Coping with commode and later stage issues

[Selinacroft]

One of the issues I am having with Dad at the moment (who is nearly end stage kidney failure hence needing frequent wees) is managing transfers to commode. Dad is not quite completely off his legs all the time but at great risk of falling . He independantly tries to get to commode with varying degrees of success. I can't get him to wear incontinents pads and I can't get him to use a urine bottle. The dementia is making him irrational and unaware of the dangers and his own limitations. I can't arrange for double up carers to assist him because as he tells me, he can't turn the tap on to order.
I am left trying to manage him at random times throughout the day. How do you cope with this on your own at home? suggestions welcome.

Is this one of the final stages of dementia or the final stage?- hallucinations, constant calling, mostly off his legs, lack of coordination, awake by night asleep all afternoon, constant fiddling with trousers, pants etc, slurring words and talking nonsense (yes no UTI or infection) -oh and not eating much at all (yes have things from dietician but refuses them)

 

[Jessbow]

Would he perhaps stand with a zimmer and pee, standing being a bloke thing, rather than sitting to pee?

Even suggest leaving the room/averting your eyes or something.

 

[Peirre]

I can relate to the

constant fiddling with trousers, pants etc, slurring words and talking nonsense

My dad is forever checking his trousers. I can also add frustration, anger, shouting, forgetting why he headed to the loo. But ATM he's calmer if I let him feel he's in control, and I'm not overbearing

 

[Selinacroft]

I never stand and watch and always allow privacy, averting eyes etc. Dad hasn't stood to pee for ages and can't get him to stand and use bottle or commode (he does have a frame but struggling with it at the moment )
I had an interesting variation of finding a saucer in the commode earlier on .
I'm not overbearing with him and always try to be calm, at the moment he needs instructions and support every step of the process.

 

[Selinacroft]

sorry duplicated post so deleted

 

[nita]

I'm afraid when my mother got to this stage in 2013, the OT advised that she be hoisted. It was a hard decision to make as it was such a downward step but I realised in retrospect that it was the only way for her to be safely looked after. She was in danger of falling, even with bringing the commode right up underneath her and holding her under the arm on one side. I was told I shouldn't be getting her up by almost lifting her under the arms. I think it would have been impossible if I hadn't.

It may have worked with two carers but she could hardly stand by herself. She also couldn't even take a step, just shuffle a tiny bit. Maybe her mobility was even worse than your father's though as she would be sitting in her armchair, we would pull that out of the way behind her and, as I said, move the commode to under her. She could stand holding the frame but it was difficult to lower her onto the commode.

 

[Selinacroft]

Hi Nita
Thanks- I think Dad is not quite at that stage yet. The next question would be how do you stop him trying to get up in between hoisting him. This afternoon when he is at his best he got up independantly with zimmer and shuffled out of theroom up the hall and back again. I had to follow him back to his chair within reach of holding a chair behind him should he not quite make it. Pleased to see him up briefly but brings its own worries.

 

[nita]

Hi again, I'm glad your father isn't yet at that stage and it's good he's able to get about a bit.. Before my mother couldn't manage to stand, I too was worried about her getting out of bed and falling, so I bought an under-mattress bed sensor (not sure now what the correct name is) which would set off an alarm if my mother sat on the edge of the bed and put her feet on the ground. I didn't find it worked very well though. There are also mats which will set off an alarm once stepped on. This may be an alternative for you but you would have to come running if it went off!

Otherwise, I would have suggested incontinence pads or pants but you say they aren't acceptable to him. Would he accept the pull-ups which others have advised they used? Not sure how different they are from normal underpants.

 

[nita]

I would also add it's hard to say if this is the final stage. My mother was quite different. She was bed-bound for three and a half years at the end - so it lasted a long time. She was incontinent and hallucinated but, unlike earlier years, she slept right through the night. She slept most of the day too. She ate fairly well but had to be fed; she had hallucinations at times, but she could still talk coherently at others. I could even have a conversation with her about something to do with cookery, for instance. So, I think it is hard to judge. Not all PWD become bed-bound and the end can be not so protracted.

My poor mother had aspiration pneumonia at the end; she went into hospital a week before she died. She came out with swallowing problems and only lived one more day but one saving grace was that she died at home.

 

[Selinacroft]

Hi Nita,
That must have been hard coping with your mum being bed bound for so long but as you say everyone's experience is different.
Dad has already tried the pull up pants for incontinents but doesn't get on with them. He doesn't sleep in bed but always in his chair-like I said- nothing is straightforward