Is a bladder pacemaker a good idea for someone that is in the later stages of Alzheimer's dementia?

I think that given her situation I would advise against the surgery. If anaesthesia is involved, that alone could exacerbate her dementia. Leave well enough alone. Trust your instincts.

I think at her age and in her condition, the top priority is comfort. As long as she can get that without surgery, I would not do it.

If I were in your shoes and my mom was that age and in late stage Alzheimer's...
I would NOT put her through the procedure.  I know it's hard because it's your mom, but you have to look at quality of life and diagnosis.  And I agree with you that she would probably look down one day and think...what are these wires and pull them out.

I wouldn't do it. If it were my mom she would yank those wires out before she even got out of post op.

Why does this have an external battery? That makes no sense. It could have an internal battery recharged through induction. It doesn't even need a battery. They could have it powered through induction. She could wear something like a fanny pack to power it externally with no wires.

Unfortunately, medical professionals tell us what they CAN do, not what they SHOULD do. I see elderly people with multiple chronic conditions and advanced dementia who are put forth as candidates for all kinds of procedures and surgeries. To me, it's all over-treatment and in some cases, abusive.
I agree with you. It sounds like a bad idea.

I don't see how this would work out for your momma since she has Alzheimer's and may pull at the leads. It's a no.

Please don't, she is 89 it would b to much for her at that age. I see people that have had surgeries at my mom's AL and they are never the same. They put a 99 yr old woman through surgery, believe it or not, she didn't look her age, and was "very" active, now she just lays in bed all day. Sad situation.

Plenty of water. somene suggested macha green tea and lemon. makes the water more alkaline. and things do not grow in alkaline water.

They sell alkaline water now in most stores. In our area these is an alkaline water dispensary, they have a whole lab stype store, for alkaline. $2.00 a 5 gallon jug.

I was visiting the Chinese restaurant when a lady pulled up and was filling up her bottles with alkaline water. Plunked in cash, and out came the water. I asked if it was worth it. She drives up there every week just for water. She lives about 10 miles away. She e=believes in it so much, she gives it to her dog as well.

I think I will try it sometime.

If your mom has dementia, most likely she will NOT KNOW WHAT THAT FOREIGN THING IS STICKING OUT OF HER SKIN THAT IS IRRITATING HER.

So, like my mom with IV'S and catheter, she pulled them out, constantly.

she is 89, make sure she is changed and cleaned constantly, put her on antibiotic give her probiotics, and give her happiness.

the mechanism may last 5 years, but will your mom? Something foreign in the body, may cause worse issues... She doesn't need that. You don't either.


My neighbor had a procedure done, with a mesh to change the angle of her bladder. She seems okay with it, no more leaking. She is 90, no dementia.

I agree with most of the posters, not a feasible solution for a dementia patient. A doctor once said to me: can they operate, yes. Should they operate? Only you can answer that. I felt surgery had too many other possible obstacles that I didn’t want my Mom to suffer through. Treat the symptoms. The best and latest procedures are not for everyone. Sadly the caregivers may have to change Mom more often, but for me that wasn’t a burden, it was my Mom. Good Luck 🙏

Horrible idea. Cannot imagine a decent doctor or caregiver suggesting such a thing. Don't do it!!!!!

Garlic is a natural preventative of UTIs. Google "Garlic and UTIs" for more info..

No! Do not do this, please. The doctors are not always correct. My mother had bladder infections for years and some are severe, now resistant to most oral meds. She is currently on IV antibiotics at home and doing very well. I stopped her bladder washes that she was getting every week. They helped tremendously for about three years ,and now stopped working. Her bladder is calmer, she is oriented to person and place. The IV antibiotics are for 6 weeks 3x day. I am working with a infectious disease doctor, and alternative doctor. The antibiotics do make a difference with pain, mental status, clears her urine, and keeps her from becoming septic. A few supplements to combat the colonization in her bladder. I sympathize with you for I know how difficult it truly is. I would not put my own mother through the surgery . Try other options that are safer and not invasive. There is going to be a time when I will need to stop treatment and provide just comfort measures for my dear mother. It breaks my heart to see my mom decline, but I want the best for her. I love her so much and she trusts me with her medical care to make the right decisions. and do what is in her best interest,. Right now she has good quality life, and we will stick to the current plan. All family members are in agreement. I would recommend another urologist for a second opinion. These UTI's are extremely painful, especially for the elderly, and they tend to get very sick quickly. I am praying for both you and your mother. Blessings.

her problem is that she is not drinking enough fluids to flush out her bladder

Any surgery at any age is a risk. For elders it is even more of a risk (anesthesia can bring on dementia-like symptoms even in those who never had any.) Surgery on someone in advanced stages of dementia? WHAT are these docs thinking! Go with your gut instinct. This likely isn't going to help your mother and could do more harm instead!

