You can’t say it is exactly incontinence because my husband knows he has to urinate and goes someplace purposefully to open his fly and relieve himself. It could be in the kitchen, against a tree or house outside. It is as if he can’t find or identify the bathroom at times. At other times he goes to the bathroom when he has the impulse. Has anyone else had this problem and how did they deal with it?
* stress - weakened pelvic floor muscles
* neurological - many reasons due to brain conditions eg dementia, PD, ABI. Also, without any dx eg the 'let go at the bathroom door' type.
There can be issues with the bladder itself or UTIs, causing frequency or sudden release.
Or other factors that make keeping continent hard.
Mobility is a big one. Getting to the toilet in time, getting out of chairs, walking slow with a walker etc.
Or being able to walk but not manage the zipper or clothing fast enough eg due to stroke, arthritic hands, neuropathy. These were called Functional Incontinence.
Memory issues that delay finding the bathroom is another problem. It might have also fallen under the Functional label, but I am not sure.
The Nurse said "If you can't cure, aim to contain".
The recomondation for my LO was for a toileting schedule. (Plus nice thick pullups). As mobility was a factor, when up for meals & snacks, add in a toilet break then. Have easy clothing, elastic waistbands. No trip hazards on the floor, bathroom door kept open.
I think you could try a routine eg before & after meals. But also, be a bit of a slueth - see if other factors/changes may be present.
If suggesting/prompting goes no-where, then assistance is next. Walk with him & divert to the bathroom at various times. You may have to be within earshot for distance supervision, then this will progress to close supervsion then eventually hands-on assistance. Depnding on personality.. some will let you help them & some resist.
I hope you find some ways that works for you both.
red toilet seat
As the disease progresses alzheimer's patients can still identify red in their brain
As the disease progresses it is difficult for alzheimer's patients to identify white tile flooring and locate where a white toilet seat is
There is a hard learning curve to this stage of caregiving. You are witnessing the devolution of a good human being. Toileting is one of our most personal behaviors that is going in the worse way hay wire. Remember he is a prisoner. He doesn't know. He is sleep walking awake in a nightmare.
I stopped my husband's mistakes in the kitchen by putting up a very good and attractive metal pet gate (with a little hatch for the cat).
Bathrooms lights were kept on and their doors open. With blue painter's tape I drew an arrow and the word TOILET HERE on the open doors.
I developed sonic hearing.
I kept the wet vac, Borateem or Lysol sanitizer always at the ready.
And when it became the wild west, when my tricks no longer worked, he had to be dressed in adaptive clothing (jumpsuits) such as those sold by Silverts, or Buck and Buck (https://www.buckandbuck.com/mens-adaptive/jumpsuits.html) and several other companies. Sometimes they're called anti-strip clothing. These jumpsuits look as though a person is wearing a T or polo shirt tucked into sweatpants, but the shirt is sewn to the pants. There is no way he can pull down his pants. In the back there is a long zip. He will not be able to reach the zipper. He will come to you for help or "go" in this pants eliminating the risk of flashing someone or making every inch of your home a urinal (or worse, that you may not know about for a while especially if he neatly bundles his huge boo-boos in a towel and then hides it like money. Used TP became another problem. He could no longer understand that it went into the toilet and so that went behind cabinets).
If you have wall-to-wall carpeting, with a good pad underneath it, and wood under that, start putting a little money away for later for a complete gut and replacement.
When this behavior started my sweetheart could not understand my nerve, stupidity and disrespect to him by hollering NOOOO STOP, those times he'd beat me to it. He was peacefully letting go. How could I be so rude. His kind eyes were hurt and questioning if I was going crazy. Innocently, he relieved himself everywhere and anywhere. If there is no one in a room, then he will pull down his pants and "go". And it escalated. He eventually would go even if there was a dining room full of people. I can tell you horror stories regarding this subject that would make you faint.
Get a small wet vac. Get a gate. Keep buckets, sponges and rags ready. Get adaptive clothing.
This unintentional behavior is strictly a result of behavioral filters going out the window with his dying brain.
It's been over a year since he passed away. If it weren't for this inquiry I totally forgot about that episode. I only remember him beautifully. He was the best.
No place is sacred. Wastebaskets, inside the dishwasher, on our place mats and dining chairs. On the bathroom floor, in the tub, on the shower chair, on various sections of baseboard. In the sink, in a shoe, in a flowerpot, on the carpet in a corner or middle of the room. In the nightstand drawer. On the magazines. Using Depends didn’t stop it, and it happened all hours of day and night. There’s no sense to it.
Inappropriate urination is a main reason for placement in memory care.
Some of it might be due to the fact that he does not "know" where the bathroom or the appropriate place is.
As has been suggested getting rid of regular underwear and replacing it with disposable and clothing that he is unable to remove is good.
Or you begin to tell him "time to go to the bathroom" every 2 hours and you accompany him.
And this seems to be a common problem with dementia.