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My 93-year-old dad has urinary frequency at night to the point that his sleep is severely disturbed. Once in a while, he sleeps fairly well, but not most nights. He is being followed by a urologist & has been prescribed all the usual meds without success. We've tried taking them in the daytime & when that doesn't work. We switch to night time. The most recent one is oxybutinin which he has been taking at night & he swears it makes things worse. I've tried explaining that these drugs take weeks to show any effect, but he is too impatient. To his credit, he has given it his best shot, but still no positive results. It's driving me crazy! He saw the urologist September & I went with him. I get a feeling the urologist is reluctant to do any procedures due to Dad's age & I agree with that. He will be seen again in March.



Anyone else dealt with this? I'm tired of hearing about his plumbing problems.

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I had to deal with the same problem at the age of 91. 15 times a night was typical.

As far as I know, you have two choices - put up with it or have surgery to eliminate the enlarged prostate problem. I had the surgery and get up once a night at the most.

Good luck.
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My mother had the same issues with urinary frequency. Her urologist took her off of all medications and told us to put her on powdered D-Mannose, found in health food stores. It worked for her. It’s worth a try.
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You also face the problem that if they try to rush to the toilet or commode that they fall. Partly due to needing longer for blood pressure to settle on rising and if like my dad- wouldn’t put a light on - I ended up putting those automatic lights in that stay on during the dark - wasn’t bright enough to disturb him but shed enough light in the room so he could see where furniture was.

I used pull up pants and a liner over the bottom sheet and reassured him I’d rather deal with wet pants and even wet bed rather than another fall so to take his time as the pants would (mostly) contain any leakage. Dad had prostate cancer so needed the toilet several times a night. No medication ever resolved that. Wasn’t prefect and I spent most nights washing sheets at 2am as often dad would try to take the pants off but it wasn’t dad’s fault so I wouldn’t grumble as I knew how frustrating and tiring it was for him too.
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A caution to everyone dealing with pull ups/diapers. PLEASE STOP CALLING THEM DIAPERS!!!! I wear PULL UPS now because in 2002 I had liver cancer and the extensive surgery had consequences, some of them coming many years later.

When it was time for my uncle to start wearing them, he really fought hard against wearing "diapers." He would prefer to wet the bed or fall getting to the bathroom before ever wearing "diapers." The hospice nurse was wonderful and focused on what they were being called. Eventually he gave in to wearing pull ups, but he would never have given in if people had continued calling them diapers.

Now that it is my turn, I feel exactly as he did. Diapers are for babies - pull ups are for adults.

If you change the words you use, it might be a bit easier to convince the person to use them!! It sure made a difference with my uncle, and to be honest, there is one person in my life who insists on calling them diapers, and I bristle every single time.
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disgustedtoo Jan 2020
I refer to them as disposable undies... Not to mom of course - we didn't discuss it at all, just removed all her underwear and replaced them with the "undies" She has never said a word to me, although she has seen me bring them into the place...
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My Father is 95 and had prostrate cancer 25 years ago that scarred tissue which has resulted in urinary frequency. He sees a urologist who prescribed Myrbetriq which he says didn't help and he isn't real patient either - guess they have this in common. He is now on an interstitial diet which has helped with the burning. The issue for us became falls at night trying to get to the restroom. He now uses an adult version of Pull-Ups (Kroger Overnight Diapers) and these have been wonderful! He changes them several times a day and wears 2 at night. He only uses them for urination, so he feels he has kept some dignity. He can finally enjoy watching a football game without having to rush to the restroom. During a recent hospitalization he had the condom catheter, but he moved around or pulled it off and it leaked, so not an option for us.
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My husband has Parkinson's Disease and an enlarged prostrate. He was getting me up multiple times at night. The Urologist recommended several medications none of which worked. He was up anywhere from hourly to 3 times an hour. I had a friend who was a psychiatrist and he recommended external condom catheters. They are amazing. I put the condom cath on him before bedtime and remove it the next morning. He sleeps through the night and no trying to get him up to use the urinal which is by the bed 8-10 times a night.
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My husband’s urologist prescribed 50 mg of Myrbetriq. It is a little expensive so I order it from Canada. It was all that worked. He was up and down 6 times per night and this is the only thing that helped him. It comes in 25 mg but he needed the 50 mg. Because he was tired from not getting enough sleep. He had had prostate surgery and had a bag for a month and then wore pull-ups for a month until he was put on the Myrbetriq. It is a wonderful medication. Husband has been on it for a year now. Still gets up once or twice but don’t we all get up once per night sometimes? He was up and down all night before the urologist put him on the right med. Just throwing it out there.
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You are right that many of the drugs take time to start working, but I also understand your dad's position - he wants the problem solved right away, and who can blame him?

