How should we deal with Mom (85) unaware that she has incontinence issues?

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My mother-in-law is 85, has no sensation of needing to go, or of being wet. Will wear depends, but does not have sensation of wet, urge to go. Refuses to believe that she has wet herself, saying that she must have sat in something wet. She will wear adult diapers, but forgets to change them and leaks. The doctor has said that there is nothing he can give her if she doesn't even have the sensation. She is very stubborn and becomes very agitated if her smell or wetness is pointed out to her. She even hangs up dirty clothes to wear again.

She has no short term memory or focus, but is otherwise healthy.

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Put her on a changing schedule. She cannot live alone and needs aides or a move to Assisted Living.
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This just part of the decline. You can't train her like a puppy by rubbing her nose in it and saying bad girl. Face it. It is only going to get worse. It took a while for me to realize all this by myself as I didn't ask anyone familiar (like this group)
She needs to change on a schedule. I have a battle with my mom every morning about putting on fresh depends. She insists that they are not dirty. she will even try to hide the new ones and lie to me saying she changed them. You need to have her change regularly as she could get infections, etc. Other hygiene is an issue I'll bet to if you are not living with her or she has no assistance. I'll bet she wears the same blouse for days, won't brush her teethe, or take a shower. If she does all these things then they are next. Either move her in with you or put her in AL. She's like a three year old. The difference is that the three year old grows up.
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My hubby, who has dementia, became incontinent quite a while ago, although sometimes he does tell me he has to go. If he is wet or otherwise, I simply wash him down and change him, chatting with him the whole time. He keeps apologizing, and I keep telling him not to worry, that other people have accidents, too. The incontinence is the least of the problems that go along with dementia, so far as I'm concerned. I didn't make a big deal of it when my three children were little, and I don't make a big deal out of it now. It's par for the course. Look at it that way.
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She may not be capable of remembering that she needs them, or how to put them on. Think pam is right, she needs assistance.
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Have to say DITTO to what the others have, and she is not alone.. many fights go on in a rest home as the staff try to change their residents, but that regular changing seems to help them.. and ignoring the fact that the pants are wet, but by saying Hey its time to go and change.. and when she resists, just respond. well its time, doesn't matter what state they are in, lets get it done its four hours.. and that indepth scientific mention of FOUR HOURs that they have no idea what that means. will often bring cooperation.[don't promise tho]
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They have leakage because she doesn't change enough. My brother in law had the same problem. He did have a memory though and when I told him how often to change he listened. She does not have a memory so she needs to have assistance. Everyone is right. It is so hard dealing with Alzheimer's and dementia. Especially in this area. My husband also has it. He has no idea about bowel! He can't shell and apparently doesn't care if he sits in it! It makes me crazy. When I smell it I strip him down and put him in the shower. What a mess. This is the worst part of being a caregiver for me. I can't stand the smells, the mess, or the clean-up! And yet I have to do it. He is just unaware of it all!
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My mom has the same issue with leakage. Some days are worse than other days. She moved on from Depends to Tena and says that Tena works better. I just wish these expensive products were covered under healthcare!
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Thanks for all the feedback. I think putting her on a schedule might work, but she is in denial, so it will take a lot of consistency on our part. She does live with us, but my husband is so reluctant to hurt her feelings and push the issue. She becomes so defensive and angry, insisting that she doesn't have a problem.
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In Arizona, I was just informed that Medicaid for my Dad, will pay for Depends BUT there must be an order from the MD that says the incontinence is the result of his disease. I am not sure if they are also going to cover the clean up clothes and barrier cream that his facility uses or not, since this is a new policy. If Mom won't or doesn't want to wash her hands, then use wipes. Keep a jar every where, and periodically, just pull one out and wipe her hands and under her fingernails while chatting to her about something else. Tell her you want to give her a 'hand massage' or something, and follow up with lotion. Accomplishes the important sense of touch that the elderly need too.... Dad's facility does it this way before all meals even....wipes or warm washcloths, followed by a quick application of lotion and hand massage ending with a hug before sitting the patient down at the table.
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joannes, thank you for the hand wipes & hand massage info. My mother picks her nose at night, so she constantly has bloody/snotty fingernails. Pointing out she needs to wash her hands doesn't help cause she can't see it, and gets irritated with me. I keep her nails short, but needed an assist for the hygeine. Thanks!
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