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First time soiling bed - question about incontinence underwear

Discussion in 'I care for a person with dementia' started by josephinewilson, Feb 12, 2016.

  1. josephinewilson

    josephinewilson Registered User

    May 19, 2015
    112
    Lancashire
    I had a call a couple of mornings ago from my mother's carer (mother is 86 with dementia in sheltered accommodation) She'd soiled the bed, for the first time. The carer dealt with the bedding so I don't actually know how much she soiled it (I presume "soil" doesn't mean just urine?) At first I was horrified as I hate this sort of thing and hoped it wouldn't happen to my mum. BUT.. I just have to get on with it so I have some questions please?
    1) Does soiling the bed at night mean she might do stuff during the day time, or is it just because she was fast asleep? I mean - I don't want to take her to Sainsbury's cafe and be embarrassed by a horrible accident?
    2) I went to Boots to look for incontinence knickers. I saw pads but thought if I buy the knicker things I can take off the wrapping and tell her they're just "throwaway knickers" to save doing washing. I'm not sure how she would react if I made the purpose of them clearer. But there was such a choice I didn't know what to get. Most of them seemed to be for urine - is there nothing for anything bigger ? :) I did find one that suggested it was for soiling but the knickers seemed to be so large and she is only 6 stone 2. I bought her some - they look like the "pull ups" my children had as toddlers. She accepted them fine with my reason that it would save on washing. But I don't know if they'll just fall off her! Should I be looking for something else? Does she need them night and day? Am I overreacting (to save my own embarrasment, sorry)
     
  2. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,681
    North West
    Hi Josephine. One thing that might help is to have your mum referred to her local continence service. I realise that she might not be happy about this but you should get more information and support for her.

    As with everything else, each person is different but, in my experience, there is no reason to assume that night time defecation will quickly be followed by daytime.

    This might be helpful with regard to what's available:

    People with dementia will almost always eventually become incontinent. Many people who look after them may have had no previous experience of dealing with this issue.

    There are many brands out there, some of them household names and some of them relatively obscure. Just because you know the brand name it doesn't necessarily follow that a particular type of product is going to be ideal for the person you are looking after. There's a certain amount of research and trial and error necessary and, over time, needs will change.

    There are 4 main types of pants or pant/pad combinations.

    1) There are washable pants with separate disposable pads.

    2) There are washable pants with built-in washable pads. These are intended for less severe incontinence.

    3) There are 'nappy-type' disposable pads which are adult versions of what most people use for babies these days.

    4) There are disposable 'pull-ups' with a built in pad.

    Whichever type you go for it's a good idea to look at the absorbency which the manufacturers claim for the product. Obviously in normal use you can't be sure that you'll get the 3 litres or more that the manufacturers may claim. All sorts of things like whether the person with the incontinence moves about a lot or how well the product has been fitted will have an affect here. A general rule would be that if you keep getting wet or soiled clothes or bedding it's time to see if you can find something that works better for you.

    Of course the best products are not cheap. In the UK many Local Authorities have a continence service which may provide free pads/pants but, sadly, it's often the case that the meagre number of pads per 24 hours provided is not enough and the pads themselves are pretty useless if you are dealing with moderate to severe incontinence. You should remember also that the costs of washing those products that can be washed may be considerable over time.

    The above does not attempt to cover faecal incontinence but small amounts will usually be contained by many of the product discussed above. The best way to deal with faecal incontinence, by the way, may not be with medication which is often prescribed which can simply lead to a constipation/diarrhoea seesaw. Diet is very important.
     
  3. Amy in the US

    Amy in the US Registered User

    Feb 28, 2015
    4,619
    USA
    It's me with another Alzheimer's Society link for you: https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=136

    I hear lots of people on this site talk about contacting the Incontinence Nurse or service in their area. I think there can be a wait, so I would do this sooner rather than later.

    I'm sorry you are upset by this and it's understandable.

    Each person with dementia is different but I am not sure that one night-time accident necessarily means that your mother will become completely doubly incontinent, tomorrow.

    Having said that, you may want to think about mattress protectors and so forth. I am sure others here can advise and there have been many past threads on the issue.

    Again, very best wishes to you.
     
  4. Aisling

    Aisling Registered User

    Dec 5, 2015
    1,807
    Ireland
    I don't have any advice Josephine except maybe to take to your public health nurse . Your idea of incontinence knickers is a good one. You are not overreacting at all.

    Aisling
     
  5. nae sporran

    nae sporran Volunteer Host

    Oct 29, 2014
    6,096
    Male
    Bristol
    You are not overreacting Josephine. I always that little nagging doubt when we go out, as much because OH would be mortified as my own embarrassment.

