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My granny suffers from Alzheimer's/dementia, she does not have the ability to tell when she has to urinate. She urinates on the floor, on me while cleaning her. She sits in her chair, urinates and cannot even tell that she is wet. I am going thru pads and Depends like crazy! Doing 3-4 loads of laundry per day, not to mention scrubbing floors, washing shower curtains, because she pee's on the bathroom floor, it splashes on the curtain. I would tell her every 1 1/2 - 2 hours to use the bathroom, but it doesn't help. Yesterday I asked her every 1/2 hour because the prior day every hour she was peeing on herself. She does not have a UTI and this is beyond an over active bladder. What are your thoughts?

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You are correct that a catheter is not the best, medically. But with her high intake of fluids, combined with her not being able to recognize the urge to go, it is the best solution for her. Last night alone, in 8 hours her output was 1400 CC's! Today alone, I needed to empty her bag 3 times, I am not sure how much it holds as there are no markings on it.
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With such a high fluid intake, you have a better chance of avoiding UTI with the catheter in place. Typically a catheter is not medically the best thing but this is a very good example of an exception to the rule.
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Here is an update! We saw the Urologist today and he did catheterize her. Doc said that it is a cognitive issue & neurological issue, nothing would help. He said it will get worse as the Alzheimer's/dementia progresses. I did ask him if I was being unreasonable with my request and he told me absolutely not. He said this would allow granny more freedom, as she is afraid to go anywhere for fear of wetting herself in public. He told her it would allow her to get a good night sleep instead of laying in cold, wet night clothes, pads and diapers. He told us it would give her some of her dignity back.
Since this was put in place, I have not seen granny this relaxed, anxiety has disappeared and so has her agitation.
To ElderCareGiving: Granny does not find it uncomfortable, she said does not even notice it. When getting ready for bed I would put on a diaper with two Tena pads, another diaper and then rubber pants, but yet she would soak through all of it. As far as the liquids, she needs to drink at least 48 oz per day due to hypo-tension. If she gets less than that her blood pressure plummets. We do cut off all liquids after 6:30 pm, just a small amt for her nightly meds.
The only thing that concerns me is the UTI's, as she is prone to them, as all elderly are.
The house is so calm and stress free tonight, first time in 2 years. Keep in mind she has had issues with incontinence for many, many years and she is only 77 yrs old. In 1959 she was involved in a very serious car accident, suffered TBI, then had a TIA about 15 yrs ago, now throw in the Alzheimer's/dementia. The doc explained to me with all these circumstances involving the brain, it is affecting her ability to recognize when she has to go to the bathroom, to feel that she is wet or to control it. I feel very good about this decision, as I was a little hesitant. I have taken care of numerous clients with Alzheimer's/dementia and have never experienced the incontinence issue like I have with granny.
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This situationssounds quite traumatic. I agree that cateterizing would probably add to your problems. You granny will probably find it uncomfortable and she will be more prone to UTIs.

Why so much urine? Is she drink more than she should? I assume you have tried using two pads at once?

I too would like to hear what other people have done in this situation.
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She already receives 240 diapers per month, is on med for an over active bladder. I just asked her if she needed to use the bathroom, she said no, I went into her room, but she had just urinated on herself, it's been an hour since she last went. She was just checked for a UTI, came back negative.
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I have an appt with the Urologist tomorrow. I will keep everyone posted as to what he has to say. Granny is not becoming too much for me to handle, I have taken care of numerous Alzheimer/dementia patients and have never experienced incontinence such as this.
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I'm so sorry you're having to deal with this. My mother-in-law was incontinent to the point she couldn't tell when she had to go too. So I requested her be catheterized also. We did it for a while, but she was prone to UTI's, so the doctors had to take it out after a while. But I would definitely talk to your mom's doctor about a catheter in your case. It is so frustrating being a caregiver anyway without having to do extra cleaning because of the "accidents". Good luck!!
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Some Medicare advantage programs cover the cost of the diapers. Check coverage with her provider, and get Rx from her MD.
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I, too, am interested to see what the community thinks about this.

I have a feeling that this would be a traumatic situation for your granny and am doubtful that a doctor would go along such a procedure on a regular basis.

I do, of course, have great sympathy for what you are enduring. It's common Alzheimer's behavior, so that's why I'm hoping the community will have some input. It could be that your granny is just becoming too much for you to handle at home. Talk with the doctor about this issue. Please let us know how it goes.
Take care,
Carol
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