Have you thought about putting a commode next to his bed so that he does not have to trek off to the bathroom - used one for my uncle and he was able to go back to sleep much faster.

I went through a terrible time with this and tried a lot of the meds. The only thing that has given me relief is botox into the bladder. My urologist is wonderful and when she suggested botox I was not the happiest of campers to put poison into my body. However, she took the time to explain it, and it has been a Godsend. Every 4-6 months she does the procedure and I get immediate relief. I still wear pull ups because nights are very difficult and the urge to go doesn't always give me time to get to the bathroom, but I am so much happier and feel such relief!!

Your dad is 93, and I certainly understand a urologist may feel reluctant to do this, but it is worth suggesting to the urologist. Many do not do this procedure, so you may need to find a different urologist.

Hope this helps.
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disgustedtoo Dec 2019
Like any medication, one can have negative side effects, from what is essentially poison! They tried to use that for an esophageal issue and I broke out in hives. I now have that listed as an allergen with all doctors along with heparin. While any medication can cause issues, for something like this, I would highly recommend some kind of skin test first - medications can eventually wash out of your system, whereas something injected can't be uninjected....
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Although he is under the care of a urologist, as others suggested, ask if he has been tested for UTIs (not just the dip stick test - actual cultures.)

When I first joined this forum, I wasn't buying the UTI comments. Then mom, who used to get UTIs all the time and knew it, got her first one after moving to MC (maybe a year or more after the move) and it resulted in late afternoon/early evening sun-downing, big time. Quiet mom who would just sit and read became a raving beast who demanded to get out, insisted she had to go home and had guests arriving and she would set off all the door alarms! Figures it was on a Friday, after office hours, so we could do nothing until Monday. She would be fine in the morning, it only reared it's ugly head later in the day! This was someone who never really exhibited sun-downing (she lived alone and had a nightly odd OCD behavior that went on for an hour or more at bedtime, before moving to MC, which we observed via cameras in her condo.)

More recently, UTIs have resulted in night-time bed wetting - we're talking soaking through disposable undies with inserts and a bed pad! When she first started this, they tried to get her up at night, but that wasn't happening. Then they would find her sitting on the floor, apparently trying to get up to go, but she stopped standing/walking on her own a while ago, so she couldn't get out of bed properly. Once tested and treated for the UTI, the bed wetting stopped. When she started again and was found on the floor again, sure enough, she had another. After treatment, no more wetting. So, now they are aware of the issue, and if she starts again, they know to get the testing done!

Note that during the day she is FINE! She knows she has to go and either "walks" her wheelchair or asks for help from staff.
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We're using condom catheters with my dad. So far so good, except sometimes he becomes alarmed as to why I'm attaching one to him, but that's another story I guess. If not for the catheters, my mom would be awakened every couple of hours to help him pee, either by lifting him out of bed and walking him to the bathroom, or by using a urinal. In either case it completely ruins my mom's quality of sleep and life.

