Incontinent but not a UTI

[Dayperson]

Mums bed wetting has come back since she returned from hospital and we did a test and it came back negative. The doctor said it is the dementia and won't do anything but is there anything we can do (pills etc). Mum takes blood pressure pills and one water pill in the evening.

Dad want to take her back to the drs, is that a good idea when she wont do anything?

Is it likely the bed wetting is a reaction to coming home after a hospital visit and should it pass soon? She is at home with us not in a care home.

 

[Bunpoots]

Hello Dayperson

My dad takes water pills and we have to time when he takes them very carefully.
If he takes them just before we go out he's nipping to the loo every 15 mins and not always making it in time, he's very slow moving now! If he takes them before bedtime he's up and down all night.

So now he either takes them first thing in the morning or just after lunch, depending on our plans and we usually (not always) manage our outings without mishap.

Maybe your mum taking the water pill earlier would help with the bed wetting. Dad's pills seem to hit his bladder about 1 hr after taking them and the effects last for a couple of hours then calm down.

Hope this helps.

 

[Philbo]

My wife is incontinent, which I manage to some extent, by frequently prompting her to pop to the loo "in case you need to go". She very rarely initiates things herself and even then, tends to just stand there wondering what to do next.

It can be a frustrating task, as she doesn't always "go" when I do take her in and sit her down. Even when I manage to get her to go successfully before going to bed, her pull-ups are always full up by the morning (she no longer to get up in the night, unless I wake up and notice she's "fidgety"). The pull-ups prevent most (but not all) of the leaks and I use a bed pad on her side of the bed at night, which has helped reduce the need to change the bedding so often.

She used to take 3 BP tablets, one of which was also a diuretic, so as her BP was very well controlled, her GP agreed that she could stop taking it. This has improved things a bit, but it really varies depending on how much fluid she has dad each day.

 

[canary]

Unfortunately, incontinence is a symptom of dementia. Infections, stays in hospital etc all tend to hasten the progress of dementia so although its possible that your mum may settle down and the continence resolve, I think it far more likely that your mum has merely entered the next stage of her dementia.

I would buy her some pull-ups and a kylie sheet for her bed which will absorb most of it (Im told that pet training sheets work as well and are cheaper, but I dont speak from experience) while you get hold of the local continence team. In my area you can self refer, but I dont know if this is true everywhere. They should be able to advise you and may supply some incontinence products.

 

[Dayperson]

Thanks for the replies. We've already had the continence appointment and a district nurse to supply pads but these have not arrived yet and we have spent hundreds on pants and pads. We also have kylie sheets but they are not much good as the urine goes either side of the sheets so some days everything has to be washed including pillow. The only good thing is we have a hospital bed with a wipeable mattress.

Mum usually takes her water pill at 6pm and is in bed by 9pm. I am not sure if this is the cause? Also we will try to give her one other pill much earlier as we think it is making her more anxious therefore she wont go to the toilet. I do keep prompting mum to go to the toilet, the incontinence seems to be just a night time thing.

 

[cragmaid]

I googled diuretics generally and found this to be the general comment about when to take the pills....

Many doctors will recommend that you take your* *diuretic in the morning as it is likely to cause you to produce more urine than normal. This may help you avoid having to get up in the night to go to the toilet.

I take Bendroflumethiazide every day in the morning. My late Mum used to take her Frusamide in the morning.... I would ask your Pharmacist or GP if Mum taking the water pill in the morning would help to control the night incontinence.

Sadly Night Incontinence is very common with Dementia.

Would it be possible for Dad to take Mum to the loo through the night? Is there space in their room for twin beds rather than their double? I would ask to speak to the Incontinence Nurse sooner rather than waiting for a sometime/never appointment.

 

[LadyA]

Thanks for the replies. We've already had the continence appointment and a district nurse to supply pads but these have not arrived yet and we have spent hundreds on pants and pads. We also have kylie sheets but they are not much good as the urine goes either side of the sheets so some days everything has to be washed including pillow. The only good thing is we have a hospital bed with a wipeable mattress.

