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We moved my mother in with us after my father died. She spent about 6 months on a secure unit of an assisted living. After several falls and 2 trips to the hospital we brought her home with and aid 8 hours a day. She is in the mid to end stage of Alzheimer's and dementia. She is incontinent of urine and feces. In the morning her depends is soaked. She takes her clothes off sometimes and is completely soaked in the morning. Any suggestions for getting her to stop this behavior.

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[[That was supposed to be "super-d-ooper" [darn spell check refuses to allow me to make system "learn" my creative spelling!]]
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LOL! I know it's not funny--the messes can be Un-believable!
But seriously, the sensation of wet nasty diapering materials, and/or wet night-wear, is terrible--there's still remaining thought processes that understand that, even in severe dementias, to try to do something about it.
Using super-cooper absorbency diapering products, along with the one-sies jammies that zip up the back, should solve it.
Getting her up once or twice per night, can also help reduce the amount of drenching.
OTHER options can help bedtime relaxation, with NO hangover, and, allows getting the person up to potty during the night, without them being a rag doll--these things help a person achieve relaxation and emotional balance:
===Mild herbals, such as chamomile [parts used = flowers; capsules or tea--but if night-time causes too much wetting, go for the capsules instead!] There are stronger herbs, but I tend to try the weaker ones first.
===Inositol: a nutrient that often causes those using about 1000mg before bedtime, to feel sleepy--no hangover in the morning.
===Rhodiola Rosea: comes in many forms. This herbal has been used many hundreds of years+ with great safety. It helps balance brain chemistry, to allow more stable moods, calm. It smells and tastes sort of like roses [to me..]?
One source says it's part of the geranium family--but it's more like a succulent plant; the parts used are the roots. We've used the liquid extract squirted under the tongue, or put into a bite of food or a swallow of juice, to good effect; we've repeated every few to several hours, just fine.
===GABA [gammaAminoBenzoicacid] can be supplemented as a single item, any time there is agitation/anxiety. It comes as capsules; the powder inside can be put directly in the mouth to absorb under the tongue, or, swallow the caps. It tastes slightly sour--so please rinse mouth afterwards.
It is a neurotransmitter that, if missing, leaves the "gate" to the lower brain open---which allows fears and anxieties to flood out overwhelmingly.
Taking GABA helps put back the "gate-keeper", to allow normal emotional levels.

More complex:
OFTEN, elders have lost the proper balances of "Anti-diuretic hormone" [ADH] [The drug for that is Desmopressin = synthesized analog of antidiuretic hormone] which our bodies make at night, which puts kidneys to sleep, so we don't have to pee at night while sleeping.
Signals to make this come from the brain--so there's multiple options for why production can get decreased.
This can happen in children too, if they have had sickness with high fevers. Something is damaged, which dumbs-down the ability to manufacture this hormone at night, and the result is soggy diapers & beds, or even daytime enuresis. AND, having too little of it causes increased confusion, sluggishness and irritability!
livestrong/article/176447-antidiuretic-hormone-imbalance-symptoms/
It , plus correcting salt balance, can also help with orthostatic hypotension for some.
There's an ADH [desmopressin] nasal spray [there may be other forms by now].
We've used some for Gma, and for our kid--both of them had had serious high fevers, and both had terrible trouble getting thru the night without having to get up several times to potty---which mean NOone in the house got any decent sleep. Using that nasal spray really helped drastically minimize the night-time potty trips.
Our kid refused nasal spray, but, when I spritzed a couple spritzes into a 1-ounce dropper bottle of distilled water, and gave a dropper-full of that into the mouth at bedtime, it did fine [kid was about 5 to 8 y.o. then]. SOME kids might need this if they develop significant enuresis after getting some of their vaccinations--that is what happened to our kid--got very sick, fevered, then severe enuresis, among other things.....so elders who've been through the mill with fevers during their lifetime, perhaps, or injuries, or many other possible causes--plus age, can easily need some of this to help them.
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My Mom was so forgetful that after trying to get off her unstrippable pajamas and couldnt, she forgot what she was doing and got back in bed, they do work. I knew someone who duck taped her moms diaper completely around it so she couldnt get it off worked for her, at least she didnt pee on the floor.
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Won't sleeping meds make the dementia worse??? I've been afraid to even ask the doctor about some for Mom. Occasionally she sleeps through the night but calls me 3 to 4 times more often than not. Sometimes she's wet and wants her diaper changed but she sometimes just calls me to ask a question or make sure I can hear her...I gave her a whistle and sleep with a baby monitor next to my head...I always hear her.
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I would wake her at 3 am and take her to the bathroom. Much easier to prevent than clean up mess.
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Try skipping top sheets, and using a fleece blanket or two. They wash and dry fast. If my night gown was wet, I'd take it off too. Try a shirt with long sleeves, and the diapers. Also, they make incontinence pads in various sizes, that way you are only changing and wash the pad, not the whole bed. (The bed should have a waterproof pad and maybe flannel fitted bottom sheet to hold the incontinence pad in place. My Dad has an oil filled heater (DeLongi) and keeps his room very warm. He tipped the heater over once, and it turned it's self off just like it was to do. He has a down comforter over the fleece, which can also be washed (I would suggest a couple down blankets for easier washing and drying), they don't usually get wet. Also, I have not tried this, but maybe no diaper, just let her go on a disposal bed pad. Check her at night to make sure she is dry. Good luck.
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The zip-in-back PJs will probably stop her from taking off her clothes, but that may not be the end of the problem. Once she realizes she can't remove the PJs, then she might/probably will complain about that. If she's like my mother was (with other things), she'll drive you nuts complaining until you do something about it...like get the zip-in-back PJs off of her. So, I agree with others who previously said, you've got to find out 'why' she wants her clothes off, and respond to that, if you can. FYI...it's a possibility you won't be able to 'fix it'...she may not know why she wants her clothes off...and/or she's doing things like this because it is one of the few things she can do in which she still has some control. (she does it, because she can.)