Anyway give the catheters a try, we've been using the Spirit hydrocolloid sheath, plus a 2000mL urine bag that has a hook for hanging (crucial, otherwise it tugs, which can lead to a wet parent and bed). Depending on your dad, compliance might be the most difficult problem.
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Lynn105 Dec 2019
What about women who have to go once in early morning hrs? 84 yr old. No dementia. But gets uti's alot last 15 yrs. Is on Keflex as prophylactic. Is now in woman Depends. She fell broke ankle, no surgery thankgoodness, in my Dad's hospice room 5 days b4 he passed. So her an I were not there. But my sister was. While there they had a new thing for 40% incontinence . It was like a sanitary pad between legs attached to suction. A pad with suction. An stuck very well all down crotch. So she didnt have to use bed pan. Cause couldnt walk. But what about at home? She now is living with my sister in her home. I was both parents caregiver. Then Dad got sick. Etc...so Mom couldnt live alone healthwise or financially. But I was basically livin with her fr Oct 29th till Dec 29. An she has Stage 3 kidney disease an gets uti's easy. shouldnt hold urine. But since in wheelchair about 60% of time she needs assisted an when its 5 a.m. an I was exhausted an barly got sleep, she need to get help. Yes. I was cranky. But i was under extreme stress. Now with sister has never actually bedn caregiver to her parents. No choice. Extra room etc.. so just moved her 110 miles away. An sister has never been caregiver for parents. I have. Last 7 yrs. About killed me an now worried to death driving off leaving her there. But whats available for her?
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- Try to cut back on fluid intake for him earlier in the afternoon.
- Use bedside commode.
- Use protective pads/diapers.
- Assess for U.T.I.
- He is at a huge fall risk since rising out of bed to go to the bathroom when one is not fully awake is not advisable.
- Vesicare rx.
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My husband is in the final stage of Parkinson’s. He is incontinent and has been seen by several urologists for UTI’s. Night incontinence is common with Parkinson’s. Staying hydrated helps the UTI’s but adds to the urination issues.
We tried the meds mentioned by others and still the sheets and husband were soaked in the am even with bathroom use during the night. The Texas catheter (external) has worked well. It comes in sizes and works very well keeping him and the bed dry and eliminates trips to the bathroom during the night.
Using the catheter allowed meds to be
reduced with better results.
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My husband has had similar issues. He has enlarged prostate -- benign prostatic hyperplasia (BPH) He had been taking
- finasteride 5 mg one/day
- tamsulosin 0.4 mg one/day
but was beginning to have more troubles with urgency & incontinence. When he was in the hospital recently for an unrelated issue he had trouble using those plastic urinal bottles. They started using the condom catheters instead and they worked pretty well. Have not tried these at home. After he got out of the hospital he saw a urologist who gave him Myrbetriq. At first this didn't seem to help but eventually "kicked in", but still having problems. My husband has other issues such that the urologist doesn't want to do surgery. The doctor DID up the tamsulosin to 2 capsules a day and that helped tremendously. My husband is doing SO much better now. Here's the current mix of meds for his bladder control problems:
- Finasteride 5 mg, 1/day (morning)
- Tamsulosin 0.4 mg twice/day, 12 hours apart. Take capsules 1/2 hour after eating. Tamsulosin is generic for Flomax.
- Myrbetriq 50 mg 1/day at bedtime
I think when the doctor upped the Tamsulosin from 1 capsule a day to 2/day, that's when he really started to see improvement. He DOES wear "incontinence briefs" all day and all night, but now no longer wakes up with 12-18 oz of urine in the briefs and on the bed pad. Good luck!
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elaineSC Jan 2020
My husband also takes 50 mg of Myrbetriq and Finasteride too. He had the prostate laser surgery. He doesn’t take Flomax anymore though. That Myrbetriq is what did the trick for him though. Went from 6 trips to the bathroom to 1 at night. I order it from Canada though because they are reasonable. The tier he was in was sooo expensive even with his Part D prescription drug coverage.
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It's not safe for your Dad to be getting up that many times each night and wandering to the bathroom.
Does he have a portable plastic toilet that could be kept by his bedside for use at night?
If that's not an option there are some good quality overnight pullup underwear that could be worn to prevent him from having to get up.
They are just like the pullups that toddlers wear and there are a variety of absorbencies and sizes available. You would want a very absorbent overnight style to provide up to 8 hours of leak protection.
You can contact the various manufacturers and request samples to try until you find one that meets your Dad's needs.
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FirstRodeo Dec 2019
Also, you said your Dad is 93. As a pharmacist I would recommend trying all possible non-medication options first.
Elderly people are already receiving too many prescription medications. Once you get to about 5 medications a day you greatly increase the chances of them experiencing a side effect, adverse drug interaction or enhancing/ decreasing the effects of one of their other medications.
Adding additional medications rarely does more good than harm.
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I have had urinary infections for 30 years which causes me to be up in the bathroom all night long. Please ask the Doctor if he will prescribe Uribel it has changed my life! Not covered by insurance but only costs around $30,00 a month and I take 1 every other night. No side effects. I am female but I don't think that matters. Worth a try to help you both get some shut eye! Happy new year to you.
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It sounds like your dad has enlarged prostate problems which make him feel like peeing all the time. UTIs may be from not emptying his bladder fully. Ask urologist what are long term options, given your dad's age and chronic health problems. Usually surgery is not as successful in older folks because of heart, lungs, liver and/or kidney problems.

