Help with Female Urge Incontinence?

[Amber 5]

I know there is another thread about male incontinence, but it has prompted me to ask about my worries about my mum. I have been aware that she has had some 'leakage problems' since Christmas when she stayed with us, after which time I took her to the GP. As expected, mum denied having any problems, but somehow I managed to get a urine sample to give him, after which he prescribed her Tolterodine.

Having recently moved nearer to me and therefore I am able to see her a lot more frequently, I realise that she is struggling to hold urine in once she has decided that she needs the toilet.

I was wondering if anyone has any advice/tips on the best way to go about dealing with this. I'm guessing I should take her to see her new GP or should I find out if there is an incontinence nurse first. I must admit I find it embarrassing, but I know I need to get her sorted out with a system that will enable her to keep her dignity. (It is a sensitive subject but she does sometimes mention it to me herself, so I hope that she will now accept some help from the Dr or nurse). Up to now I have been making sure there is always a good supply of pads on show in her bathroom, prompt her to use them and prompt her to change and wash!!

I have always tried to make sure she is in clean pants, tights and clothes but admit it is becoming more of a problem. Is it something that usually creeps up like this, or is this just my mum? I need to help her but don't really know what to do next.

Thanks for any help you can give.
Gill x

 

[Angela66]

Hi Gill,

My mum also used to have the problem of struggling to hold urine in once she had decided that she needed the toilet then it got worse and she would just "wee all over the place" without warning

I say "used to have the problem" as now it is the exact opposite! She is now holding on to her wee for as long as possible during the day then round about tea time and during the night, she decides to "let it all out". Not sure if she is aware of it or not or if this is a behavioural issue with mum, her illness seems to change every week now!

My mum is in an assessment ward and has been for the last 4 months and the nurses encourage mum to go to the toilet every hour but she doesnt always go. Not to sure how they will handle this but just hoping its just another phase that will pass with mum.

Not really been much help to you I guess, just wanted to give you my story but I'm sure others will be along soon to give their advice.

Take care,


Angela x

 

[zoet]

Hi Gill, I think the best you can do is get an incontinence referral from the district nurse, to see what aids your mum can have.
You will not get the knicker-type pads on the NHS and they are very expensive so it might be an idea to have a little surf on t'internet and see if you can find some washable knicks that you can slip a small inco pad in. They dont come cheap either, but at least, for this stage, they are used again and again.
You dont mention nightime incontinence, but if that happens try your mum with a kylie sheet which is very good for small amounts of urine, and better than wearing a pad all night. Your mums "bits" need extra gentle hygeine, I find baby wipes with added aloe vera very gentle, and she could do with a good quality barrier cream on after her morning wash.
This might all be too much for your mum to handle alone so you may have to look at getting some help with toileting eventually.
Watch out for your mum reducing her fluids. Thats very common when people are becoming incontinent, as they think that reducing fluid intake stops the accidents, which it does not. You dont want her to get dehydrated and bring on a whole set of new problems.
Many ladies become incontinent for all sorts of reasons, not just the elderly or people with dementia, although certainly with dementia it is often part of the next stage in the progress of disease for many.
Also make sure mum has plenty of clean underwear, as she may start to hide or even throw away wet knicks in an attempt to hide the reality of her situation.
The incontinence advisor may be able to suggest other ways of helping, and there really is NOTHING to feel embarrassed about Gill. When I was at work loads of the ladies suffered from a bit of incontinence in one form or another (the staff I mean)and when they got chatting about it to each other they always had a giggle and shared sense of "being a woman", as its just so very common, especially with ladies that have had children. I understand it may be a sensitive subject to discuss with your mum, but the more you discuss it with her, the less embarrassing it will become. Good luck. Zoe x

 

[Skye]

Hi Gill

An excellent reply from Zoe, and I've nothing really to add.

Just wanted to reinforce the fact that urge incontinence is very common in ladies ho havehad babies. Pelvic floor exercises are usually recommended, but that wouldn't help in someone with dementia.

I'd go for the pull-up pants, they're easier to manage. Also, would your mum wear trousers? Elastic waisted ones would be easier than skirt, tights, pants.

It's not easy when it's your mum, but I think you have to talk about it in a matter of fact way, stressing the fact that it's a common problem, to get over the embarrassment.

Good luck!

 

[julieann15]

Continence nurses

Hi
We contacted the district nurses- a "continence" nurse came to see mum and she wrote mum a prescription for pads and knickers free- number can be obtained through GP. No point paying for things when you can get them for nothing? at preseent we have to collect them but soon to be delivered free in area of Leics where mum lives

Julie xx

 

[Beezed]

Incontinence or poor hygiene?

