Every time my female client (98) gets up, there is an uncontrollable stream of urine. Is there a medicine that would help?

My wife with dementia, who seems to be unaware of anything and cannot communicate, has taught me some things.
Holding pee, bashful-bladder, clenching,

My wife started puddling everywhere and then wouldn't go when we set her on the toilet. We put her in diapers.
Then she started overflowing, so we just changed them on schedule.
But often when we stand her from her chair, she would let loose, either in addition to a full diaper, or just a lot of pee. Then she would not finish when we got her to the toilet. Bashful bladder. Some people are very private about personal acts and will clench and pinch off the flow. She was always that way. I am that way, I could never pee in a cup.

She lost all of her memory, doesn't know us or even herself. She auto responded to needs of eating and toileting by expression.
The one thing she is that pee is a very personal thing to her.

We realized that she is not physically incontinent. She simply forgot how to take herself to toilet and was too bashful to express to anyone.
So she would hold it until she couldn't.
Then she hated peeing in a diaper. As would we.
So she would hold it until she couldn't.
We stopped using crotch covers in 2013. Skirts and gowns for privacy.
We toilet her every hour. I am old and I have to pee every hour.
She sits and sleeps on washable bedpads with cotton overlay.
Rarely an accident or UTI in these 8 years.

The strain of getting up and down puts pressure on the bladder, I've noticed this and I'm only in my 60's 🙄. I think it would be best to get her to the bathroom on a schedule BEFORE she needs to go (and before her shower), and when there is an accident to allow a moment for the urine to soak in to the pull up before attempting to change. If the product you are using doesn't hold the urine then a different absorbency or brand might make a difference.

This sounds like she has stress incontinence. Tab style incontinence wear might be helpful here, so that you can get her out of them easily. There are some that hold more volume than the Depends--you might have to let her stand and drain completely into what she has on, then replace it. I know that some folks add a pad to the depends for extra absorption, but it sounds like the tab type would make things easier.
What about starting or stepping up a toileting schedule so that there's less urine volume to handle?
Caution needs to be used for some meds. A lot of docs aren't aware that
''aggravation of symptoms of dementia (e.g., confusion, disorientation, delusion) have been reported after tolterodine/oxybutynin therapy was initiated in patients taking cholinesterase inhibitors for the treatment of dementia''. So meds like Detrol would be a no-go if she was on something like Aricept. (Ask me how I know, LOL!)

She has stress urinary incontinence. Movement causes the bladder to squeeze and due to her age, leaks. I would think she is not a great surgical candidate due to her age. There are meds to help but remember….an empty bladder doesn’t leak! Toilet her more frequently for starters. She may additionally have a decreased sense of urgency due to her age. Again, offer her to void even if she’
says she doesn’t have to go. You will also be training the bladder with more frequent voiding! Good luck! God Bless her!’ Amichee Board Certified Urology

Mom tried a medication for the condition that you are describing. Let me say that it took months for us to notice a very slight improvement.

I will share with you what her hospice nurse told us. She said that sugar increases urinating. Mom was tiny and never had much of an appetite. She did like Ensure drinks, which are fairly high in sugar. When she cut back on Ensure, there was some improvement. My mom lost any control, like your mom. It is miserable for them.

Mom’s hospice nurse arranged for her to enter a hospice house for the last month of her life. They placed a catheter in her then. She was completely bed bound with end stage Parkinson’s disease.

I feel for you and your mom. It’s a frustrating situation. Wishing you and your family all the best.

Stop all caffeinated and sugary drinks

My 84 year old Mother is the same. It’s simply lack of being able to control her bladder. I’ve gotten to where I take a thick bath towel and hold it between her legs to control the excessive mess. This works for me. I don’t know what else to do. Due to Moms deteriorating health she’s on comfort care. Drs are reluctant to do anything under general anesthesia.

I have had 2 doctors recommend ways to help this. One is a botox shot recommended by her urogynecologist. Another is InterStim therapy where a device is implanted. You might want to ask about these two.

I have the same problem and went to a women's MD. There is a small surgical procedure to lift the dropped bladder, but the MD said I wasn't far enough to warrant it. So I wear a pessary in my vagina that keeps the bladder propped so I don't have continual leakage. Ask your MD for a referral to a specialist. And yes, there is a prescription for what they call "Overactive Bladder." It helps, too.

Catheritization = infections. Not a long-term strategy at all.

Agree with the info on "shy bladder". If she could use a bedpan, would there be an issue? One of the problems is "getting comfortable".

Folks realize that there are people in certain areas of the world who toilet train babies. It's a matter of trigger, response, reward. And some people can understand some instructions but nothing complicated.

I'd suggest the following:
- Try a bed pan. Put her in control of using it.
- Try the underwear inserts (basically like sanitary pads).
- Talk to a urologist (with female experience) about any hormonal methods to control urine. If it needs to be applied directly to the area, use the previous suggestion and spread some on there to not have to be too personal about it.

Good luck. Urinating is more important than making a BM, and it's really difficult for some people, even if we have all our marbles. Distracting myself (counting tiles in the bathroom for example) while trying pee often works best!