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Mum unable to go to toilet

Ratters

New member
Sep 4, 2021
4
0
good evening!
I have been reading around the forum and I am just so amazed at the number of people this awful disease affects - my heart goes out to each and everyone of you.
My mum (74) lives with me in Spain and started showing short term memory loss 6 years ago, she has now been diagnosed with frontotemporal dementia. There is zero help and support here in Spain, so I struggle on with my husband and fear very soon we will have to seek returning her to the UK or find a home here (very limited as Spanish family pretty much do everything).
My main current concern is that despite going to the bathroom 10,20 times in the space on an hour - she just can't pee or open her bowels, she can't figure out what to do at all. I have to sit in there with her and direct her - with an awful lot of physical pushing and straining from her which exhausts her - sometimes we strike it lucky and get a good amount, sometimes nothing.
Worried it may be a mechanical issue - I went to her gp with her and he just said it is normal with her dementia.
If I wasn't with her- she would just fill up and goodness only knows what would happen.
She takes trazadone and rivastigmine patches. She eats a god diet and drinks as much as I can get down her (but not as much I would like)
Interested to know if anyone else has experience of this? I thought I would be dealing with incontinence not this!!!!
 

Jaded'n'faded

Registered User
Jan 23, 2019
2,026
0
High Peak
There are many things that most of us do automatically, from going to the toilet to walking downstairs or getting into a car. I'm afraid that as dementia progresses, people simply forget how to do things, or more accurately, the part of the brain that controls such things becomes damaged, so they can no longer do them automatically.

So there are often 2 parts to incontinence. First is that people lose the sensation that tells them when they need to go, and second, they forget what to do when they get there! Your mum is in that difficult in-betweeny stage where she still has enough awareness to know she needs the loo (though that awareness seems a bit faulty if she's going that often!) yet doesn't know how to make it actually happen. And she's probably getting false messages that she needs to go when she doesn't.

It's time for you to start looking at incontinence products and getting her into pull-ups. Then she might relax a bit if she's not panicking about the embarrassment of an accident. It is a difficult time...

Oh - contrary to what you fear, she would not just fill up indefinitely or explode! At least, I have never heard of that happening... :eek:😊 Good reason to get her in pull-ups though!
 

Jessy82

Registered User
Mar 15, 2021
66
0
Ratters, my mum is exactly the same, she wears pull ups and is incontinent, she does not know what to do when she goes the loo, even puts the lid down to sit on it. She does know what I mean when I say to "have a little wee " usually just sit her there and hope for the best with the tap running. Luckily we seem to catch number twos on toilet most of the time. I know it's very frustrating, don't know what to do either.
 

Frank24

Registered User
Feb 13, 2018
155
0
Like Jessie82, when my mum was in this stage we spent a long time sitting on the toilet with the tap running.
 

Violet Jane

Registered User
Aug 23, 2021
260
0
Mmm, I’m not sure that it’s just the dementia. She might be constipated, despite her good diet, and require laxatives. Is there any possibility of an organ prolapse? The doctor sounds a bit dismissive if he just sent you away without directing you to other sources of advice and support.
 

Ratters

New member
Sep 4, 2021
4
0
Thanks for the replies- encouraging to hear others in a similar boat. I did actually give her a laxative yesterday - and my goodness I have never seen so much!!!!!!!!! So this may have added to the issue. Violet- my worry certainly was a prolapse or something- I thought in the very lease he would examine her!!! I spoke to our local town hall today and the social worker is coming out tomorrow to do an assessment for us - how amazingly quick is that?!!! Lets see what happens.
 

Violet Jane

Registered User
Aug 23, 2021
260
0
If you supervise all your mother's fluid intake then perhaps you could record, using a measuring jug, how much she is taking in. This would give you and any health and social care professionals information about her fluid intake versus her urination.

It's interesting that she's not having wetting accidents. Perhaps she is stressed about wetting herself and is clamping her pelvic muscles shut and doesn't know how to release them in order to urinate. She shouldn't be straining to urinate. Straining to have a bowel movement is commonplace, although not desirable.
 

Lemondrizzle

Registered User
Aug 26, 2018
181
0
Please also be careful with the laxatives. I have been told twice by hospital staff that poo can bypass an obstruction and even if there appears to be a successful evacuation after laxatives so close monitoring is needed.
 

Ratters

New member
Sep 4, 2021
4
0
If you supervise all your mother's fluid intake then perhaps you could record, using a measuring jug, how much she is taking in. This would give you and any health and social care professionals information about her fluid intake versus her urination.

It's interesting that she's not having wetting accidents. Perhaps she is stressed about wetting herself and is clamping her pelvic muscles shut and doesn't know how to release them in order to urinate. She shouldn't be straining to urinate. Straining to have a bowel movement is commonplace, although not desirable.
Ah, yes good idea to do a fluid balance . It is incredible that she doesn't leak,it is just so odd. I have tried going through her pelvic floor muscle exercises but she really doesn't understand anymore. It is worth noting she has never used public toilets most of her life and she has been able to go long periods of time with out going to the toilet- but back in those days she drank very little, because I now care for her I give her more fluids than she ever drank before!!!!
 