Recently when mom started to refuse to walk/stand, they put a lanyard on her with a call button. No harm to her, but she has no clue what it is. Sometimes she just pushes the button because it is there! Having to deal with any incisions, wires, battery packs, I would give this surgery a hearty NO.

I'm not even sure what the shock treatments do for her. You say "...is plagued with constant UTI's for years and who was taking PTNS (shock treatments once a month to her bladder to help prevent UTI's) If she's been getting this treatment for years and is still getting UTIs, then I would put a halt to THAT treatment as well.

I would also consult with another urologist, perhaps one who might specialize in caring for older people. There are many reasons why someone might get UTIs - wiping wrong, not changing often enough, etc. There also should be a culture done, to determine the specific antibiotic that would work best. One urologist told me that if I had continued to get UTIs (only had TWO), it would mean getting on an antibiotic long-term, at least 6 months. If this were the case, get a recommended probiotic as well - last thing you need is #2 issues, to counteract the good antibiotics might be doing! These new "care-givers" need to be more diligent, perhaps, in seeing to it that she is clean. They might be thinking this will reduce their work load?

There is also another condition that may make it seem like one has a UTI - interstitial cystitis. Mom was told she had this (but sometimes there WERE UTIs) and was given a list of things to eat/not eat, told she wasn't emptying her bladder and needed to "drain" herself with little catheters, etc. Funny that she still continued to get UTIs, but when dementia started, she either decided she didn't need to do this or forgot. The result was FEWER UTIs. Go figure.

Seems like you and most who have responded are in agreement - why put mom through this? There isn't even a guarantee that it will stop the UTIs (clearly the monthly treatments don't seem to be, why would this be any better?) This is invasive and mom isn't going to be very compliant with the "after-care".

Get another opinion. Culture. Long-term antibiotics. Ask about catheter. ANYTHING but not surgery.

there is a learning curve to an interstim, at least that is what i learned when Mom's wasn't doing much for her. It stimulates you so you know to get up and go. But you have to acknowledge it and go!
The doctor added botox after a few years, and together they work perfectly. She doesn't have to think anything!

There are risks no matter what. I am not going to voice a yes or no, just some thoughts. Having a constant UTI makes one feel bad. Are you sure the leads are exernal and not internal (so she cannot pull at them)? Surgery can be hard on a dementia patient. How is her health otherwise? Has she tried some of the medications that might help? Will this help her for a considerable time or not? How hard is it on her to go get the shock treatments? Will they eventually have to be more frequent? What I have read (https://healthcare.utah.edu/urology/docs/interstim-therapy-info.pdf ) indicates the external wires are for a test procedure that lasts a few days to see if this thing is better or not; the final implant has only internal wires. The whole procedure of implant (see the post) does not sound like something that would work well with a dementia patient--they have to provide feedback about where a tingle feels, etc. Can your mother do this, even?

My opinion on this is to get another maybe third opinion. I am in the same boat as you and am findng gynecologists opinions vary widely. I recently watched a talk show where a noted female gynecologist said cranberry is over rated, that there have never been any studies showing cranberry works. I still give it to mom anyway. Make sure she is getting 100% juice and not cranberry cocktail juice.
D-Mannose was mentioned, try this. There is also a firm Uqora that has a D-Mannose product in combination with vit C and other stuff, something to look into. Probiotics, make sure you get the right one. A pharmacist, or good vitamin store consultant should be provide direction on this, a female probiotic specifically to help with UTI's. There are also some good bidet seats that attach to the toilet, but she may not be able to operate one if her dementia is advanced.
There are medications that voids the bladder of left over urine. Talk to your doctor about these. I have never heard of a badder implant device. It sounds a bit radical for a dementia patient, but it also sounds very interesting. Love to read these comments. Good luck,

My mother just got hit with incontinence and can't remember she needs to wear special underwear. I can't imagine her dealing with leads... Don't do it. You'll spend the rest of her life explaining it to her, over and over and over, and one time you might not explain it quickly enough...

