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I am not a healthcare worker or expert - just a daughter, mother, wife and full time worker to help pay bills. My mom is a widow ( lost my dad 2 years ago) and stays in a wheelchair or recliner most of the time due to fear of falling for severe neuropathy ( not feeling her feet or calves ). She sleeps from about 3 am to 1 pm and many nights does not even wake up and finds everything wet when she does. I think due to the fact it is hard for her to get up and down (weight) she waits until the last minute during waking hours to get to the bathroom but at least she does get to the bathroom. Question: we have washable pads on the bed at night but at least three nights a week these pads get soaked. ANY TIPS on handling this issue would be helpful. I have her put them in a plastic garbage bin with a lid in the garage until I (once a week) wash them and bleach them. Her doctor said most people just live with incontinence until it gets too unbearable because the meds have side effects and the surgery (for her age/weight) is not recommended - and I feel sure it is because the recovery would be too hard on her. What are people doing to make sure things stay clean enough (bed, linens, these pads etc) ?

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My mom has had incontinence issues for years, kept putting off surgery but has now reached the point where it doesn't make sense anymore as well as the point where it's worse. She just doesn't get enough sensation for the need to pee to wake her up or even know a fair amount of the time when she's awake.

She has the pads for the bed as well and a waterproof barrier/ mattress pad on the mattress as well. When she was sleeping on a bed (long story) we had the mattress plastic encasement, mattress pad, incontinence pad, sheet, incontinence pad, sheet incontinence pad down every time we made the bed. That way when she wet it we could often just pull off the top layer (pad and bottom sheet) and still have a dry set already on the bed so we didn't have to make it every night. She wears Depends, yes they have simply worked best for her, all the time and we have now discovered the nighttime Depends, which when she remembers to put them on before going to sleep keep her dry through the night and the bed/couch dry in the morning! Fantastic believe me! They are more expensive so she uses the regular ones during the day, I get them at Costco when they go on sale a couple cases at a time and have now found the nighttime to be cheapest from Amazon so I have them on automatic delivery for her. Again it takes her remembering to put the right one on at night for it all to work but she is fairly good at that because waking up to a wet bed and having to wash everything is miserable.

The other issue of course is UTI when they wear incontinence undergarments all the time so even though she worries about the expense we minimize that so much and help it by buying in bulk so she doesn't try to save money by leaving them on too long. We are fortunate so far though that she doesn't have regular issues with defecating in the undergarments, she seems to get and pay attention to that urge most of the time, since we added fiber pills to her regiment so she isn't bound up that is.

I found these great small plastic garbage bags that have a light lemon scent (other scents as well) and got her a small metal garbage can with an auto close top (step on foot thing) for the bathroom and she puts the used Depends in there and ties it up each day or two to put in trash can outside so the smell isn't bad in the bathroom and when she does wet her bedding she has some powdered Oxyclean that she can either put in the washer and pre-soak everything with that and a little white vinegar (neutralizes the smell) or she can pre-soak in a big wash bin or bucket. Your medium trash can would work just fine, the sooner you get it soaking at least the better and you don't need to bleach everything then. I also gave her a spray bottle of white vinegar and water 1/2 & 1/2 to clean the waterproof barrier when she gets through to that to take away the smell and disinfect. She has a shower curtain down over the couch and then a sleeping bag on top of that and then bedding or not because she prefers sleeping on the couch or just falls asleep there and that makes clean up when she wets stuff a bigger drag especially with the sleeping bag but so be it and the shower curtain at least protects the futon mattress/couch. The spray vinegar/water cleans the shower curtain when this happens well.