Don't quite know where I am going with this but here goes. I seem to spend my life washing at the moment. I am convinced that Mum doesn't wipe when she goes to the toilet anymore. I have had to change her bed twice this week because it was streaked in you know what. Also 4 nighties. Her underwear is unspeakable but I am unsure if she is dribbling or not. I don't live with her so am unable to help with toileting. To my shame I am not comfortable with the more intimate aspects of being a carer. Don't know how you guys do it. I do have a fantastic carer going in 3 times a week to shower her etc. Mum does virtually nothing for herself except make a cup of tea. Even then I found 5 teabags in the kettle on a recent visit! I suppose my question is how does incontinence present itself or is it different for everyone? Every day seems to present new challenges for us with this disease I guess. Thank you for taking the time to read my waffle, feels good to get it off my chest. Going to refill the washing machine now.
Regards,
Jeanne

 

[Skye]

Hi Beezed, I've just replied to that on another thread.

http://forum.alzheimers.org.uk/showpost.php?p=229506&postcount=8

It is a common problem at this stage, and how you get round it when you don't live with the person you care for, I don't know.

Sorry!

 

[karenlsinging]

I am convinced that Mum doesn't wipe when she goes to the toilet anymore.

Sadly that seems to be part of the progression of the disease. My mum stopped wiping a while ago now and if you ask her if she needs toilet paper she says yes and then you give it to her and she folds it up neatly (as she does with everything flat) and lays it on top of the toilet roll again! Thankfully I got her an assessment from incontinence nurse and she gets free pull up pants (just like adult Pampers really) on NHS. She is cared for by dad at home and when they are running low he just phones a number and they are delivered again. I look after her one or two evenings a week and have been lucky in that I have only had to deal with wet pants occasionally and never with "dirty" ones. My poor dad has had that lovely job! She gets regular respite care once a month for a week and will go into long term care in the same hospital ward where she has respite towards the end of this year. Oh how I could weep for the fastidious woman that was my mum!

 

[Skye]

Hi Karen

You're lucky you got free pull-ups. Some LAs provide them, others, like ours, will only supply pads and nets.

It's another example of the postcode lottery, but it's always worth asking for them.

 

[Splat88]

I've tried unsuccesfully to broach this subject recently, because even though I try and make sure MIL changes knickers every day, I'm sure that from the state of them for washing, she says she has and doesn't. I am not sure of the state of them is from more than one days wear, or leaking.

My prompt that maybe she has a problem realising when she needs to go ( you can tell from the wet patch on her dress when she walks across the room) met with her saying she was sure she'd know if she was doing that!!!

She too doesn't always wipe, and as she can't get the hang of the push button flush, I have to go in after her and flush the toilet so I know she doesn't always use toilet paper. I also have to clean everything, and have to keep an eye on the towel, as I think she uses this instead. I have two toilet rolls, one which is usually covered in excrement from her fingers, and one in the cupboard for the rest of the family to use!!

I have wipes in the toilet, but she's so independent I can imagine what her response would be if I suggested she use them!!

 

[dalesman]

I've solved the problem of my partner not wiping by installing a "bidet toilet seat" that gives a wash and blow dry to the relevant bits . Not a solution for everybody, but it works for us - for now at least.

 

[Cl13]

My mum is in the CH now so I dont see the same as when she was living with me, wiping was not the problem in our house, mum did plenty of that, she just couldn't seem to remember where you put it once you'd used it, we used to find it all over the place, from the side of the bath to the window sill in the living room, I got so I was following her around to find where she would put it next, no where special just anywhere would do lol,
I laugh now but I've had situations where visitors would use the bathroom and find mums little parcels around, on the way there or on the way back.

Love Lynn

 

[Amber 5]

Thank you to everyone for your replies. It makes me feel a lot better to think my mum's not the only one! I will see if I can find out about a referral to a continence nurse and if there is any chance of prescriptions - that would be great. Not sure if this would be complicated by the fact that she has just changed LAs when she moved - but hopefully she comes under the new area now.

Hazel, I have suggested trousers to mum and she said no, but I might just get her some to try as I'm sure they would be easier than bothering with tights.

The wipes sound like a good idea, as I am still working on getting her to wash those delicate areas regularly! She is in a care home now, but in the assisted living part, so I am still playing quite a big role in her care. I can see I need to discuss this fully with her care manager. I suppose part of my embarrassment and fear is that they will want her to move out of assisted living into the dementia unit, but she is settling in quite nicely and really quite calm at the moment - so I don't want to upset the boat. Or maybe I'm worrying unnecessarily!