Mum usually takes her water pill at 6pm and is in bed by 9pm. I am not sure if this is the cause? Also we will try to give her one other pill much earlier as we think it is making her more anxious therefore she wont go to the toilet. I do keep prompting mum to go to the toilet, the incontinence seems to be just a night time thing.

The kylie sheets should be absorbing most of it. Good ones can absorb up to three litres! However, when washing them, make sure you are not using fabric conditioner or detergent with built in conditioner, as this will prevent them absorbing liquid! If you have done, give them a couple of hot washes with nothing in, to get rid of the residue, and they should absorb liquid much better.

 

[Loopiloo]

My husband was on a diuretic for mild raised blood pressure for years before dementia and GP instruction was to take it in the morning. When his blood pressure worsened he was prescribed other medication along with the diureic and took all his meds before his breakfast. With the exception of one tablet taken both morning and night. Then of course, with dementia and its progression, I had to attend to that for him. Plus the increasing bladder problems.

I would think taking a diuretic at bedtime not advisable.....

Some years after dementia my husband fell, fractured his hip, had surgery and in hospital his dementia worsened as did incontinence. Also his Type 2 diabetes. He was in 2 acute hospitals over 6 weeks - not good experiences with dementia. At home he had intermittent times of incontinence, but was fully aware of when he needed to go, just did not get there in time.

He was still aware in hospital and very anxious when he needed to go but then was incontinent because he forgot where the toilet was. Toileting by nurses was poor. He had pads put on and left to it, and began to lose awareness.

When later in the Community hospital over 4 months he improved, regained the ability to go to the toilet when he needed. Toileting was good, patients regularly prompted/taken to the toilet. But he had periods when he had to be got up once, even twice, during the night to be changed and washed (which he hated).

To cut a long story short, he was in hospitals six months as not allowed home. Everything gradually improved including incontinence after he went into the care/nursing home. The nurses on the dementia wing were great, and most of the carers they supervised. He regained the ability to go to the toilet when he needed, using a zimmer frame.

But as his dementia progressed his awareness lessened, incontinence worsened and was permanent. He was very wet overnight from neck to toes despite regular checks and was producing excessive urine overnight. So yes, dementa related and eventually double incontinence.

However with women ageing can weaken the bladder even when there is no dementia. Weakened pelvic muscles due to ageing, childbirth etc. Bouts of incontinence, a need to wear pads. Also men with enlarged prostrates. But they don't have the added dementia problem of not knowing when to go, or what to do....

The puppy sheets for the bed get a good name from carers who give home care, and they say they are as good as the more expensive ones. As cheaper, they can put two on the bed or overlap them to cover a wider area.

Just passing on what I have heard. Everyone with dementia can be different though, it can be trail and error can't it... Difficult at home as it becomes a 24/7 problem requiring constant supervision, plus the changing and washing of bedding and clothes. Not easy...

Good luck trying to find ways to deal with this difficult problem.
Loo x

 

[Dayperson]

The kylie sheets should be absorbing most of it. Good ones can absorb up to three litres! However, when washing them, make sure you are not using fabric conditioner or detergent with built in conditioner, as this will prevent them absorbing liquid! If you have done, give them a couple of hot washes with nothing in, to get rid of the residue, and they should absorb liquid much better.

I gave them a 60 deg wash with nothing in them then some non bio powder. I did wash them initially in wash with fabric conditioner but maybe some of the residue got on it?

Took mum to the doctors and we now take the evening pill in the morning as well. Fingers crossed that this works.

 

[nita]

Do you have an airflow mattress with a pump? I don't know if this is correct but I was told not to put Kylie sheets on my mother's hospital bed with an airflow mattress as it would affect the working of the mattress. I bought quite large disposable bed pads from various places, including Amazon. They usually soaked up the water but sometimes it was worse, even, as you say, going up to the pillow which must have been horrible for her. I bought pillowcase covers to try and prevent the pillows getting wet. These were terry towelling and plastic-backed. I still had to often soak wet sheets in Dettol cleanser.

 

[malengwa]

My mum's incontinence has got quickly much worse since she had a UTI but after two courses of antibiotics it hasn't improved. It just annoys me that the incontinence clinic see her as mild and won't give her anything on prescription so as you say it costs a small fortune.
I wish you luck, it's the one aspect of Alzheimers that dad really struggles with.

