Double incontinence HELP

Discussion in 'Middle - later stages of dementia' started by Trini, Feb 15, 2016.

  1. Trini

    Trini Registered User

    Dec 7, 2015
    39
    My MIL has recently become doubly incontinent and soiling herself regularly overnight. She seems unaware what is happening and makes no attempt to clear it up even when it is all over sheets bed floor etc. she seems not to understand where it has come from or what it is! She lives on her own with a carer going in for one hour per day in the week so if it happens at the weekend she lives in it! What products/ help is available for this? At end of tether with in laws who say it is just an "accident". This cannot carry on. If she was my mother.......
     
  2. Beate

    Beate Registered User

    May 21, 2014
    11,729
    Female
    London
    Sorry to be blunt but someone with double incontinence in my opinion needs constant supervision. A carer for an hour a day is nowhere near good enough.
    In the first instance though you should take her to the doctor and see whether she might have constipation or overflow. This could be helped with Fybogel or Lactulose. My OH is doubly incontinent but not at night. I also got referred to the Continence Service. He gets pads and medication, I bought Kylie sheets and mattress and pillow protectors, he has skin creams, I wash daily and its a constant struggle to keep him clean - no way could someone with dementia do this on their own, they simply do not understand what's wrong anymore. It requires time and dedication, and more support than she is currently getting, so please try to press for a needs assessment with social services. They need to be made aware that her needs have increased.
     
  3. Izzy

    Izzy Volunteer Moderator

    Aug 31, 2003
    59,757
    Female
    Dundee
    I must say I agree with Beate. She certainly needs to be seen by the continence service. I hope you can get the in laws to understand this.
     
  4. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,953
    Apart from it being very degrading for your MIL to be "dirty", she risks damage to her skin, food poisoning and other horrors.

    She needs constant care (whether from family, a live-in carer or residential care services) to protect her ... which takes time and a lot of hard work to put in place.

    You've a very difficult situation to deal with, you apparently being the only family member at present who realises the true awfulness of the problem. Good luck!
     
  5. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Frustrating!

    Thank you for your responses. Her GP thinks she may have UTI so is testing for that today. If not he will refer her to continence service who should provide products. SIL is trying to up her carer hours. This only seems to happen at night not during the day. Fortunately her son is there this week to deal with the washing every day and get her to have a bath! Easier said than done. I spoke to social services on Monday but they just said speak to GP. They will not do anything as she has more than £23,000 in assets! Personally I think she should be in a care home so she is looked after properly 24/7 but I am only the DIL so what do I know?!
     
  6. CJinUSA

    CJinUSA Registered User

    Jan 20, 2014
    1,125
    eastern USA
    Your MIL might have a UTI if she has had repeated bouts of incontinence. It sounds as if she would benefit from being on a schedule.

    When my mother got so she couldn't toilet herself well any longer, we made sure we got up to assist her at night. One night, she kept forgetting that she had gotten up, and she tried to arise 5 times, requiring my going to help her each time, to make sure she would not fall and would wipe herself.

    As she became more and more feeble, we planned around getting up two times a night with her. My OH did the early morning time (anywhere between midnight and 2 AM) and then I was "on duty" in case she got up between 2 and 6 AM. We spent about 3 years like that. I have kept my job; my OH is retired.

    I can't imagine attempting to leave my mother on her own under the conditions you are describing. Is there a reason why overnight care has not been sought by her family? These are not accidents, as you know. No one likes to soil herself, and if she has dementia such that she doesn't realize what is occurring, then she seems to me to be way past living on her own.

    Sorry - I know this is blunt. She needs assistance for more than a UTI. If she has assets, it would made sense to use them to place her in an appropriate care home, where she will be attended to properly.
     
  7. fizzie

    fizzie Registered User

    Jul 20, 2011
    2,731
    Definitely first two stops are the GP and the admiral nurses - give them a ring you will get an instant response Admiral Nursing Direct on 0800 888 6678 FREE or email direct@dementiauk.org. This requires urgent action because without the medical advice which may be simple solution, then you can't make other decisions

    Simply changing main meal to lunch time and ensuring toileting during afternoon and evening will help the problem in the interim.

    if she hasn't got a urinary tract infection already she will have within days because it will cause one and then the situation will get a whole lot worse!

    or your continence service with the NHS Trust (just google it) but there is a waiting list everywhere so you would have to explain the situation in graphic detail and ask for an urgent referral
     
  8. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Not sure what is meant by being on a schedule? Do you mean a course of antibiotics? Not heard from GP yet about UTI. Don't understand why given it takes 2 secs to dip test a urine sample. Not heard before about Admiral Nurses so will pass that on to SIL and also urgent referral to continence nurse. As you will gather I am piggy I the middle being only DIL. Family obsessed with keeping her in her own home. Obviously she would never agree to going into a care home. It was difficult enough getting her to accept a carer during the day even for an hour because she looks after herself and does not need any help - to quote her! I am at the stage where I know it will take something really bad for the family to wake up and take action - as if this wasn't bad enough! What if she just refuses anyway to go into a home. Presumably we would have to have her declared mentally incapacitated. How do you do that? Social services said they couldn't do it.
    Sorry rambling on now. Sheer frustration.
     
  9. Beate

    Beate Registered User

    May 21, 2014
    11,729
    Female
    London
    I believe the aforementioned schedule simple means a regime of toileting at regular intervals. I usually send OH to the toilet and check his pads every 2 - 3 hours.

    Yes a diptest doesn't take long but it's often inaccurate. Our practice send the urine samples to a lab and it takes 5 days to get a result which is why GPs often prescribe antibiotics without waiting for them. If the urine smells strongly and she is more confused than normal, it usually is a UTI!
     
  10. CJinUSA

    CJinUSA Registered User

    Jan 20, 2014
    1,125
    eastern USA
    Trini, I'm sorry I didn't come back and answer, but I was facing some emergencies (now averted) with my mother's care today. Beate had it right. I mean a planned series of toileting events. When my mother was more active, we toileted her every three to four hours. We had to participate, because she started to forget what she was in the bathroom for. We'd have to go down, help her off with her clothes (which we still do, of course), and then help her clean herself up afterward, help her back on with her clothes, and then back to bed. At this stage, it is very hands on if you want to assure that they are clean and as fresh as possible.

    I don't quite understand the insistence that she stay at home if the family is unwilling to change their lives to make her life better accommodated.

    Fizzie will be able to help guide you through the possible steps that can be taken. It must feel frustrating for you not to be able to help them make the right decisions about their mother. She is so very lucky you are there, even if forced to be in the background, to have her best interests at heart.
     
  11. Trini

    Trini Registered User

    Dec 7, 2015
    39
    Thank you all for your input. MIL does not have a UTI and we are now waiting for the continence service. In the meantime we have increased carer hours. This is just another step in her steady decline which we have witnessed over the last two years. Now in the process of filing in the form to claim attendance allowance and then I believe she can claim an exemption from council tax. Trying to ensure she gets all the benefits she is entitled to as her carer costs go up.
     

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