I did speak to mum today and checked she had enough clean pants, and was everything ok. I also mentioned that I thought there was a nurse who could help with that sort of thing and we can probably get some pants and pads. So, thanks again all of you - I'm glad I posted and received your helpful thoughts and advice. And good luck to all those in the same boat or worse!
Regards, Gill x

 

[Bookworm]

Not much to add to superb replies - does anyone know if there is a fact sheet on AS - expect so - if not we should all volunteer to write one!

The continence nurse (note name is positive version not in-con....)will probably suggest regular by the clock toilet visits to reduce urge - & did someone mention dip stix check for UTI - can't remember. Your mum probably will need tested to see if she is incompletely emptying her bladder - common in older people & esp years after childbirth - this will lead to urge and also make her prone to UTI. I think they recommend sitting for an extra pee - not getting up too soon.

As for poo in pants & on sheets - I'm winning at present - but there have been deep moments of despair.

Current regime - white pants for self assessment, reminders about wipes, bath night, shower morn, clear towel each time & both pants & pj bottoms in bed & visit to loo if/when windy sounds start.....

 

[KatherineW]

does anyone know if there is a fact sheet on AS - expect so - if not we should all volunteer to write one!

Hi Bookworm

AS produces the following factsheet: Coping with Incontinence

The Bladder and Bowel Foundation may also be a useful source of help and support.

Best wishes,

Katherine

 

[Bookworm]

Fact sheet name change?

Thanks Katherine - I knew someone would know. Might I respectfully suggest that the "incontince" one might be named "Promoting continence and coping with incontinence" - the content would need to be reviewed to check it fits that description.

Without having viewed it/them I would still think that there are ideas here in TP that could enhance the fact sheet - really "fact sheet" may be a misnomer - maybe it is a "fact and suggestions sheet"??

Sorry - digressing a little from the thread.

 

[KatherineW]

The titles and content of our factsheets would be down to our Publications team to decide, but I can pass your suggestions on…

There are lots of ideas on TP that could potentially add to several of our factsheets: the problem would be fitting all the information in!

Katherine

 

[karenlsinging]

Hi Karen

You're lucky you got free pull-ups. Some LAs provide them, others, like ours, will only supply pads and nets.

It's another example of the postcode lottery, but it's always worth asking for them.

We were very lucky with every aspect of care mum has received, by all accounts! When she goes into hospital for respite week, they use the pads and nets. She is way past the stage of being able tell when she needs to change them herself. The good thing about the pull up pants is that although she struggles with you when you try to help take the pants down because "I'm a laydee" (it's like Little Britain honestly!) you can tear them down the side seam and whip them off saying they are wet before she can object. Once you get them off she is quite happy to put on a new pair!

I like the idea of the wash/blow dry bidet and wish I'd known about them before but suspect that wouldn't go down well, knowing her reaction to getting water on her in the shower!

Hope you get on with the continence nurse. Mum had one UTI after another every time she went into respite care for a while and doctor was never sure whether it was UTI or just the degeneration of the disease until the results of each test started to come back clear. I was buying pants from Boots but our dementia co-ordinator told us to contact our GP and explain the problem and GP then arranged for the continence nurse to come and assess mum's needs i.e. how much is she leaking etc. She started off on the medium strength absorbency but is now on the high strength absorbency. I think we have been helped a lot by our GP whose mother also has Alzheimers so he has already been through it all and fully appreciates the situation.

The world at large has no idea what we all have to go through with this dreadful disease.

 

[Amber 5]

Hope you get on with the continence nurse. Mum had one UTI after another every time she went into respite care for a while and doctor was never sure whether it was UTI or just the degeneration of the disease until the results of each test started to come back clear. I was buying pants from Boots but our dementia co-ordinator told us to contact our GP and explain the problem and GP then arranged for the continence nurse to come and assess mum's needs i.e. how much is she leaking etc. She started off on the medium strength absorbency but is now on the high strength absorbency. I think we have been helped a lot by our GP whose mother also has Alzheimers so he has already been through it all and fully appreciates the situation.

The world at large has no idea what we all have to go through with this dreadful disease.

Thank you Karen - its the practical things and what to expect that we need to know. It's similar to dealing with kids, but actually its your parent so - not quite the same!!!
I'll let you all know how we get on.
Gill x

 

[Sam Iam]

Can I add some advice from the Tissue Viability Nurse.

1. Dont use barrier creams they stop the continance products working, as they spread onto the surface of the pad and act like a water proof sheild and fluids run to the side of the pad exiting at the side of the pad.

2. When washing the person in your care at a pad change, use a soft flannel and plain water as this stops a break down of the skin which in turn lets the bacteria enter and causes sore's


Hope this is of help. xxx