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Here is a copy paste of what I had to say in my book "Dementia Care Companion" about this problem. I hope it helps.
Incontinence Overnight Incontinence is especially stressful at night, as it disturbs the patient’s and the caregiver’s sleep. You can make the experience less stressful by planning ahead to make the process of changing sheets, clothes, and underpads streamlined and easier.
Plan Ahead With the right precautions in place, nighttime incontinence episodes are usually handled quickly, often by simply changing the patient’s pajamas and underpads. · Cover the patient’s mattress with a waterproof mattress cover. · For added protection, put a large underpad under the bed sheet, and another one over the bed sheet. · When putting the patient to bed, roll up the back of their pajama top above their hips so if the underpad gets wet, their pajama top remains dry. · Keep all the necessary supplies in the patient’s bedroom for easy access. You’ll need spare pajamas, underpads, sheets, a wastebasket, latex gloves, baby wipes, and paper towels. · In case of fecal incontinence, wear two latex gloves on each hand. After the initial wiping, discard the outer gloves to prevent contaminating clean items. With the outer gloves discarded, you still have a pair of clean gloves on to complete the cleaning process.
Use Appropriate Sleepwear My dad is incontinent. During the day, my mom takes him to the bathroom at regular intervals. At night, he wears diapers and pajamas to bed, but we find him naked and totally wet in the morning.
Nighttime can be especially confusing for the patient. They may wake up feeling the need to go to the bathroom and may even manage to undress in time, only to forget what to do next. Or, they may think that they are already in the bathroom and relieve themselves in bed. · Early on, convenient sleepwear such as loose-fitting T-shirt and pull-up pants can help simplify bathroom visits at night. Over time, additional measures such as incontinence pads and shorts, or adult diapers will become necessary. · Eventually, simple pajamas or pull-up pants may become impractical because the patient may keep removing them. If so, have the patient wear a one-piece sleepwear, or union suit, so they cannot undress easily at night.
Watch for Signs of Discomfort My father wears a one-piece jump-suit to bed, but somehow still manages to pull out his diaper in the middle of the night.
Wearing a diaper for long hours can get uncomfortable. The patient may feel hot in the diaper, or may have skin rash or other irritation. Other potential causes of discomfort include constipation, urinary tract infection, or enlarged prostate. Approach behavioral issues by trying to discover and eliminate the root causes of the problem. · Does the diaper get hot at night? · Does the patient’s skin show signs of irritation, rash, scratches, or insect bites? · Is the patient constipated? The associated feeling that they need to go to the bathroom can make the patient try to undress. · Does the patient have urinary tract infection? UTI is associated with burning sensation and frequent urination. · Does the patient suffer from an enlarged prostate? An enlarged prostate does not allow the bladder to empty completely, leaving the patient with a persistent feeling that they need to go to the bathroom. Behavioral issues are often clues to underlying discomfort. Approach them as opportunities to identify and resolve the pain that the patient may be suffering in silence. Stay vigilant to notice them at first sign, and spring into action to relieve the patient’s discomfort quickly and effectively.
They make a cotton panty with a pocket for a disposable heavy duty bladder pad will fit.Sometimes they just don't like the feel of the diaper against the skin.
Habibah: Obtain anti strip clothing. Of concern is that she "falls asleep on the loo," aka toilet. This could be deemed a fall risk if she rises up off the toilet and then tries to be mobile in sleep mode.
This is (generally/possibly) caused by anxiety / bordom, or a combination.
IMPORTANT: Be sure there is no itching which w/c/ould prompt this behavior.
* Ask MD about medication adjustment. * Visit more often / enlist volunteers / others to visit. * Encourage games, activities - whatever your mom can do.
* Some depends on where she is and how often a person / staff person checks in on her. You likely cannot 'stop' this behavior all the time.
* Yes / no: try some washable underwear although she will likely keep (finding ways to) picking at it.
* Perhaps do not use disposal at all. Use fabric and wash, just insert a pad and do so in way she can't get to it ... if possible.
* Give her something else to pull apart (I don't know what ... just thinking of a disrtraction which might give her the same satisfaction.
You can tape the diaper. I have tried that, and it is a little cumbersome for me. I use washable bed pads with a disposable pad on top. Or, in my case, since my husband can not get up out of bed on his own, I like to use two pads. When the top one is soiled, I can just roll it up and dispose of it, and there is still a clean dry pad under him. Sometimes, I leave the diaper off, as I know he will remove it anyway, and let him pee on the disposable pad.
My mom used to do that especially when her routine was disrupted or a new caregiver. Instead of diaper, put reusable bed pad, and disposable bed pad on top of it. Hope this will help
Tape them. I know if sounds bad, but it works. I would tape it around at the highest point, and go around three times and leave a little folded notch in the back so i could quickly release it later. Also, i used to put my mom in zippered adult(onessies) PJ's, but with the zipper to the back..she could never reach the zipper! The anti strip clothing for dementia is too expensive and cheaply made, you can get adult zippered PJ's at Walmart or Amazon.
Hi, we have tried putting normal underwear over it but she still does it. Onesies won't work as she manages to undress. Giving her less to drink in the second half of the day is another thing we tried.
My sister and i share the care of mum. With my sister doing the lion share and me stepping in when she needs a break. I try and bring mum over for 3-4 months at a time, I live in another country and have to fly over to bring mum to me (1hr flight, visa restrictions). The reason I am mentioning this is, mum does much better in regards to incontinence when with me. As soon as she goes back to my sister, she goes back to wetting/soiling the bed. Mum by herself gets up to go the loo at night but either does nothing (sleeps on the loo), does her business without wiping herself nor flushing OR just does her business in bed. you can never assume with her.
