Mom does not have dementia. She has neuropathy but is mobile with rollator and attends to her own personal hygiene. She claims she uses the toilet during the day and gets up several times per night to urinate. She has consulted with a PC and urologist. Recently, she used Wick-type device when in hospital, but couldn’t use it due to sensitivity.
She has med anxiety, so meds not an option. At age 84, we’re trying to keep her dry with these products. We have tried many brands, but currently use Ultimate absorbency. I manage the money and ordering supplies. I’ve noticed the huge number of products and am trying to determine if she’s being candid about it. I’ve calculated by the number I order that she’s going through 8-10 per day, plus 3 disposable underwear. This is urinary only. Also, there is a huge amount of bathroom tissue and paper towels that are being used. I suspect she’s using those items too!
It’s so bizarre. I have looked into a permanent catheter, but know they have issues. Thanks for any input.
Most people urinate every 3 hours - more or less. So start with that number in mind. She should change products when they get "used". So 8 pads per day is reasonable. If she is also using 3 incontinence undergarments - diapers - as well she may be having more urine than usual or bowel incontinence. Please have her doctor check her for a urinary tract infection and issues with diarrhea if her hygiene product usage goes up.
Since she is going through a lot of paper products, consider options to help her stay clean and cut down on paper usage. A bidet attachment to the toilet can rinse her perineum and then she can pat dry. Flushable moist wipes may help her feel fresher too.
Also, many people with dementia get cognitively "fixated" on a subject. Your mom may be fixating on using the bathroom. If she lives with you, try a toileting schedule: offering her to use the toilet every 2-3 hours while she is awake. If she doesn't need to "go," then divert her attention to another activity.
My mom has struggled with bladder issues for years. She’s seen 2 urologists, gynecologists, PC, etc. My mom has been resistant to pretty much everything. But, the urologist after a sedated internal exam found no reason for her incontinence. So…..she used to have frequent UTIs, but not now.
She takes one Blood pressure pill after trying many. No water pill. Her BP is finally normal. No other meds, just vitamin D.
I take her to her PC about every 3 months. We always discuss her incontinence issue….She won’t go for pelvic floor training. She refuses to try to get on a bathroom schedule. I know she will sit in her recliner for 5 hours without getting up. She could have gone 5 times in that time period. It’s likely due to her poor mobility. She dreads struggling to walk with neuropathy and her rollator. It’s painful. I understand , but she refuses anything for pain.
She has bedside toilet by the bed and regular toilet 5 feet from her bed. She does get up at night to go. She had sleep study before and no apnea. She has extremely high anxiety, panic attacks, OCD and health anxiety.
My dad has transitioned to pullups too. So with the bathroom tissue, paper towels, pads, pullups, trash bags! Massive amounts. They have weekly trash pickup but I have to take extra trips to carry away all the bags of paper products. Plus cardboard the supplies are delivered in. I order through Amazon or Walmart. It’s really overwhelming to see such huge amounts of paper products being used. I think I will bring up the topic of a catheter at her PC visit next month. Just exploring anything that can help her. She also uses huge amounts of petroleum jelly.
What the urologist found was a high level of bacteria in bladder. So she was but on an antibiotic to clear it up. It really helped. So maybe worth a visit.
WRT Kegels, think about having her see a pelvic floor physical therapist. This can help quite a bit!
There's also a misconception about disposable underwear for bladder leaks. The disposable underwear does not hold very much urine. It is for leaks, but full emptying of the bladder will overwhelm the pull-up type underwear.
Your mother may be going to the toilet when she feels the urge, out of habit, but she is likely not making it in time to empty her bladder in the toilet. 8 to 10 pads a day sounds about right, especially if she is leaking continuously and it probably feels uncomfortable, so she goes to the toilet and changes out the wet pad.
Adult briefs (diapers) will hold more liquid, and may be more appropriate for her, especially over night. But, if she wants to change every time there is a small bit of wetness, she will go through many of those as well.
My husband is in diapers. He is unable to get up, walk, and go to the toilet. A good, ultra absorbency diaper will be soaked 3 to 4 times a day.
She may be more comfortable with a catheter, although the risk of infection is greater.
Make sure she has washable and/or disposable pads on her bed as well. Once urine starts leaking into the mattress, it will stink forever!
Wrt pads in Depends, I have heard of others doing this so they don't have to change the depends as often. it's easier to change a pad than a Depends. Could that be her thought too?
I have wanted to try wick product for her at night, but concerned with her dementia that it would cause confusion and fall risk. Thanks for sharing about sensitivity issues, so I know to watch for that if we ever do try
It is great that you are helping her!
Side note about gluten free— almost any whole food is gluten free: vegetables, beans, fruits, dairy, cheese, meat. The processed foods are generally what contains gluten. No one needs crackers and bread.
But like already said, just be grateful that she's at least using the incontinence products and still able to change them herself.
I can’t fathom using the toilet regularly throughout the day and night AND having that much extra leakage. It’s extremely expensive though and I’m not sure how she’ll continue to afford any more of an increase. My sense is that she ignores going to the toilet due to her mobility struggles and just goes on the pads with pullups. Still, we have no choice but to continue on. The urologist said he sees no reason for her incontinence. I’m wondering if it’s neuropathy. Not optimistic it’s reversible.
Don't put her on a permanent catheter. So what if she's using a lot of toilet paper and paper towels. If she's not blocking up the toilet, it's fine and leave her to it.