My 91 year old mother, who has early to moderate dementia and lives in AL, is incontinent. She leaks a lot. She goes into the bathroom at least twice a day for 30 minutes because she is washing out her underwear and changing clothes. She absolutely REFUSES to wear a pullup or even a sanitary pad. We've tried explaining she smells and it's unhealthy. Sometimes she denies she leaks but when we call her on that, she just gets quiet. She's always been someone who worries about what others will think and so you'd think she wouldn't want to smell. But that isn't the case. She refuses to acknowledge she has this issue. The AL staff has suggested we take all her underwear away and replace it with pullups. We know she will pull a nutty if we do this so we've resisted. Suggestions? Thanks!
Don't worry if she "pulls a nutty", she will have to deal with it.
The AL has given you sound advice for dealing with this. Please listen to them.
What she does in reaction to the staff request is between her and staff.
Stop resisting and give it a shot. Do NOT give an audience to her anticipated outburst.
By refusing to acknowledge this inappropriate behavior she is drawing negative attention to herself and causing others to be uncomfortable and unduly concerned.
Be sure that you as her caregivers are not assuming some embarrassment for her behavior. If you are complying with staff requests you can’t be expected to do more than you’re doing.
My Mom wears a very absorbent pad, most of the time. But when she was in a PT rehab facility they used pull ups for her and she was fine with it. Modern pull ups can look like panties.
My mom is 91 and also wants to use the toilet.
Good luck.
she’ll have no choice then, you have to do what needs to be done and what is best for her as she cannot decide what is best for herself.
who cares if she goes nuts - let her carry on as you do with a child, eventually they tire themselves out and accept that their tantrums don’t change anything.
Again you have to do what’s best for her as she cannot make those decisions for herself
Remove her normal underwear. To leave it is cruel. It’s confusing. Out of habit she will choose the familiar. Don’t discuss it anymore. Just put the pull ups in her drawer and walk away. This will be over before 2020 gets here.
Gently mentioning here that you are having a problem with this. It will be okay. Mom can’t help it but she will adjust.
I do admire your Mom's desire to use the toilet, like my Mom it's a sign of independence.
Older adults can't control a lot of things in their life, so they try to control what they can.
First I had to remember that it was her who was experiencing this loss of control not me. We were pretty enmeshed so I had to separate us out to keep my sanity and to remain compassionate towards her.
I had no choice but to put plastic on all the places she sat or lay down and wash the covers I put in top once or even twice a day. It was a real chore, but the only way I could keep the place and her from smelling. Tips:
put down plastic sheeting where she goes. Disguise it with something easy to wash and dry.
I gave mum a bath or a good wash every day. Get a really lovely carer if that’s too much for you, or mum won’t let you. Make sure good but light barrier cream especially PH balanced is used a least once a day. It will stop mum getting sores.
Try just panty liners at first.
work your way up. Didn’t work for my mum, she just took them off and threw them down the loo blocking it, but it’s worth a try.
If you can bear it, amd situation permits, go away and leave her in a nursing home for two weeks. They will get her used to wearing them. Just let her know she needs a holiday and get her somewhere nice. Tell them not to try it for a couple of days if they can. She doesn’t need the shock. It’s only short term. Remember it’s to do you both good so that you can continue to look after her. Your not selfish at all. This is clear. Arrange it well in advance. Take her for lunch at the best place you can find and afford, as an introduction. Get her in the garden there, with the best view so she gets familiar with it. Don’t do it alone. Try and treat it as a day out with family or best friends even bring little presents or a simple game, so the focus is on you being together. You don’t want her feeling abandoned. Take your mind favourite snack or cookies. Don’t allow the staff to bring things that are too unfamiliar. Everyone needs a holiday.
Thats how I got my mum to wear pants in the end. We were forced to do that though, and the opportunity came when she broke her ankle throwing bread crumbs out to the birds.
The suggestions here about taking underwear away seem doable. Make sure you get support to stop you feeling guilty. It won’t help either of you.
Your mum is very advanced in years. Something may change that gets her wearing those pants things.
I wouldn’t want to wear the best ones, they are soooo heavy. She’s obviously a delicate girl. Maybe there’s something out there that is more discreet and pretty.
remember your not alone. But you are a wonderful person for doing this. Not every person loves their parent so much.
I hope something helps. This is a great site for tips. I can only tell you my experience (which was gruelling). Don’t feel guilty yourself, don’t apologise for the situation to anyone if you can help it.
