He has been wearing a depend for 5 yrs now. He is only incontinent with urinating. I urge him 2 or 3 times a day to get up and try and go in the toilet because he can. He always says he doesn't have to urinate but he always has a wet depend. He says they aren't wet. I'm assuming he can't feel the wetness. Plus I like him to get up off his chair and move about some . If I ask or tell him to go try to use the toilet more than this he refuses and looks at me like im crazy...... any ideas???
I had a caregiver five hours a week. She pointed out that I was telling my mother what to do and that my delivery of the information was getting in the way. When she wanted my mother to do something she would make it a conversation, not a directive. She might say she had heard some people do XYZ (whatever she wanted mom to do) and ask what my mother thought of that. Then the caregiver would say "do you think we should try it and mom would say "yes" usually.
Might you employ a similar approach? For example; "Dad, you know I was talking with a friend who had surgery for prostate cancer. Did you know incontinance is a complication of such surgery? (Let him enter the discussion). Do you know anyone who has had prostrate cancer surgery? (Again, let him contribute to the discussion). He told me about a method that he uses to keep from having accidents. He does not wait for the urge to urinate, but when he sees a bathroom available in a public place or if he is home he just stops in and uses it. He calls it preventative maintenance. Do you think that might be a tactic that you could use to make your life more pleasant?"
Notice that the ultimate focus is on betterment for his sake. You are having a conversation so do not stand over him, sit near him. Sit and watch T.V. for awhile before bringing it up. Talk about something else first. Slide it into the conversation like it came to mind organically. Notice also that you are using words that appeal to men; method, preventative maintenance, tactic. He needs to feel that he had a say in it, and ideally that he is in charge. No one likes orders or directives. As a caregiver it is natural to just want to "cut to the chase". But you have to package your message and make it palatable to him if you want hime to buy-in to what you are saying. Good luck!
My husband could still sense when he had to go ... but without much lead time. So when he got the urge he definitely couldn't wait for commercials.
When they no longer recognize the urge, then scheduled bathroom breaks are probably the best approach.
However, having worked in healthcare for about a million years I know this conversation by heart. The person with incontinence denies needing to use the bathroom and then when we check they're wet. Do they not feel the wetness as you wondered? Who knows.
You can try encouraging your dad more frequently to use the bathroom. Once an hour? Let him sit there for a few minutes in private. If he doesn't go then you'll have a wet brief on your hands again. If he does go try it again in an hour.
You may come across a dry brief from time to time. Celebrate! But this isn't like toilet training. It's incontinence. Elderly people don't pee in their pants to be stubborn or because they want to or because they want to get back at someone. Usually they just can't help it. My dad was incontinent of bowel. Consider yourself lucky!
Pick a time when your dad is comfortable and in a decent mood. Then approach him with this problem you are having, prevention vs cleanup, and you do all the clean up. Tell him it's not easy, that you don't relish cleaning up after him. Be semi-brutally honest. Remind him of the last time you asked him to use the toilet but he didn't want to because he was watching TV. Next thing you know, he's wet and it's a mess. Tell him that grownups get up from watching TV so they can use the bathroom (a little more brutal) and this is what you expect from him. The occasional accident is no big deal but when your dad refuses to participate in his own toileting it's time to call in a professional and how would he like to pay an aide to come into the home to take him to and from the bathroom?
jeannegibbs is right. This does happen to men. But when you remind him it's time for him to go and you're standing there waiting to help him, he needs to go. This is a partnership between you and your dad. He needs to do his part as best he can.
Incontinent of bowel is the worst. Not just from a clean up point of view but from their point of view too. It just strips our loved ones of all the dignity they have left. I have a mental image in my mind of my beloved father having an accident in a parking lot and the pain and humiliation on his face is something I will never forget. He made such an anguished sound, it was horrible for him.
Can your dad wear a condom catheter? or have a urinal set into the diaper?
Some adult diapers have a 'line' on the outside of the diaper that turns a different color when it becomes wet. Would that be helpful? Use an absorbent bed pad (Chux) under him in the chair, just in case.
Try to imagine your dad as a patient, not your dad. Set the timer for every 2 hours and try to have him get up to go. Is there some kind of treat/reward he could have afterwards (food goodie, etc., of course without him knowing about it.) "Dad, I'll make some hot cocoa and it'll be ready when you get out of the bathroom."
Good luck.
As bad as some might think this is, it beats the heck out of having to 'follow the trail' down the hallway to the bathroom. That too gets old in a hurry.
Sometimes we just have to think about what is easier for the patient instead of what is right socially. I even told his son (lives several states away) - if you can't understand his need to go when he has the urge and in the living-room, than just stay home. I don't need the grief. Fortunately, his son is able to accept it.
We don't get an 'owners manual' with our elderly so we just have to take it one day and one thing at a time. Right now, my Ray doesn't need Depends - really, they would just complicate things at this point. Yes, I am very fortunate. Living alone with no company, he also doesn't have to stay dressed - he always wears a shirt and this covers pretty much everything.
I'd like to believe I would have done the same with my father - but he has been gone for 6 years now and I don't know anyone else with a 95 year old patient. Definitely a learning experience - but as tiring as it is, it is also rewarding as he thanks me all the time "for everything."
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