    We got some good pads for the night time from the continence nurse service, but sometimes they do the job and not others. Sometimes OH is dry and gets up ok, sometimes she is not.

    Sorry that is not very helpful, but the problem we have had with continence and dementia is that you have to be prepared for anything. Most people recommend Kylie sheets for the bed, but I find a couple of 60cm by 90cm sheets on top and under the sheets to be adequate.

    All the best and I hope you get some success from your GP and the continence nurses.
     
  6. Bod

    Bod Registered User

    Aug 30, 2013
    1,182
  7. LadyA

    LadyA Registered User

    Oct 19, 2009
    13,540
    Ireland
    Josephine, your mum might not be as horrified or embarrassed by the idea as you expect. My own mum (who doesn't have dementia) wears pads. She had five children in quick succession in her youth! It causes "women's problems" - with which many women will be familiar! In fact, women don't even have to have a lot of children to end up with continence problems in later years! Lack of exercise, or various other reasons, can cause problems. With my mum and a lady I work with (I work as a part time Home Help and trained as a Home Care Assistant), I introduced the idea of incontinence pads/pants during the day as an "insurance policy" - I put it that it wasn't so much that they needed them (they actually did need them!), but as neither of them (for different reasons) were fast on their feet, the pads would give them a little bit of reassurance, especially if they were out, that if they couldn't get to the loo quickly enough, it wouldn't matter. Only took a few days for them to realise that this peace of mind was worth wearing the pads. Of course - as I said - there was no dementia involved.

    When my husband (who did have dementia) first started having continence problems, I got him pads. I knew he was mortified by wetting himself, because he would try and hide the evidence. So I just got the pads, and explained to him that it was such a common problem as "we" (although he was 30 years my senior) get older, that you could actually buy these pads in the supermarket!! That was what clinched it with him - if you could just walk into Tesco and buy these things, then everyone must have the problem, so he was fine about it from then on - he would still occasionally hide pads, especially if they were dirty - but he was happy to wear them.
     
  8. josephinewilson

    josephinewilson Registered User

    May 19, 2015
    112
    Lancashire
    Thanks

    Thanks everyone for your helpful comments and for the links which I am going to look at right now :)
     
  9. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,585
    Female
    Auckland...... New Zealand
    My Mum has started to become urine incontinent since Christmas.
    She has taken well to using pads, but I did have to show her how to put them in her underwear... i thought she would have some memory of sanitary pads but she didn't seem to.
    What I have struggled with is getting Mum to use them all the time.
    She will either use them at night, but not during the day or vice versa.
    Mum doesn't like Dad knowing her business :rolleyes:, so it is up to me to remind her when going out especially.
    Sometimes I forget all about it, until Mum needs the toilet and has had an accident :eek:
    Has happened twice when out, so now I have an extra pr of pants & a pad in Mums bag, and my bag.
    I had bought a waterproof protector for Mum & Dads mattress, and saw it on the washing line one day, but then on checking their bed later that night the bed had been remade without the protector back on :( Dad is a bit oblivious to everything also.

    Mum has had 2 urinary infections since Christmas, and I am waiting on an appointment with the Incontinence Nurse.
    Personally I think the only solution here, will be to throw out all her underwear and only have disposable pants. I don't think Mum will take too kindly to this :(
     
  10. Bod

    Bod Registered User

    Aug 30, 2013
    1,182
    Thats what we had to do.
    At least all the new ones look the same, so no "Their not mine!"

    Bod
     
  11. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,585
    Female
    Auckland...... New Zealand
    Out of curiosity ( and sorry to highjack this thread) but what does the NHS in the UK provide and fund as far as incontinence pads/pants.
    I have been told her in NZ it works out to be 2 a day. Laughable really!
     
  12. Beate

    Beate Registered User

    May 21, 2014
    11,745
    Female
    London
    It depends on the LA. We get 2 pull ups a day. We could get 4 nappy style ones a day but they are not for us. The pull up strength we get is Normal. Totally laughable. I buy in Super and Maxi for him to supplement. They cost about £1 a pad. Incontinence is a costly business.
     
  13. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,681
    North West
    Each area probably differs in the UK but we were only ever offered 3 x pads (1 of them was a 'night-time' pad) per 24 hours and had to buy our own fixation pants. They did work for a while but eventually found that there were far more effective products and bought our own. As Beate says, a costly business.
     
  14. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,585
    Female
    Auckland...... New Zealand
    Oh wow you have both given me a thought. Mum can claim a disability allowance on top of her pension for medical related costs. I sure hope this can be counted as one?
     
  15. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,681
    North West
    Logically it should do but there's often precious little logic in the way these things work.:(
     

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