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She wears depends, but never uses them! Rarely has accidents. Needs to get up with full on assistance every 30-45 min up go to bathroom. Has 24/7 care, with maybe 30-1 hr in between shifts with no one.

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If you were still able to know when you had to go to the bathroom and knew you could make it to the toilet with help, wouldn't you rather do that then to have to pee in a diaper? I know I would.
All too often, especially in nursing facilities, folks who otherwise could make it to the bathroom with some help are left to have to pee in their diaper, because facilities are short staffed and they find it easier to change ones diapers than have to take the time to assist them to the bathroom.
It's very sad actually, and quite degrading especially to those who still have their minds and are left with no choice but to pee in their pants/diapers.
Perhaps try putting a bedside commode close to where she sits or spends most of her time. That way it will be quick and easy for her(and you)to go as often as she likes.
And remember to always treat others as you would want to be treated, because yes, you will be old one day too.
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She should be checked for a UTI as well as interstitial cystitis, also known as IC or overactive bladder. There are medicines that treat IC to relieve the constant urge of having to go.
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She should not have to get up to use the toilet every 30-45 minutes; that is excessive. If this woman has dementia, then obsessions with the bathroom go with the territory. I would often say if it weren't for the need of a toilet, my mother with advanced dementia would have NO problems at all! But she had a bathroom obsession something fierce, so she felt the need to use it 20-25x a day and wound up falling off of the toilet A LOT as a result.

Your lady has 24/7 care, so helping her is not an issue........the real issue lies with WHY she's feeling a need to use the toilet 48x a day. She should be checked for a UTI or given meds for an overactive bladder, like Fawnby recommended. But again, if dementia is the culprit, it's likely nothing is going to help this issue. Oftentimes the brain misfires, sending signals that the bladder is full when it isn't, leading the elder to feel the need to 'go' when there really isn't a need in the first place.

Wishing you the best of luck with a difficult situation.
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There is a new vacuuming system for extracting urine from the bladder while the patient sleeps. It is being advertised on TV. Check with your urologist or gynocologist
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My mom who has dementia use to do that! She was flushing the toilet constantly! We were going through so much toilet paper. I started listening to see if she was urinating. Guess what? She was not even urinating. Finally, I took her to primary care doctor for OCD. She had an obsession with the mailbox too. Once she started taken Sertaline it all stopped!
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