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Caring for elderly aunt with incontinence and dementia. She rarely toilets. The time intervals between toileting or having accidents is quite excessive (she's also averse to drinking much). When I try to suggest she go, she continues to say "I'll go when I have to go!" and "I never have an accident!"

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Hi Rt. I use any excuse to get her off her chair and while up guide my Mom to the bathroom. I say things like “let’s go see if there is candy in the kitchen” or “I’ve got to show you something beautiful by the window”. I don’t give my Mom the chance to object. My suggestions are while helping her up from the chair. Then while up I say, “ hey, let’s stop in the bathroom since we are already up”. Good luck.
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rtdennis Dec 22, 2019
Thanks! I do find it is easier to get her to use bathroom while she is up from her bed (though not always). She usually is inclined to spend the majority of day in bed and isn't interested in getting up for much of anything. I just have to find a few things she will get up for (I have no idea what that would be but if I can just figure that out...)!
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Bowel and bladder training is every 2 hours. You can put her on commode by bed or chair if she is weak. Toilet upon awakening and limit fluids before bedtime.

If they are combative, they are tryng to retain their dignity and a trick is to
just go with her when she has to go to bathroom and get personal care done.

Accidents are messy but if using diaper pullups, even with accident, you can remove by tearing diaper on crease while on toilet. We use a bidet and you can install a portable one for 99. dollars.

Put infectious waste ( dirty diaper) into plastic bag and tie.
Use a bucket with
a little bleach and soap to wash out clothes
Use chucks aka paper liners for bed and chairs.
Be sure you use gloves.

Once you have a person on toilet, if you have access to shower hose and no bidet, you can rinse perianal area and flush.

Use incontinent care products for geriatrics (spray body wash, toilet paper, and wipes) Do not flush wipes into toilet.

Hope this helps.
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GraceNBCC Dec 23, 2019
Excellent advice but I suspect " Training every 2 hours" came from nursing profession.
The invite to walk them to the bathroom every 20-30 minutes works better. Please see my post.

Nursing would consider this too hard to keep to...but it worked and made their jobs easier.
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Does she wear adult incontinence briefs like Depend? It’s been suggested here that you take all her underwear and replace them with these briefs.
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rtdennis Dec 22, 2019
She now wears Depends all the time. They help a little... Though I find it often still messes clothing and bedding. I'm probably more concerned that she just doesn't urinate enough and also that she may be sitting in her urine soaked Depends and isn't keeping clean. For someone that has had a regular history of UTI's, just not good!
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Put a thick liner in the depends. This is easier to change, it has self sticking strips. Tena is a comfortable brand.
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Ok, got this! This is from a research study done about 20 + years ago that one of my professors was part of. So simple but reduced incontenience by 80%!!

Every 20 to 30 minutes, timers were set for consistency!, all staff and volunteers offered to walk patients to the bathroom.
" Would you like me to walk you to the bathroom"
"I am going over by the bathrooms now, may I walk you over."

A simple invite, low key...
Never asking if they Need/want to go now!!!
Just an offer, every 20 min worked better, but keep it as consistent as possible. Have any visitors looped in to the routine and protocol!

When there were accidents, it was cleaned up, nothing said, just back to offer, even if it was during clean up or just after an accident.

This being treated with respect, as an adult, no shame, kindness becomes their routine. Often they go through the motions due to the attention. Improvement in days to a week, by 6 weeks 80%-95% reduction in incontenience. Reduced UTIs.

Staff kept up the protocol and we're monitored for a full year. Results held! Just ask them to walk with you! Use your phone timer or a kitchen timer. Only during waking hours! Their body will start to adapt and less issues during sleep!
Please pass this on!!!
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tornadojan Dec 28, 2019
Interesting! I have this problem with my mom. I can't speak for my mom's helpers but I have to admit to expressing some impatience (!) to my mom when she has an accident right after I've tried to cajole her to the toilet. I will definitely try this approach.
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Omgosh, rtdennis, I have the same problem with my sister, which results in a UTI every six weeks and many packages of panty liners. I hear the exact same words. If I say she hasn't gone in the last 4 hours, "How do YOU know when I went?" Well, we've been in the same room for the last 4 hours except when I went! I thought getting her to drink more would make her go more, but she doesn't get the signal.