I would not- my husband is in late stage and I will not take extraordinary measures. In my mind, nature has a plan and I will trust it since I don’t see the benefit of prolonging this horrible disease with interventions.

I'm the caregiver for a dementia patient, who just had a procedure that involved both catheters and IVs. She constantly pulled them both out, and the nurses kept trying to explain to her that she shouldn't do it. But they didn't have much experience with dementia patients, and had trouble understanding that they couldn't reason with her. Finally, we hired someone to sit with her 24/7 to intervene every time she started to pull at a tube. Bottom line: Unless the urologist has A LOT of experience working with dementia patients, and can explain why he is confident your mother won't pull out this catheter (and why it will significantly improve her quality of life), I would really hesitate to put her through this.

I know nothing about bladder pacemakers, but surgery for one who is Alzheimer's and 89 years old sounds too risky. She is likely to spend her last days in the ICU after such a procedure. But the urologist does not think about the consequences. And you are right in thinking that she would pull the leads out which would probably lead to visits to the Emergency Room to replace them. For a different viewpoint on surgery and care of the whole person I could recommend a book: "Being Mortal" but Atul Gawande, although I don't think it deals exactly with your M's problem.

I vote with "bad idea" especially for someone with any form of dementia.

Curious: what is the cause of your mom’s UTI? Maybe the doctor should try to fix the cause rather than the effect. I agree with JoAnn29 that a doctor and a caregiver who know about dementia would not push for the surgery.

I took care of my stepmother (and dad now too) who had dementia . She had constant UTIs. Found out she was wiping FORWARD when she pooped! Sooooo, guess where the poop was going? Yep. That was the cause of her UTI's.
Couldn't get her to stop wiping wrong and she was on Hospice for terminal cancer as well. Their solution was a permanent catheter. She was on meds, antibiotics and cranberry pills and something that made her pee orange to relieve the burning sensation she felt, until she passed. Thank God for the catheter. She had to dribble every 15-20 min....ALL NIGHT LONG! For 3 months I never got decent sleep because I had to carry her to the bathroom in a wheelchair. I had to explain to her OVER AND OVER AND OVER about the catheter. But it was better than going to the bathroom every 20 min. I wouldn't even think of placing something with external wires to a battery in an ALZ patient!

No you are not wrong. I wouldn't have put my mom through it. She had seven UTI's in less than a year. Prophylactic antibiotics and some other meds took care of the problem.

THis is my personal opinion, without having read any other responses first. I am with you, for all the reasons you stated, and it infuriates me personally that the MD would even consider this. No, it's not great to be on antibiotics, but I'd guess that is less risky than a surgical procedure that would be rough going to being with either with a block or general anesthesia, and the risk of pulling those leads out.
If you're having trouble deciding and want advice beyond here I'd suggest finding out which is the best regarded hospice service in your area and seeing if your mom doesn't qualify...as well as a group called Curadux which has experts to objective professionals to weigh in on complicated situations. This doesn't seem complicated to me, it just seems like you are using common sense and are right. My gut tells me that the MD involved possibly doesn't have his/her patient's well-being at heart.
Stick with your gut instinct and let us know how it goes....

Sounds like a great idea for the doctor who gets money to insert it and money for follow-up appointments.

This sounds like a nightmare situation. I would try any and all other treatments before that. I couldn't imagine trying to tell someone with dementia not to touch wires that were coming out of her skin. My mother couldn't keep a band aid on her toe for the night.

This doctor has no idea how a Dementia person is if he is suggesting something like this for an 89 yr old woman who suffers from it. My Mom was 89 when she passed and in her final stage. There is no way this procedure can be explained to Mom and to have something she could play with. No, not a good idea.

I guess u have tried everything. When my Mom had her last UTI, she was given a probiotic and cranberry tablet daily. Both continued when she went back to the LTC. She died a year later but never had another UTI. I like Alva's idea. My Moms LTC kept her clean better than the AL she was in. Grandma's ideas are good too.