Bed Wetting at Night Balanced Against Fluid Intake

Discussion in 'I care for a person with dementia' started by Ethelred88, Nov 21, 2018.

  1. Ethelred88

    Ethelred88 New member

    Nov 15, 2018
    9
    My wife and I care for my 90-year-old Mum who lives with us. She has worsening vascular dementia and Alzheimer’s. Main problem at the moment is bed wetting at night balanced against fluid intake. She is on a low dose antibiotic to combat regular UTI’s and we have to keep her fluid intake up. At the moment she has around 1.6 litres/day as drink plus another 350ml as fluid added to food by way of gravy, sauce, milk (porridge / breakfast) etc. We used to calculate the 1.6 litres by including measurable fluid added to food so the increase is really only the 350ml. We profile her intake so that she takes about two thirds of her fluid before 1200 hrs when she has a nap, and the rest up to around 1800 hrs. We take her to the toilet sometime around 2100 hrs and she then goes through the night until 0730 when we get her up. Up until the last couple of months the Tena incontinence pads have coped overnight but recently (maybe because we have upped her fluid intake?) they don’t. We have tried a middle of the night visit to the toilet but she really struggles having been in a deep sleep, doesn’t really know what’s happening and fails to go. So it just becomes a change of her pad which is sometimes dry, sometimes moderately filled.

    We don’t really know what to try next given that we have to keep her fluids up, the middle of the night toilet visit / pad change isn't working but she then fills her pad when asleep and wets the bed.

    Just wondered if anyone here might have any suggestions.

    Thanks.
     
  2. karaokePete

    karaokePete Registered User

    Jul 23, 2017
    5,022
    N Ireland
    Hello @Ethelred88, welcome to the forum.

    I know some members use Kylie sheets on beds etc to keep things dry. Otherwise I wonder if your surgery may have a continence service that may be able to advise.

    In the hope that it may help, here's a link to the relevant Society Factsheet about this issue. Click the PDF line for an easy read
    Continence and using the toilet (502)
    PDF printable version
     
  3. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,839
    England
    #3 Katrine, Nov 21, 2018
    Last edited: Nov 21, 2018
    Increased night-time urine production is probably as a result of daytime fluid retention in the tissues. When she lies down her heart is able to pump more efficiently and the excess fluid is eliminated. Not much you can do about the production process, and I think you are quite right to keep up the fluid intake. It's more a question of managing the output.

    My mum's carers also used to lift her for a toilet visit about 11pm but, as you have found, eventually she got too sleepy and wobbly with her walking. We experimented with incontinence products of varying sizes and absorbency. In the end the carers used the pull-ups prescribed by the NHS incontinence service during the day but at night they used the most absorbent product I could buy, Tena Flex Maxi (4800ml) which is put on like an adult disposable nappy. We also bought washable bed protector pads, waterproof pillows plus waterproof duvet protectors (very heavy those are, but needs must).

    If you get into the washable bed protector game, we found that it was best to do a rinse and spin cycle before doing a full machine wash. The pads are good at absorbing urine but then don't want to let it go again!
     
  4. Ethelred88

    Ethelred88 New member

    Nov 15, 2018
    9
    Many thanks for your replies. We are using Kylie sheets and they do help a bit but the volume they have to deal with is way more than they are designed for I think. I'll have a read of the PDF.

    We have just ordered some Tena Comfort Maxi (2900ml) but they haven't arrived yet. My wife thought they were to highest absorbency, will have to look for the ones you mention.

    Thanks again.
     
  5. witts1973

    witts1973 Registered User

    Jun 20, 2018
    718
    Male
    Leamington Spa
    Hi have you contacted the continence service with regards to getting any pads,my mum has abri san pads for night the one she uses is called ABRIS FORM premium,her bed has a good quality inco sheet 60X90 cm made by Robinson healthcare the cheapest I could find them was on Ebay under the name READI disposable bed pads 100 for £24 delivered
     
  6. witts1973

    witts1973 Registered User

    Jun 20, 2018
    718
    Male
    Leamington Spa
    They are a wrap around pant with sticky fixing straps,well more of a nappy I suppose,your doing very well with the fluid uptake,I have just started making my mother Angel Delight 1 portion is made with 300ml of work and mum managed that in 1 sitting,I used to like it as a child,I was pleasantly surprised when I tried it again the other day as it's not over sweet
     
  7. Ethelred88

    Ethelred88 New member

    Nov 15, 2018
    9
    Thanks again for the advice. We have contacted the Incontinence Service and get Tena pads for night time and day time use. Trouble is the night time ones arent quite up to it at the moment so we are buying our own and as said above are starting to experiment with higher retention pads. I was hoping we might have been doing something wrong with the fluids but unfortunately(!!) not. Interesting that the night time urine production is related to her laying down.Hadnt appreciated that and it explains alot.
    All the best.
     

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