 

[Dayperson]

Do you have an airflow mattress with a pump? I don't know if this is correct but I was told not to put Kylie sheets on my mother's hospital bed with an airflow mattress as it would affect the working of the mattress. I bought quite large disposable bed pads from various places, including Amazon. They usually soaked up the water but sometimes it was worse, even, as you say, going up to the pillow which must have been horrible for her. I bought pillowcase covers to try and prevent the pillows getting wet. These were terry towelling and plastic-backed. I still had to often soak wet sheets in Dettol cleanser.

Yes, but I was not told not to use them. I have washed them in just water as suggested. Maybe because I use conditioner for other washes, some got into them even though I washed them in non bio powder.

 

[Dayperson]

My mum's incontinence has got quickly much worse since she had a UTI but after two courses of antibiotics it hasn't improved. It just annoys me that the incontinence clinic see her as mild and won't give her anything on prescription so as you say it costs a small fortune.
I wish you luck, it's the one aspect of Alzheimers that dad really struggles with.

If your continence service is like mine, they wouldn't do much because with the dementia she could not be retrained to go to the toilet and we've waited ages for the pants to come. For me it is the worst thing to deal with. We have doubled the dose of oxybiutinin and that makes the bed less wet.

 

[Dayperson]

UTI has come back but mum is worse than before, she was vomiting and couldn't keep stuff down so we decided to send her to hospital for observations.

What worries me is how quick she became ill, she was fine on Sunday and by Monday she was extremely dizzy

 

[malengwa]

I could have written this. Mum went from walking chatting etc to being unable to stand and dehydrated in three days. It's really knocked her literally off her feet. Fuilds and IV antibiotics and she is bouncing right back. Mums was the third in 3 weeks and turns out it was urosepsis which is quite serious. You are right to have got her to hospital.

 

[Dayperson]

I could have written this. Mum went from walking chatting etc to being unable to stand and dehydrated in three days. It's really knocked her literally off her feet. Fuilds and IV antibiotics and she is bouncing right back. Mums was the third in 3 weeks and turns out it was urosepsis which is quite serious. You are right to have got her to hospital.

It sounds more common than I thought to have multiple infections, I guess mum never got rid of the first one. The hospital confirmed a kidney infection yesterday which explains the vomiting. My fear is they will keep her in a week or so, run the tests and say she is fine, then it returns again quickly and she has to be readmitted.

I know many cases where the infection didn't clear first time, my aunt who is 70 and has diabetes and a hole in her brain has taken a year to clear up pnumonia and my ear infection came back when I took a flight (I felt my ears burn after getting off the plane).

I do feel a bit of a fraud sending mum to hospital with an infection (this time more valid as she needed iv and monitoring) because most people can deal with it at home, but I guess the fact she has dementia and alzheimers makes it hard for us to cope and more of a reason to be under medical supervision?

 

[gardengirl]

Mums bed wetting has come back since she returned from hospital and we did a test and it came back negative. The doctor said it is the dementia and won't do anything but is there anything we can do (pills etc). Mum takes blood pressure pills and one water pill in the evening.

Dad want to take her back to the drs, is that a good idea when she wont do anything?

Is it likely the bed wetting is a reaction to coming home after a hospital visit and should it pass soon? She is at home with us not in a care home.

Hello, one or two options - ask GP for appointment with incontinence nurse/bowel and bladder nurse just to check there is nothing untoward! Also if this turns out to be part of the dementia, the nurse will be able to ensure any incontinence pads are supplied free instead of you paying for them. Check out incontinence sheets which cover the mattress and you put your sheet over the top, saves problems with damp mattress. Also Age Uk sell a Maxi absorb cover, which is like a large pillow cover, which goes on top of the bed sheet or any chair, easy to wash and saves sitting on damp patches! Easy for you and your mum! Hope this helps, it worked when I needed them! Above all don’t panic, it’s just one of those things!

 

[Dayperson]

Done all of those gardengirl, I think it must be part of the dementia but at least we get the pads.