Taking clothes off is not an uncommon behavior with dimentia/alzheimer patients. While my mother (early dimentia) didn't do this, it was not unusual to see naked senior citizens in wheelchairs in the nursing home/rehab unit where she was. Nurses said it was a constant battle to keep them clothed. Nurses would re-dress the nude patients, but the seniors would soon be naked again.
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So sad to see our loved ones regress like this. I have gotten my mom to use Depends. She is still continent, but often waits too long to go to bathroom.
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My mom takes hers off too. However the times she is taking her bottoms off and having an accident, she tells me she was afraid she was not going to make it to the bathroom and didn't want to get her clothes wet. She forgets that she has on the pull ups to protect everything from getting wet and therefore gets everything wet and the floor too. She isn't doing this as often at the moment. I just try to be available when she is going to the bathroom. (but I am extremely tired due to being up most of the night)
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Try her on 1/2 or even 1/4 of an Ativan and see how that works.
Removing clothes is very common in end stage dementia and little you can do about it. For those that can still be toileted why not keep a commode at the bedside for night time use.
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My Dr gave me ativan for anxiety (haha) and I only take 1/2 a pill. How much is she on??
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Ativan is sometimes way too sedating for older folks, as you've found out. But, there are lots of other things to try, so you're on the right track in asking her doctor. I'd be careful of Ambien too as some people sleep walk on that. Depending on how well her doctor knows her, he might agree to call in a prescription rather than moving her appointment up, and then on her appt, you can discuss with him how the new med is (or isn't) working.
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She may be feeling too warm in bed in pajamas, I know I do. My kids will have a handful with me because I must sleep without anything on, not even undies. Can you accomodate her that way, maybe just cover her with a sheet instead of sheet/blanket/comforter, etc.? Lighter pjs may be the way to go, too, if you can get her on the sleeping pills or some other sedatives.
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As others have said there may be mental issues for this behavior......as for my MIL she likes to sleep completely naked so when she gets up at night to go to the bathroom there is nothing for her to do but sit on the pot. Yes, you can laugh, I know I do as she is a very lazy person. Too much work to pull up a nightgown and then pull down the panties; and then reverse the process.
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Duct tape is helpful... The backwards facing pjs are good. Also, do you us a bed pad? That is a good resource!! The padded bed pad like they use in nursing homes. Then if you wanted, you could just put a gown on and no diaper, pull the gown up so it isn't wet. She probably needs to be checked once or twice a night and changed accordingly.
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Sometimes this problem can not be adequately solved to the caregiver's satisfaction. My MIL would take her clothes off at the kitchen table and stroke my husband's thigh in front of me. I would leave the table. This was after trying nearly everything imaginable to prevent her from removing clothing. Eventually, I just left it in his hands. All of the ideas above are excellent and I wish I had known of some of the resources while she was with us. Good luck everyone. You have my deepest respect and sympathy.
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Regarding taking off clothes at night.... could she still be having hot flashes? That will make you kick off the covers and try to find some relief. For some of us it seems like flashes never go away, it's been 15 years for me. A portable fan that lets a nice breeze across the bed is a godsend.