She has a phone alarm that goes off when it's time to take her meds. These are generally every two hours. So I'm trying to get her to go then, based on "instructions from the hospital" that she was given during her last UTI visit. (I retyped them to read "every two hours, even if you don't feel the need." It helps to have something in writing to point to. But even then, I hear, "I just went 20 minutes ago!" If I continue to try to persuade her, she'll usually get mad and go just to prove to me that she doesn't have to. But I don't want to always be arguing because the one thing she doesn't forget is bad feelings.

As someone mentions below, I'm also trying to get her to go and wash up for dinner as an excuse. That usually works without too much difficulty. Every evening she gets an M&M snack. This is her addiction and used to sit eating them all day long before she came to live with me. Last night she saw them laying out for her and I asked her to go to the restroom before she took them and she agreed almost cheerily!

I have an upcoming fight on my hands because many mornings I go into her room and find her PJ bottoms and panties hanging on a door knob drying. So I'm going to insist she start wearing Depends at night. She doesn't wet the bed, but she can't make it to the toilet in time once she's on her way.

I wish I had good advice to give you! But I've mostly just vented here to someone who understands because I'm stuck in the same spot! Sorry.
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Tothill Dec 21, 2019
She may need a bedside commode if she cannot make it to the bathroom at night.
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Hi Rt. I just read your post about your Aunt getting up for the dog. Ah, I would use this all day long. Especially since she will not remember the tactic. “Hey Auntie, can you let “Spot” out, I’m busy with “whatever””. “Can you please let Spot in as I’m busy with “whatever””. Maybe you could get her to the chair after the steering to the bathroom with another tactic? Strip her bed while she’s on the toilet. Tell her “whatever”. You spilled something by accident maybe. I tell white lies all the time. No harm, no foul. Good luck.
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GraceNBCC Dec 23, 2019
I love your tactics!
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she forgets, which means you have to put her on a toileting schedule around the clock. walk her to the toilet or bedside commode every several hours. Eventually they will lose even that ability. If she is the type that likes to stay in bed mostly she will become bedridden much faster and that will require scheduled diaper changes and routine bowel schedule which means enemas and laxatives. You will also need to do bed baths. IF you can't handle all of this, then get her to a nursing home.
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Willie said "don't be afraid to give her coffee, tea, soda or whatever she likes" With my Mom these drinks were a no no. They caused the other problem and Mom suffered from Gerd so coffee was definately out. Juices did a number on her. And soda, not good if your a diabetic. Mom drank green tea.

If she has a history of UTIs try a probiotic and cranberry tablets and as much water as u can get into her. One problem with Dementia is the brain no longer tells them they are thirsty. The every 2 hour thing is good. Let her sit. UTIs are also caused by not completely voiding. As woman age the bladder drops and it doesn't completely void. The last time Mom was in the hospital for a UTI, she was catherized and they got every bit of urine in her bladder. Make sure a culture is done for the correct antibiotic. When on an antibiotic, a probiotic should be given. This is when Mom started the cranberry tablets. Its not so much sitting in urine that causes UTIs its sitting in #2. Make sure she cleans up real well even if you have to do it. I used a handheld shower head when I bathed her. Some recommend soap but that can cause infections if soap gets in the urethra. I buy Huggies wipes they are big and thick.

When Mom went into LTC they took her every two hours. Eventually your Mom will be incontinent. She just will not know what "holding" it means. She won't know she has to go.
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Honestly, I would buy an M&M dispenser and use them as bribery.

You can set them to dispense as few or as many as you want. A couple of M&Ms 10 or 15 times a day is far better than 1 UTI.

Best of luck, such a difficult challenge.
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