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Please - suggesting ANYTHING to a caregiver to be done every two hours is unrealistic. 15 years a caregiver here. I personally have found overnight Depends to not remotely be absorbent enough for all night and leakage requires frequent linen change and clothing wash. I have found Unique Wellness Brief Original Adult Diaper to truly absorb overnight.

Good luck to you. Every caregiver has different challenges. I have found dealing with adult toileting and incontinence to be one of the hardest.
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dawnna911: Since PSP (Progressive Supranuclear Palsy) can cause problems with balance and movement, I can understand why she has "a fear of the bathroom," i.e. more importantly, perhaps she has a fear of actually ambulating TO the bath ROOM, for a valid fear of falling. I can understand that totally. Anyone who is unstable being upright should actually not attempt to walk. It is no wonder that she opts for a depend undergarment. Perhaps also a bedside commode would provide her more security, especially since she also (per your profile) suffers from Parkinson's Disease.
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First off bless you!!
Taking care of someone with PSP is very exhausting both physically & mentally.
It's a cruel disease.
Would it help if you went into the restroom with your Mom?
It may calm her to know that you are there & available for her.
I know it's probably not your ideal lot in life to be a bathroom buddy but it couldn't hurt to try it. ???
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I have read all the answers.....forget the why, this situation is impossible and I think the answer is clear. She needs to be placed where she can be tended to and taken care of. This should NOT be you any longer. She has fear AND DEMENTIA.
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My mother has a fear of the bathroom and getting stuck on the toilet or dying on the toilet too. she is very deliberate and cautious with her steps when she does walk in the bathroom. We put up grab bars on the door and prop the door open on the toilet paper holder actually it doubles as a grab bar /toilet paper holder. Her issues is falling, and I think a vagus nerve thing going on because she gets weak whenever she voids her bowels and passes out. So we just avoid the bathroom most of the time.

She has an external catheter for the night and just voids in her diaper. It is a breeze. I get my sleep and so does she. I just use the diaper to wipe up most of the feces then the hygiene wipes for what is remains.

Everyone has suggested a bedside commode but there I drew the line because I just don't like the handling of it, rinsing and storing something that has had feces in it. Plus, she as osteoporosis and multiple myloma which can cause hairline fractures and eats away at the bone density leaving a swiss cheese like holes in her bones. So I'm afraid to use anything that is unnatural to her in regards to toileting.
We just bought a swivel shower chair. I'm hoping that that will settle a lot of her fears of the bathroom and showering.
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seee a psychologist consider hypnosis, consider letting her use depends IF she then tells you she need to change them and helps instead of sitting in wet pants and smelling like urine , Dr Jack Grenan speak to your PCP, Psychologist, Pastor and Pray! Dr Jack Grenan
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I advise using overnight strength Depends type underwear and putting overnight incontinence pad into bottom of Depends. The pad will get saturated first and then the Depends. Also consider putting mom on a toileting schedule - every 2 hours pop her onto the toilet while she is awake. You can get toilet seat attachment to raise the seat if needed. You can also install a bidet attachment to your toilet to help with cleaning bottom. If she can not walk far enough to the toilet, there are bedside commodes. If she is anxious about using the toilet, she may benefit with anti-anxiety medication.
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Try letting her use a bedside toilet.
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I had a shower wheelchair that I used for my Husband. It has a seat that looks very much like a toilet seat and has a basin that slides under the seat. Or the wheelchair can be rolled over the toilet with the basin removed so everything just goes into the toilet.
That might work well, she can sit on the chair and use it as is or she can be brought into the bathroom and pushed over the toilet. and the shower wheelchair is much more stable than a commode.
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Just a comment on the safety of commodes.   One that's a stand-alone, without reinforcement or support, isn't that safe.  My mother discovered that, as did my father and I when he tried to help her with a commode during the night.  She was tired, sleepy, needed help to get off, but  fell over.    We had to call EMS to help her get her up; there was no way of telling what injuries she may have sustained.

My memory is fading, but that might have been the time she ended up staying several days in the hospital.   (As I age, all those events become less clear.)

If I ever had to use a commode, I'll have each leg reinforced with the adaptations that provide a greater area of floor contact, and or have other safety features.
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cwillie Oct 2021
Yeah, I was surprised at how flimsy some of the ones I've seen online look. I think they should all be like the ones marketed as bariatric commodes with full bench seats and heavy duty arms and legs.
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I looked up PSP and balance and mobility is a problem. Maybe she feels she will fall off the toilet or just getting on and off throws her balance off. Unless a hi-risers with handles sre screwed onto the toilet, they are not really stable. (Our clients at the VNA didn't care for them) But a commode is. You can remove the toilet seats altogether or just keep them up. (Commodes have their own) Remove the bar off the back and slide the commode over the toilet. New ones should come with a bucket and a splash guard. (Either can be bought from a medical supply store) Take the splash guard and put it where the bucket would go. The legs on the commode are adjustable so adjust them so the bottom edge of the splash guard is at least below the rim of the toilet bowl. At this point it can be lowered for Moms comfort. Now she has arms on the side and legs firmly on the floor. When she gets up, she has the arms to hang onto till she can stand fully.
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I ma recovering from major ankle/foot surgery--and weirdly enough, the hardest thing to learn to accomadate was lowering myself onto the potty. It was just that final 5" that I'd kind of 'fall' onto it that really was kind of scary, to be honest. The knee high boot I was in kept me from just 'sitting' and also caused a lot of bruising on my legs.

I got online and found a toilet seat riser that was absolutely the best DME I'd bought for this recovery.

I really DID get the 'fear' of falling--and I knew full well there was a toilet behind me.

People suggested a commode in the bedroom, and I had to laugh. No way in this life would DH have cleaned one of those!

The seat felt VERY secure and that was helpful. Actually, it's coming off the toilet today as I am like 80% and walk with regular shoes. The seat riser is now kind of annoying, where it was an absolute godsend.
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To add to vegas lady's question - might she benefit from a seat riser and grab bars?
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Is it a fear of the bathroom or of falling and not being able to see well?
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Do you have a commode? That way she still evacuates property and hygienically but doesn't have to go into the bathroom.
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I can offer no help as I am dealing with the same thing. My mom is bedridden and often wets thru everything causing a complete change. I’m interested in seeing what advice others have to offer
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BurntCaregiver Oct 2021
MicheleV,

I've had many bedridden clients in homecare who would wet through everything either in the overnight, or if they weren't changed every hour.
Then I had an idea. It sounds crazy, but it works.
In addition to the actual diaper, I added a trimmed down baby diaper as a liner. Baby diapers are made from a different material then the adult ones. No matter how much liquid gets on them, it gets drawn down into the diaper and turns into a kind of gel. The surface of it stayed dry even without being changed in the overnight. Give this a try because it works.
All I did was trim the tabs and elastic off of the baby diaper and lay it flat to line the adult one.
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