Sometimes medicines can cause hot flashes. Even my Dad got them with one prescription, and he said it was driving him crazy.... welcome to my world, Dad.
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My mother had the soaked bed problem. When she was finally admitted to the ER, the hospital found congestive heart failure. That was the cause for her wetting and then, water retention, too. Her socks were always too tight. With meds and full time care, she is more comfortable, now.
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You may have thought of this--and of course it doesn't get to the heart of the matter, but may help with ease of cleanup: I remember reading a tip about putting a fitted sheet beneath the waterproof mattress cover (in addition to another one over the cover) so that when you are doing clean-up, the "new bed" is already half-made. Hope that makes sense--and is helpful, even if just a little bit.
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Not sure if this will help, but we found that even using two Depends did not keep Mom's bed dry at night, so we switched to Abena Abri-form diapers. They are super soft and absorbent and Mom loves them! You can order them on Amazon. They absorb all of the nighttime urine and she still feels dry and doesn't get chilled from being wet. This has resulted in her sleeping longer and not waking me up in the middle of the night because she's cold / wet. Not sure about how to stop your Mom from taking her clothes off. Guess it depends on why she's doing it. My dear MIL did that in the last month of her life. It can be a typical end-of-life behavior, like they can't stand to have anything that feels constrictive. But if she only does it at night, it probably isn't that.
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Mom's Depends would get so soaked that she would get her pj's wet and wiggle out of them...I switched to an adult diaper that I order from a medical supply place for night time. They hold a lot more and it keeps her bed from getting wet. She just started not being able to get up on her own to go to the bathroom...odd thing is when she could she was wetter in the morning then than now because she was so slow that she had finished before she got on the pot and would just get back in bed...now she calls me when she feels wet. Has never been as wet as when she was supposedly going on her own. I felt guilty thinking it was easier after she lost the ability to get to the bathroom on her own, but it really is. I was having to wash her bedding daily, and I don't now. Her bed stays dry and I don't have to change her clothing as often. I still have her in the pull ups during the day and change her every few hours, which seems to be working better. Not sure why she does not seem to be able to tell me she's wet during the day but can tell at night???? We also ripped the carpet out of her room and cleaned all the paint spills on the concrete and put a couple of coats of wax on it ... so much easier to keep clean...a lot of elbow grease but almost no money and didn't want to put down a floor that will just be covered back up with carpet eventually. Mom is 91 and it is also much easier to roll her wheelchair on a hard surface floor than on the carpet. Put an office matt floor protector next to her bed and a yoga mat under and in front of her recliner...can both be disinfected and very low profile so her chair rolls easily over them. At this stage, I'm all about what ever is easier...
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I wish I would have known about the pajama's when mom was with me. (She passed in July). I tooo would find her naked, close to naked and either wet or worse. I got a waterproof mattress cover, would tuck in her socks, place extra bed chucks under her. There is one that has a sticky underside in the baby dept. if that is a problem and tucked her bed sheets in on all sides. I would place a pillow near her feet under the sheets so she would not feel as constrained around her feet. I also had her on a medium/high sleep aid. it did get a bit easier when she no longer was walking on her own...although even then she would surprise us and walk when she wanted to. Sadly, this disease is cruel and finding creative ways is the only choice. I too would clean up lots of messes I would have preferred to not even acknowledge but I would take that over this void I have now. Good luck!
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Short of securing her to the bed, others have suggestions about pajamas, but discuss the behaviors with her neurologist, because there might be a simply explanation why she keeps removing her clothes. Are they too tight, is she too hot, does the pattern remind her of something dangerous, etc. If she is up at night, this is "sundowners" and a little sleep aid of melatonin or something the doctor prescribes might help. Hopefully her room does not have carpeting, and if it does remove it and put in another flooring to help with cleanups. She could also be allergic to the carpeting. I have not had this problem yet, just Depends for men shields and husband is still toileting on his own. Good luck!
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Hope the PJ's work for you.They wouldn't in my case,as my Mom does this constantly with her sheets and blankets because she says she feels tied up or restrained.I have her in a short, light, button up long sleeve night shirt. It doesn't get tanglrd up and it's easy on and off the bedpan. It's still a constant battle with keeping her covered, which is from her anxity,confusion,figiting,etc.( I give her a little shot of Loranzapan to help with this)When she first started doing this(couple weeks ago) it was extremly frustrating, espeically during the night. Now I look at it, as she doesn't have much else to do.So we start from scratch and get her all situated probably about 10-15x a day.
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when mom was in a SNF (after several falls also), the CNAs would periodically check her thruout the nite to see if they needed to change her. this way, she was never too soaked. thankfully, she's continent now (more or less). could it be that she takes her clothes off because she feels she's too hot? mom started doing that in the SNF, so we got her portable fans and checked her periodocally, pulling off extra blankets when she got hot. (the SNF let us stay with her 24/7 when they realized mom was a fall risk; bed alerts don't do much good when staff aren't nearby.)
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here they are...

Tranquility TopLiner Booster Contour Pads, Super-Plus, Extra-Large Diaper Inserts Case/48 (4 bags of 12)


by Tranquility
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farrellgd, unstrippable pajamas are also on buck and buck web site, and clothing. I went throught this with my Mom years ago too. she got up, pulled down her pants and peed all over the floor, omg it was so horrible. The poor thing, as I was washing her floor she said " what are you doing dear?" I said "oh just washing the floor" and she told me I didnt have to do that, etc. I buy the attends with tabs and put in a xl booster pad for overnight, on amazon!
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Thanks, great advice! I ordered 2 pairs of pj's on amazon! I think it will work. She has a prescription for Ativan, but it really sedated her too much the next day. She can walk a little with assistance, but after taking the Ativan she becomes like dead weight. I have an appt with her new doctor on 1/16, but I may call him sooner.
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Talk to the MD about a sleep medication. get her the jumpsuit pajamas called "onsies" and zip them up the back.
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