Ratters

New member
Sep 4, 2021
4
0
Please also be careful with the laxatives. I have been told twice by hospital staff that poo can bypass an obstruction and even if there appears to be a successful evacuation after laxatives so close monitoring is needed.
Yes- good point, I very very rarely turn to laxatives , but we did get a good movement. I wanted the dr to at least have a feel of her tummy and ? a scan to look for obstruction- it is just so frustrating.
 

heatherj

Registered User
May 26, 2021
12
0
My mum can still go to the loo. She does know what to do. But she does often suffer from constipation which distresses her greatly. The fact that she never drinks enough and eats little doesn't help. The carers dispense her medication and will only dispense prescribed medication. I got the GP to prescribe senna. Initially the carers were asking her if she wanted it and she would invariably say no, so I got the GP to change the dispensing instructions on the label and they now give it to her daily. Haven't had a problem since.
 

Ton3

Registered User
Dec 2, 2019
64
0
My MIL has a terrible time evacuating, she is bed bound and her tummy swells like she is 9 months pregnant and ready to drop! GP has not been out physically since Dec 2020 its all been telephone calls with the odd visit from a community nurse who herself requested a GP visit to no avail. They have doled out Laxatives, suppositories and even Enemas that my wife is expected to perform as the carers do not do this as part of their role. With the laxatives my MIL ends up pooing for England and then gets blocked up again. After recent blood tests the GP asked if she had ever had her bowel checked out and was told yes in 2017 and his reply was the camera is not advisable with her dementia being at the stage it is (whatever that stage is?) so we are at a stalemate at the moment where its a case of my wife rolling her mother from side to side and trying to release gas (MIL cannot even pass wind voluntarily now) to relieve the discomfort and using laxatives every now and then when there has been no bowel movement. Passing urine seems to be ok at present maybe not as much as the carers would like but MIL is at least passing urine.
I do feel for you @Ratters and hope you can get some help.....
 

DesperateofDevon

Registered User
Jul 7, 2019
3,242
0
good evening!
I have been reading around the forum and I am just so amazed at the number of people this awful disease affects - my heart goes out to each and everyone of you.
My mum (74) lives with me in Spain and started showing short term memory loss 6 years ago, she has now been diagnosed with frontotemporal dementia. There is zero help and support here in Spain, so I struggle on with my husband and fear very soon we will have to seek returning her to the UK or find a home here (very limited as Spanish family pretty much do everything).
My main current concern is that despite going to the bathroom 10,20 times in the space on an hour - she just can't pee or open her bowels, she can't figure out what to do at all. I have to sit in there with her and direct her - with an awful lot of physical pushing and straining from her which exhausts her - sometimes we strike it lucky and get a good amount, sometimes nothing.
Worried it may be a mechanical issue - I went to her gp with her and he just said it is normal with her dementia.
If I wasn't with her- she would just fill up and goodness only knows what would happen.
She takes trazadone and rivastigmine patches. She eats a god diet and drinks as much as I can get down her (but not as much I would like)
Interested to know if anyone else has experience of this? I thought I would be dealing with incontinence not this!!!!
Yep & lactulose was prescribed for Mum 🤦‍♀️
Sadly the incontinence started afterwards
 

Ramblingrose

Registered User
Feb 2, 2020
72
0
My mother doesn't remember if she has had a bowel movement and has been very constipated. By gum when she did finally go!! Major clear up. The medication from the memory clinic causes constipation which doesn't help. Have asked doctor for laxatives to help. Many people don't have a clue the effects Dementia has on the person mentally and physically.
 

Violet Jane

Registered User
Aug 23, 2021
260
0
Constipation is quite common in elderly people and if people were prone to constipation / had a sluggish bowel when they were younger it tends to get worse. The bowel is a muscle and, like other muscles, if it is not used regularly can become less effective. Obviously, people with dementia are not able to / less able to notice when they are getting constipated / take steps to avoid constipation or deal with it. As well as being unpleasant it can, I understand, cause UTIs, which are always a risk for Delirium, and it can, for reasons that I don’t understand, be bad for controlling hypotension.
 

Melles Belles

Registered User
Jul 4, 2017
822
0
South east
My dad had similar problems either constipation or diarrhoea. He was taking Laxido but erratically. Once my sister took charge of the Laxido and gave him one dose a day in a glass of squash, the problems more or less resolved.
Maybe a different medication will work better
 

Ton3

Registered User
Dec 2, 2019
64
0
The problem is in our case and many others the PWD is on so much medication for many other ailments including painkillers and some of these can actually cause Constipation so its a vicious circle and you are forever battling trying to get enough liquids in and the correct balance of food etc, MIL has been on Laxido for donkeys years and even though my wife now makes sure its more regularly taken she still has to resort to Laxatives. No easy solution for this at all sadly as with many things that come along not just Dementia but old age in general the dementia just makes it 100 times harder as the PWD has no control over going or not going its just another discomfort to them and a worry for their carers...