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

I have the same issue with my mom. There are days when she will fight me or her health care provider about changing but its not getting any better. Normally she will sense the urge to "go" and get up to visit the bathroom. But often she will soil her diaper on her way to the toilet because she cant hold it. Some night she just wont get up to go to the bathroom like she does during the daytime and so she wets her bed due to a leaky diaper. Again, not every night but I can see it getting worse. I stopped giving her liquids after 7pm but that doesn't seem to help and if she asks for water I will give it to her despite the time.

I have yet to try a potty schedule. I would like a schedule but I'm not sure how often I should get her to go to avoid accidents. She used to have diarrhea accidents all the time until the doctor cut her diabetic medicine to half the original dosage. Once doctor put her on a low dose anxiety pill, not only did it stop her panic attacks, it also caused her glucose reading to drop! Little did we know that her anxiety was spiking her sugar levels. Now that she's so much calmer, most other things are better with my mom!

Finally, my mom doesn't get diapers via medicaid or medicare or the supplemental insurance either. I used to buy them at Walmart until I was told I could buy them at the local Flea Market at a greatly reduced price. It's true! So it might be worth your time and effort (and pocket book) to visit your local flea market for adult diapers.

You can avoid your mother wetting her bed due to a leaky diaper by diapering her more than you evidently are. I put male Depends on my husband, and here is how I do it, and in the morning, except for his Depends, everything else around him is perfectly dry. I insert TWO pads inside a pair of Depends and then on top of that I slip on another regular Depends without a pad. He is secure for the night, and there is no way in the world he can leak. Good luck!

I'd put her on a 'toileting' schedule, that way you can assist her in changing if she's wet, she can sit on the commode while you change the depend/pull up. If she has some dementia, you can contact your local chapter of the Alzheimer's association and ask about how to deal with behaviors & toileting. Make sure she is drinking plenty for you don't want her to have a UTI. It's a game of trial and error, you keep trying approaches until you find something that works for her. good luck

I attended a dementia workshop recently and it was discussed that if caregivers have set times to take the patient to the bathroom, there will be less incontinence. Think of how you potty train a child and match the times with how most people routinely 'go'....before or after a meal, first thing in the morning, last thing before bed, before leaving the house, upon coming home from being out...but basically every 2-3 hours while awake. No long discussions...just take them and get them on the toilet. And periodically, as needed wash the area, apply barrier cream and check for redness or breakdown. Physically, it's not that the person cannot stay continent, but it's that the brain doesn't send signals of a full bladder or bowel fast enough for them to get there by themselves. Often the signal comes through just prior to having to 'go'....so no time to make it to the bathroom. And remember, getting an infection, from sitting in wet clothes, WILL almost always cause a huge increase in dementia symptoms, so worth avoiding at all costs as much as possible. And, consider that 'of course' she is going to tell you she doesn't have to 'go', because her brain is NOT telling her she has to 'go' until just as it's ready to happen. So just say, 'it's time' and take her hand and lead her. If she argues, and she's prone to the doctor being the authority, just tell her the doctor told her and you, that she needed to go in and try, every 4 hours or whatever timeframe works.

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.

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!

Yes, I just observed the caregivers at Dad's place doing this, and then asked them 'why'?? Because, you know, we don't always wash our own hands before dinner....but when we were kids, and played outdoors, with pets, etc, our Moms did this....so with dementia, people seem to be in that same frame of mind....and, since their hands 'get everywhere' too....it's a way to clean, sort of without cleaning. I watched the caregivers go right under the fingernails and be chatty and if there is resistance, they just say, well, time for a little hand massage. That, of course, works really well with ladies...sometimes not so well with the men...

Another factor that affected my mother's incontinence challenge was that as she aged it got harder and harder (and slower) to get around. When she realized she needed to 'go' she couldn't get there in time because it was taking her longer to get out of a chair and walking was slower, etc. so she would have 'accidents.' And just as you get through this phase, another one pops up. You have entered the world of constant adjustments. And depending on your home situation, living arrangements, proximity to bathrooms, etc., your adjustments will differ from those of others. That's why all we can do is make general suggestions. As mother aged, walking slower, but still able to get around, I made sure there was a small light on in her room at night and a bedside commode (with sturdy handrails) positioned right next to her bed. (Along with a waste basket, toilet paper & hand wipes) All she had to do was stand, grab a rail, turn and sit. It was also a bit higher than the standard toilet, so it was easier for her to use. The loss of personal freedoms to a previously fiercely independent person is devastating. I tried to keep her as self-functioning as possible for as long as possible, for both our sake's. She liked the commode because it moved the bathroom closer to her. For the dementia, I labelled cupboards, drawers, etc. She liked that, because, once again, it helped to restore some of her loss. It worked for a while - Then we moved onto another phase and adjustments.

Mom has no problem with holding urine but seems she has lost the ability to hold #2. She gets the feeling but tends to wait if she thinks I'm busy or knows I've gone out on an errand. I tell her to just get up and go and then call me. But, there is no set time to catch her.

My husband doesn't have the sensation for number 2. He will be shocked when he goes to the bathroom and has it in his attends. Most of the time he is cognitive enought to be extremely unset about this. At this point he is able to clean himself but he will deny it happened many times. but I can tell. He absolutely refused to go on any kind of schedule for either 1 or 2. If we are leaving the house I won't leave until he consents to go to the bathroom, This has made us late for appointments but it is better than an accident at the doctors office.

I really wish we could all agree on a different word than "diaper". We have so many great minds on this site. Everybody think about it. I know when my mother heard from hospital staff that they were going to change her diaper, sometimes she would get very angry, and other times she would cry because this is where her life has come to. We should have a politically correct word or phrase that would make our loves ones feel like they still have some dignity left. Maybe we should say "It's time to change your pad, or padding" When they ask what is that, just say when you get older you sweat between your legs, and the pad keeps the irritation under control. Maybe I'm just too sensitive, but I think that's what i would like to hear. Just saying.

I agree. The word "diaper" is so demeaning. I had to call this to the attention of the nurses and aides at a rehab my husband was in for three weeks. I had to educate them as to how the person with dementia or some other problem feels when he/she hears this word. Why didn't they know this already? Anyway, I refer to my husband's Depends as "undershorts." Why not? And this pleases him, I can tell. If the patient with dementia is a female, then why not refer to them as "panties?" Why do caregivers feel they have to refer to them by what they really are? What's the point?

Willows, I think they are great words. You brought up a very real point. Why don't staff at hospitals, rehabs and nursing homes have the professional courtesy to make sure the patients can keep their dignity as long as possible, just by having the courtesy to not use the word "diaper". I really hope "undershorts, panties or pad" become the politically correct term that all staff must use!

I say panties, Mom uses th pullups. I worked as a secretary for a visiting nurse assoc. and one of the nurses hated the word diapers.