Incontinence

[barraf]

Hello
This is my first post as I have just discovered the site. My wife who is in the middle stages of Alzheimer's is becoming increasingly incontinent. The problem is not too bad if I remember to prompt her to visit the toilet, however if I forget she invariably wets herself. The other problem is that she absolutely refuses to wear pads or incontinence pants, when I have managed to get her to put some on, she takes them off again at the first opportunity. I have discussed this with the CPN and at the support group for carers run by our local branch of the Society, but haven't yet found a satisfactory solution. Has anyone else come across the same problem, and what if anything is the answer. Thank you
Barraf

[Charlie]

Hi Barraf,

this factsheet may help. Hopefully someone can also chime in with some other practical advice...

http://www.alzheimers.org.uk/Caring_...continence.htm


Kind Regards
Charlie

[barraf]

Hello Charlie
Thank you for your contribution.#
Barraf

[Nada]

Dear Barraf

You might like to have a look at this previous discussion on incontinence - it might help.

Best wishes
Nada

http://www.alzheimers.org.uk/talking...t=incontinence

[kareng]

Hi,

My mum too was in the 'mid' stages of dementia when she became incontinent of urine if she wasn't taken to the toilet regularly. As has been mentioned in the previous discussion, I think this is often because she no longer heeds the physical warnings that tell her she needs to go to the loo and just doesn't reach it in time. It may also be a problem of confusion about where the loo is. However, my mum doesn't appear to mind wearing pads, which is a blessing. I wonder if it is quite common for people with dementia to lose inhibitions regarding continence - such as not being overly concerned with certain aspects of hygiene? My mum certainly forgot that she should flush the loo and wash her hands a long time ago.

In the home where my mum is cared for, they take her to the toilet before and after every meal. Perhaps you could set a routine to remind you to prompt?

It's quite distressing to deal with though isn't it? I think for me it was the first 'physical' sign of deterioration in my mum, which was upsetting.

All the best,

karen

[Brucie]

They certainly seem to lose their sensitivity towards incontinence once it starts to happen.

How do we know, because the ability to communicate goes as well! It is one of the horrible things about the illness that one doesn't know if they are in a private hell, or are blissfully unaware! I am still quite upset because Jan DOESN'T seem to notice.

Best thing to do is to treat it as the most normal thing in the world - which, if you think about it, it is. Strange thing about dementia - it makes you cut away all the trappings that 'civilisation' has given us and we get back to basics.

[Charlie]

I have to agree Brucie, being in the middle of bring up a child and dealing with someone with Alzheimer's, this kind of reaction/situation is nobody's fault. It is really important to make sure that someone doesn't feel 'bad' about what's happening. All you can do is minimise the effects. Incontinence was a big surprise for all of us, but most of all my dad who just seems so confused about the whole situation. I read my daughter a bed time story and remind her to go to the loo before bed, then I ring my mum to make sure she had done the same for my dad.

[barraf]

Hello
Thank you to all who replied to my post, the mere fact that I can talk to others who know from experience what is happening is a big help. I have read the fact sheet, in fact (ha-ha) I already had one. I have now been in contact with the continence advisor department at the local Health Trust, and I am waiting for them to contact me and arrange a meeting. Meanwhile I am relying on prompting, although I sometime get abuse and aggravation when I do prompt, it mostly works.
Thanks once again
Barraf

[Charlie]

Hi Barraf,

I wondered if you had any feedback from the 'continence advisor department at the local Health Trust'. We have been waiting for over two months for someone to visit only to be told that we didn't go through the right procedure and now have to get a referal from her GP rather than the consultant Grrrrrrrrrrr. We obviuously need to contact the Incompetence Incontinence Department next time ;-}

Anyway, the situation is, that it is just getting more and more difficult for my dad to control himself mainly at night times. I'd be interested in any advice you were given by the continence advisor who came to see you.

Many thanks
Charlie.....

[Kriss]

Dad was fine until admitted to hospital with a heart problem - up till then apart from repeating the same tales several times at each meal sitting he had shown very few symptoms of the dementia. However overnight he became totally incontinent and we were shocked to find him often wearing slippers soaked in urine. The staff seemed unaware of how much attention he needed and their best solution was to move him into a side ward near to the desk so he could be spotted when he attempted to "go home". He was kept in for about 5 weeks by which time the incontinence was total. This was probably the biggest of the problems that Mum had to face when he first came home but with endless patience and persistance - steering him to the bathroom every few hours or even more often, constantly asking if he wanted to go etc - for the next 14 months he was dry except for occasional accidents at night. We even managed to cope with short but regular shopping trips. Sadly when admitted to the local specialist ward - the sundowning had escalated to aggression - to give Mum a little respite, once again the incontinence returned. Happily the staff on the EMI team were wonderful. We realise they couldn't provide the same one to one care to maintain the toilet routine but he was always well dressed and clean and he held a special place in their affections. His physical condition deteriorated rapidly - to this day I think he gave up - and he passed on several weeks later.

My Aunt has been totally different in that it seemed to start with her just not getting there in time. When admitted to hospital it escalated to trying to urinate in a washbasin even though it was next to the toilet. Now she has settled into a residential home she is having accidents but knows when she has to go and does her best to get there. Good days - bad days (sound familier?)

As it seems with most symptoms we can only persist and repeat our efforts to reduce or maybe improve the problem. Don't give up on the incontinence there may be a small chance for you to reduce the problem until pads become acceptable.

[barraf]

Hello,
Thanks to everyone who has replied to my posting.
To Charlie, we have not yet met the Continence advisor although we now have an appointment for mext Friday the 28th May. Two months must be the norm for Continence advisors.
I also had to stick out for a home appointment to which anyone is entitled, they always try to get you to visit them. I persisted because Margaret is far better in familiar surroundings and we may get better results from a meeting at home than if we were somewhere strange.
I am still struggling with promting and the success rate is about 50/50. This last few days she is on anti-biotics for an infected cut on her leg. This seems to have made her very lethargic and even less able to tell when she needs to visit the toilet so we have had a few accidents in the night.
I will post another reply once we have met the advisor.
Regards
barraf

[barraf]

Hello
As promised, a further posting after the visit from the Continence Advisor.
I was dissapointed with the advisor as I felt she was just doing a job without much interest. She was 20mins late for the appointment and promised to ring back the same afternoon with some further information, which she didn't do.
She did however suggest some washable absorbent knickers, which might get over Margarets objections to wearing pads. But as this was one of the things she was going ring back about I am at the moment not a lot wiser.
She also suggested a washable waterproof bed pad but wasn't sure whether they were available for double beds, something else she was supposed to be ringing back about. (I am at present using diposable sheets but they are only available in single bed size and tend to move when used in a double bed.)
Both these she said were available free for the first ones, after that had to be purchased.
Will keep you posted on any further developements.
barraf

[Kriss]

Now you mention it I can recall Mum getting washable pants for Dad - I seem to recall they had a pocket insert which either contained a washable pad or a disposable one. I shall try to find out.

Oh dear another "memory problem" these things are obviously still swimming around my brain but need hooking out!

Kriss