I tried taking her to the loo 3-4 times at night, which helped me to keep the bed clean, but my sister can't keep up with interrupted sleep longterm. And mum seems to sense that she "can" get away with this when with my sister.
I feel helpless when my sister tells me what mum has done.
Maybe try putting regular underwear over them . If that doesn’t work , they do have clothing , big onesies for adults with Alzheimer’s . I saw some onesie pjs on Amazon . Just type in “ onesies for adults with Alzheimer’s “.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Incontinence Overnight
Incontinence is especially stressful at night, as it disturbs the patient’s and the caregiver’s sleep. You can make the experience less stressful by planning ahead to make the process of changing sheets, clothes, and underpads streamlined and easier.
Plan Ahead
With the right precautions in place, nighttime incontinence episodes are usually handled quickly, often by simply changing the patient’s pajamas and underpads.
· Cover the patient’s mattress with a waterproof mattress cover.
· For added protection, put a large underpad under the bed sheet, and another one over the bed sheet.
· When putting the patient to bed, roll up the back of their pajama top above their hips so if the underpad gets wet, their pajama top remains dry.
· Keep all the necessary supplies in the patient’s bedroom for easy access. You’ll need spare pajamas, underpads, sheets, a wastebasket, latex gloves, baby wipes, and paper towels.
· In case of fecal incontinence, wear two latex gloves on each hand. After the initial wiping, discard the outer gloves to prevent contaminating clean items. With the outer gloves discarded, you still have a pair of clean gloves on to complete the cleaning process.
Use Appropriate Sleepwear
My dad is incontinent. During the day, my mom takes him to the bathroom at regular intervals. At night, he wears diapers and pajamas to bed, but we find him naked and totally wet in the morning.
Nighttime can be especially confusing for the patient. They may wake up feeling the need to go to the bathroom and may even manage to undress in time, only to forget what to do next. Or, they may think that they are already in the bathroom and relieve themselves in bed.
· Early on, convenient sleepwear such as loose-fitting T-shirt and pull-up pants can help simplify bathroom visits at night. Over time, additional measures such as incontinence pads and shorts, or adult diapers will become necessary.
· Eventually, simple pajamas or pull-up pants may become impractical because the patient may keep removing them. If so, have the patient wear a one-piece sleepwear, or union suit, so they cannot undress easily at night.
Watch for Signs of Discomfort
My father wears a one-piece jump-suit to bed, but somehow still manages to pull out his diaper in the middle of the night.
Wearing a diaper for long hours can get uncomfortable. The patient may feel hot in the diaper, or may have skin rash or other irritation. Other potential causes of discomfort include constipation, urinary tract infection, or enlarged prostate.
Approach behavioral issues by trying to discover and eliminate the root causes of the problem.
· Does the diaper get hot at night?
· Does the patient’s skin show signs of irritation, rash, scratches, or insect bites?
· Is the patient constipated? The associated feeling that they need to go to the bathroom can make the patient try to undress.
· Does the patient have urinary tract infection? UTI is associated with burning sensation and frequent urination.
· Does the patient suffer from an enlarged prostate? An enlarged prostate does not allow the bladder to empty completely, leaving the patient with a persistent feeling that they need to go to the bathroom.
Behavioral issues are often clues to underlying discomfort. Approach them as opportunities to identify and resolve the pain that the patient may be suffering in silence. Stay vigilant to notice them at first sign, and spring into action to relieve the patient’s discomfort quickly and effectively.
IMPORTANT: Be sure there is no itching which w/c/ould prompt this behavior.
* Ask MD about medication adjustment.
* Visit more often / enlist volunteers / others to visit.
* Encourage games, activities - whatever your mom can do.
* Some depends on where she is and how often a person / staff person checks in on her. You likely cannot 'stop' this behavior all the time.
* Yes / no: try some washable underwear although she will likely keep (finding ways to) picking at it.
* Perhaps do not use disposal at all. Use fabric and wash, just insert a pad and do so in way she can't get to it ... if possible.
* Give her something else to pull apart (I don't know what ... just thinking of a disrtraction which might give her the same satisfaction.
Gena / Touch Matters
I use washable bed pads with a disposable pad on top. Or, in my case, since my husband can not get up out of bed on his own, I like to use two pads. When the top one is soiled, I can just roll it up and dispose of it, and there is still a clean dry pad under him.
Sometimes, I leave the diaper off, as I know he will remove it anyway, and let him pee on the disposable pad.
Good Luck
My sister and i share the care of mum. With my sister doing the lion share and me stepping in when she needs a break. I try and bring mum over for 3-4 months at a time, I live in another country and have to fly over to bring mum to me (1hr flight, visa restrictions).
The reason I am mentioning this is, mum does much better in regards to incontinence when with me. As soon as she goes back to my sister, she goes back to wetting/soiling the bed. Mum by herself gets up to go the loo at night but either does nothing (sleeps on the loo), does her business without wiping herself nor flushing OR just does her business in bed. you can never assume with her.
I tried taking her to the loo 3-4 times at night, which helped me to keep the bed clean, but my sister can't keep up with interrupted sleep longterm.
And mum seems to sense that she "can" get away with this when with my sister.
I feel helpless when my sister tells me what mum has done.
To remove the duct tape safely, get a pair or rounded-point bandage scissors and cut it.
Or you can put a pair of mitts on her so she can't tear at the diaper.
https://www.silverts.com/shop-by-need/dementia-clothing
If that doesn’t work , they do have clothing , big onesies for adults with Alzheimer’s . I saw some onesie pjs on Amazon . Just type in “ onesies for adults with Alzheimer’s “.