Good luck and remember while this is a PIA and often embarrassing for us it's 10 times worse for them, god I hope this doesn't happen to me! But I try to look at this experience as a method of learning what to do do in case it does, the things she does or doesn't do that make it harder I will know not to do if it happens to me!
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Reply to Lymie61
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lucyinthesky Jan 6, 2019
like the shower curtain idea...thanks.....
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Blue chux underpads = you chuck them in the trash afterwards! We use 3-4 large ones under mthr all the time, and when one gets wet, it goes. Not all get wet everytime, but it protects the furniture, the wheelchair, and the bed. Cheap at Sams. You might want to put her in depends overnight since that is the problem time. That's how we transitioned mthr from panties to depends full time, started with night which was worse for her.
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willnotorcannot Dec 17, 2018
Thank you - I may purchase the underpads and use several - and just throw away the ones that get soaked. She is only incontinent during nighttime for the most part and it is not every night (thankfully). I never thought of using more than one pad and the throw away kind I have seen at CVS and Publix look very thin. I will check out Blue chux - Thanks for the tips!
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If she's afraid to walk but still capable of standing she may be able to use a bedside commode with a sturdy bed assist rail to help her transfer. I'd also recommend some physical therapy to make sure she retains as much ability to stand, transfer and walk a few steps as is possible, if she loses that it will be nearly impossible to care for her at home. I would encourage her to use a walker/rollator as often as possible.
As for the laundry - I assume you already have a waterproof mattress cover. Washing the bed pads with bleach is usually not recommended as it will ruin the waterproof layer - check the label.
What kind of incontinence pad or pull up is she wearing, there are many that are more absorbent than those commonly found at the local drug store.
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I agree with dkentz72! You need to get her to a Geriatric Urologist, or just a better doctor! UTIs are so dangerous, and cause problems in old adults that young people don't realize. Falls, weakness, ...so many they always test for it in ER!

Realize that she may not feel the urge to go until her bladder is very full. Also anything that spikes blood sugar will increase her urine volume! Steroids can be a major cause!

First let's talk days! In grad school my Professor was part of a study at a NH where grad students simply offered to assist people to the bathroom every 20 minutes. They did Not Ask, " Do you need/want to go to the bathroom now?"
They asked, " Would you like me to assist you/ go with you/ bring you..to the bathroom?" Doing this, I this manner consistently decreased incontinence by 80%!
This less intrusive question, and it's frequency & routine let them to say yes before as well as when they felt an urgent need! 80% improvement!!!

I sleep the same hours as your mom. But my service dog wakes me when she needs to go out, and sure enough my bladder is full. No one likes being woken from a deep sleep. A baby monitor will allow night help to see if she is restless, and choose a time to wake her for a quick bathroom trip. A cammode at bedside is very helpful here. One of those large entry way rubber backed rugs or puzzel like pads of 1/4 inch rubber foam..for kids or workout areas can be set under it for stability, then moved in the daytime.

Yes, you need well trained help at home. Staff that will add this routine to their schedule of duties, and develop a rapport with your LO.

Also there is a medication, DPPA???, that is often given to incontinence children to keep them dry at school. You should discuss using this at night only with your new doctor. Even a good Promt Care doctor may be able to get you started on a plan until you can change primary care Doctor's.

Then institute the every 20 minute offer to assist plan and stick to it!
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Reply to GraceLPC
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caroli1 Dec 18, 2018
Grace, I believe the O.P. Indicated she was not living with her mother, and it was not clear if her mother had other help. Her mother is clearly doing all of her own bladder/bowel clean-up at this time, and she's also getting herself up to toilet and putting on her own incontinence pads/pants. I wondered, if she is currently that self-sufficient, if she could set an alarm clock to wake herself up periodically to get herself to the commode/toilet when needed? It's not clear to me whether her mother would rather sleep through and have wet pants or get up and make it to the commode/toilet more often.
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If she doesn’t already wear incontenence pull-ups or briefs at night, I would start now, along with the washable bed pads. If she sleeps from 3 am to 1 pm can you wake her up in the morning for a bathroom run when you’re getting up and ready for work in the morning? Then she can go back to bed. If she doesn’t want to get up, you could change the disposable brief and the bed pad if needed while she’s in bed. Theres a method to this (you can google it) that the cnas at Moms NH use by rolling her on her sides and she barely wakes up if she’s napping. It just takes a couple of minutes.
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willnotorcannot Dec 17, 2018
Hi,
Thank you for the reply. I do not live with mom - but I am within 3 miles in a straight shot ( so I am not there to wake her. I don't know how I feel about ever having to change her - I guess we do what we need to do when the time comes and when that time comes I guess I will be able to do that. For now I wash , dry, fold , grocery shop, put away groceries and visit and eat at least two meals a week with her. Just want to make sure I am keeping things as clean as I can in this stage.
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Dear willnotorcannot,

