds, he slipped out f Wheelchair and the belt got tuck around his neck, I found him by the candy machine sitting on the floor with his neck and one arm in the belt. Good thing we checked on him constantly. We had to confine him to his room at night when he started going into other patient's room , ladies specifically and wheeling himself up their bed and groping them while they slept.
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BeccaJoy: Imho, perhaps your father is suffering from OAB (Overactive Bladder). He may be helped by a medication, Myrbetriq.
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My mother is in almost the exact same situation as your dad and it's a mystery to me too!
I've talked to a few of her doctors about this (including her primary care) and her nurses and no one has given me a definite answer. She was found to not have a UTI and no other issues thus far.
My mom has always been one to go to the bathroom often, so I really think her dementia has magnified the situation.
I cut off her fluids between 5-6 p.m., she goes for the last time at night around 10 p.m., and she STILL wets through about 3 diapers per night, on top of getting up and going to the bathroom throughout the night!
Her PCP initially reduced her fluid intake to 32 ozs., but then she was found to be slightly dehydrated. Mind you, she wasn't drinking all that much during the day to begin with- maybe around 40 ozs. Reducing her fluid intake did not help- she went just as much as she did before.
He then placed her on overactive bladder medicine- that didn't even help- and it gave her diarrhea.
So now we're back to her regular fluid intake and no medicine.
I've even bought her the Wellness brand briefs with NASA technology- nope, they're still not powerful enough.
I could see if she drank a lot of water all day long, but she doesn't. She doesn't eat or drink anything either that could stimulate her bladder (caffeine, spicy foods, etc.). It makes no sense at all! So, the conclusion for me until I hear differently is dementia.
As I still try to get answers from her doc, I think I am going to get her the PureWick system for women (it's an external catheter) as I would rather her not get up at night.
There are condom catheters for men- maybe that is something that may work for your dad?
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