In the meantime, I agree with others to use adult incontinence measures (diapers, pads, and allowing him to rest more during the day).
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I too had problems with my husbands constant incontinence. He also was having constant UTI'S, because I cannot keep him hydrated enough. His Dr. finally put an indwelling catheter and that has been a blessing not only for him, but for me too. I only have to drain the bag in the morning when he wakes and at night before he goes to bed. During the day ther is hardly any output, but the next morning, the bag is full. My husband does not complain of any pain when the change his catheter out, because the Dr. says if you put enough lubricant on the tubing, it won't hurt, also, they have a numbing spray they can apply before insertion. I have never tried a condom catheter, do they really work so he doesnt have any accidents? What keeps it from slipping off and how often do you have to change the condom?
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has your father been checked for urinary tract infection?
if no infection there is a catheter that can be placed, it
does not need to be long term; there is also an overnoc
condom that can be placed hooked up to a bag and he
won't need to get up
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At 95 and needing sleep, use the men's pull-ups and put down a pad in the bed as a back-up and one in his recliner if he sits in one. He may not like wearing them but the catheter and all is worse than wearing a diaper. My Mom didn't want to wear one but we finally told her she would HAVE to wear one and that many, many people wear "Depends". It is advertised even for people who have urological problems but still active too so don't fret about it. Get those Depends and have "the talk" with your Dad about it.
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My Dad is 95 and too old to have any procedures done.

It really doesn't matter for your dad to get up all hours because he can make up his sleep the next day. It is however awful for the Caregiver having to help him since they can't make up the sleep.
My 95 yr old Dad has a Catheter but it's a pain to have to drain it a few times a day and most importantly, it hurts a whole lot having it changed out once a month and I feel so bad for him to go thru this once a month.
But, your Dad and mine are way too old for surgery.

I guess you could start letting him wear Adult diapers at night.
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There is something called a urosheath that goes on the outside of his penis. This will allow himto go in a bag with out an internal catheter.
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You have lots of sensible suggestions here. You'll have to do "trial and error" and see what works. I would start with the simplest and least invasive actions:
1. Drink as little as possible liquids after 6pm.
2. Do kegel exercises throughout the day if he will.
3. If there are prostate issues, it might be helpful to see Michael F. Roizen and Michael Crupain's "What to Eat When: A Strategic Plan to Improve Your Health & Life Through Food ( National Geographic Book, 2019), Chapter 31 "What to Eat When You Need to Shrink Your Prostate," pp. 239-242.
4. Moving on to the many suggestions you have from other caregivers.

Just remember that incontinence is an inconvenience, but retention of either urine or bowels is a big deal requiring immediate medical intervention.

All the best

Prayers and Hope
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Does your dad recline a lot during the day?
When my Husband would sit it would be one thing but when he either reclined more of lay down I would end up with a flood! It seems that going to a laying down position allowed the bladder to fully empty.
You might want to try having him fully recline during the day to allow the bladder to empty so there is not a lot retained that will empty when he goes to bed.
A condom catheter works well if your dad will leave it alone. My Husband would "fiddle and reposition himself" so I could not have used that on him. I did once he declined to the point where he was no longer "readjusting" himself and it was so much easier than changing him every 1 to 2 hours.
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Would he consider a condom catheter aka Texas catheter? This way he doesn’t have to get up.
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Why does he have urgency? Diapers are an alternative; condom caths can be irritating and messy...the medication is only for certain diagnosis and obviously is not working. Kegel exercises help as well. Urinal by his side is another option.
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Condom Catheter.

Instead of telling him that you're tired of hearing about his plumbing problems, tell him you're working on it with his physician.

A Condom Catheter sounds like what he is needing but only his physician can say for sure. We considered it for my DH but his physician felt DH should go on a pill that would allow him to have more time in-between needs. DH passed before it became a problem, but he was waking me hourly to void so it was getting a lot closer. He was 96.
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Hubby has Parkinson’s and a condom catheter is our way to deal with this issue. All external so no infections. Works for us.
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Thanks for the suggestions, some of which I will never be able to get him to do. But, in a weird way, it's reassuring to know that others have tried the meds & they had no luck either.
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My 75 year old husband with Stage 5 Parkinson's started this last April. He wakes up about every two hours and has to urinate (and it's more than just a dribble). He's been to two different urologists / taken different kinds of meds / and nothing seems to be working. We limit water intake after 5:30 p.m. I'm exhausted - as I have to get up with him - as he has a balance issue and will fall. We keep a urinal next to he bed - as it is much faster than getting him in to the bathroom. It's called nocturnal something or other. He doesn't do this during the day - when he is up and awake. ??

Husband has sleep apnea and uses a cpap machine nightly. He's been using the machine for about seven +/- years.

Husband has been on a drug called Tamolusin (sp?). I don't see any improvement or difference.

Looking forward to reading other comments / suggestions.

Thank you.
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Have him checked for diabetes. Frequent urination is one of the earliest signs (regardless of age).

if his glucose levels are normal, then urologist can figure this out. Get an appointment
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