Your mom's doctor is correct that there are side effects to medications. While I do not have any medical background, I would respectfully argue that incontinence and staying in wet pull-ups for long periods also has negative side effects, UTIs for one. My m-i-l in assisted living has nighttime incontinence. Staff had her on a toileting schedule waking her 3 -4 times per night to help prevent "accidents" but the sleep disruptions were having a negative impact on her mental health. With her frequent UTIs her MD prescribed a medication called Methanamine which can have negative side effects. However, the medication has greatly decreased the frequency of UTIs which in turn has decreased her nighttime incontinence. Now staff only has to get her up once a night.

Honestly sometimes I think it comes down to deciding between the lesser of two evils. M-i-l is 86 so for us it is about her quality of life.

I am so sorry you are having to deal with this.
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My Mom is completely incontinent. She wears diapers with a pad liner at night, believe it or not we like the CVS drug store overnight super plus over the name brands. Try it! Her diaper is full every morning but the bed is dry!
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Invisible Dec 18, 2018
We like Target's because it straddles L/XL better.
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Try calling a good local medical supply store and ask them about their incontinence products. They probably have incontinence products that are better - more absorbent and better fitting - than Walmart products (even Depends). They may have a specialist on staff who can recommend good solutions for the bed issue as well. They may even deliver!

Secondly, certain physical therapists specialize in "pelvic floor dysfunction" - the muscles that support the bottom of the pelvis, including the muscles that assist with continence. There are therapies to strengthen those muscles and hopefully regain control. I couldn't say what the possibilities might be for your mother, but it would be worthwhile to get evaluated. Start by asking her primary care doctor if they know anyone. It may take some digging to find one.

Hope this helps!
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GraceLPC Dec 18, 2018
Try major University Hospitals. If there is not one nearby, call them for a referral. They will know where graduates of their program are located.
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I would suggest putting her in diapers that are strong enough to hold urine and or poop. I had the same issue with my parents as their health decreased. I started with just the pads on the bed. than I went to a waterproof sheet cover, that helped a lot. I I put the pads under the sheet and than also over the waterproof sheet cover. that gave them double the protection. that helped a lot. after a period of time it got to where they couldn't walk anymore so I put them both into diapers. that helped a great deal. once in a while the bed got wet but not to much. the hardest part for me was caring for the two of them at the same time. It never failed if mom screamed to me that she pooped her pants that dad would scream two minutes later that he did the same. it was tough but I did it .
good luck.....
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Reply to lizzy1952
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I am the caregiver for my mother in law, age 92, who has ALZ and lives with us. She has very little bladder control has severe nueropathy in feet and calves and diabetic. She can walk and uses a cane. She uses the disposable underpants and pads. When she started loosing all her urine when she would stand up it was a flood. I changed her fluid intake from having a large glass of drink with her evening meal to a small glass. He has a bottle of water next to her at her easy chair and only take a sip now and then. She has her big glass of drink in the middle if the day and a couple of cups in the mornings. Also any significant sudden changes in bathroom habits indicate a UTI. She can't explain any symptoms so I need to be somewhat of a detective but this is what I have found out about her. Everyone's is different tho so keep trying things. Also we removed all the carpets so floors are easy to clean.
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dkentz72 Dec 18, 2018
Being that she is diabetic and issues with water retention (my Mother does too), she needs more water. The water retention will cause a spike in her blood sugar. The legs, ankles and calves can swell to the point she is not getting enough blood flow which will cause gangrene. Keep her legs up like having a recliner. If possible, try placing a pillow under her legs when she's lying down to help keep her legs raised. She needs to walk as much as possible too. The more exercise of walking the more it helps her to try from urinating.
The reason she does when she sits up is she can't feel her bladder, so when she places pressure she will relieve herself. My Mom becomes very upset if she realizes she has messed her adult panties.
Bless you for being able to care for your Mom.
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