Lastly, it’s impossible to teach someone like our mums something new. Don’t expect to. None of it’s your fault. Keep yourself well.
Love and strength. Naomi
Good luck!
Good luck!
https://www.womansworld.com/posts/best-washable-incontinence-pads-156282
Put padding and old towels in the chairs she uses.
Remove her underwear and replace them with Depends. In the long run, you are doing her a favor since it's a necessity.
There are some really nice colors of Depends as well as other brands.
You might get several types and ask her to try them.
Replacing the regular underwear with Depends is important because of hygiene. When it’s done, she might be upset for a while...it is worth a try.
Best wishes and prayers.
Remove her underwear and provide the pull ups.
If she asks tell her that all her other underwear is in the laundry and the machines are broken and it will be a while before her other underwear comes back.
This way she will not have an option unless she goes "commando" and I am guessing she would not do that.
With dementia you will not be able to convince her that she "smells", "it is unhealthy" that is not a concept that she will understand.
The staff should also be encouraging her to go to the bathroom at least every 2 hours. And by encouraging her I mean walking her to the bathroom and "suggesting" that she should use the toilet.
Also made the adjustment to “new undies” easier. Still had to remove all the old to get her to try them though.
I too imagined a huge fight but it was only a couple hours of bad mood and the silent treatment.
Being in a facility when the switch is made helps too. The staff will encourage/reinforce a positive attitude.
Good luck!
"Pulling a nutty" is a fact of life with declining seniors and it is incredibly hard to take. I know implementing it is hard, but what worked for me and my mother, who went through the phase you are describing, was to take the regular underwear away as it comes up for washing.
I take care of my Mom so it was easy, and the garbage can got real full real fast. She had no choice. You may have to enlist staff at the AL facility to help. It has been almost a year, and panties still occasionally appear. Not sure where they come from as I have emptied the drawers, but. . .
As others have said there are a wide variety of incontinence options. In Mom's case, she likes the Depends. They leak at night, but are OK during the day. I have bed pads and just rinse with vinegar and then wash them and whatever else she has soiled.
Good luck, and be sure YOUR doctor knows the stress you are under.
Replace all with “pull-ups”.
Be prepared for well-intentioned folks
to bring gifts of mini-pads in warehouse
size packaging. (Take them as well).
I also learned about the Plan B bag.....
ALWAYS carry an extra set of clothes, shirt, pants, bra, wipes, socks, shoes,
a large sealable trash bag to handle soiled stuff, Depends, antibacterial wipes for you and a diaper rash cream to prevent rashes....when it starts to happen often you will be grateful for each and every item you have in your GO BAG.
Need More? Add that layer of protection to your car seat.
* Also, at night, get a pad insert for the disposal underwear to absorb more. The pads are for leakage, they are NOT sanitary napkins. They are POISE or something in pink wrapping.
* ALWAYS ALWAYS have the large 'bed pads' to put on a chair and cut or get something to fit car seat if you drive with anyone with incontinence in your car.
I use on the bed, in this order:
1. Mattress protector (can be costly although saves the mattress).
2. paper disposable sheets (2) next to each other.
2a. Sheets (bottom fitted);
3. Washable pads - come in various sizes. Two smaller ones are better than one very large one - easier to wash. Have extras for when some are getting washed.
4. Paper pads on top of those.
5. Top sheet if you use two sheets.
The key is to avoid washing as much as possible and saving the mattress.
The washable bed protectors are a gift from God.
5. Be sure to put protector on a chair or anywhere s/he may sit during the days.
* Have plenty of disposal gloves on hand.
* A waste paper basket or can with a top is good or, for my client, she manages fine with a large garbage bag and remembers to close it. I have to empty it when I arrive - this works out okay. Depends on the level of cognitive functioning/ability.
* Always keep a can or two of Lysol or something like that to kill germs.
* Is helpful to have a flowery air scent too - depending on the situation at hand.
* Between forgetting and embarrassment and denial, we do what we can. Tough love is essential. (Set boundaries.)
* I hired a caregiver (or wanted to). He met with my friend (86) of 16 years for 15 seconds and said "can I talk with you outside?" He said he couldn't take the job due to the stench of urine. At times, I have to leave my friend too due to the smell. He is embarrassed, gets over it, says it has more to do with depression than incontinence. Its both. He is in denial.
* If you allow her to wear her real underwear over the disposal ones, she might not do that on her own - it a good idea though if she can wear it as needed. My sense is that she'll toss the disposal and just wear the real ones. Gena.