How to deal with my father-in-law who has urinary incontinence?

Oh dear. What a difficult situation. Hugs to you all.

My suggestions are on a practical level (although I'm guessing that is not where most of the distress is).
1. Men have it pretty easy in one sense -- a urinal is a good alternative. We always have one in the car, along with hand wipes in singles packages. When hubby is weak or sick, there is one next to the bed, too.
2. When laying out his clothes for the next day, transfer items to the new pockets and thread a belt through the loops. (Own two belts the same, so you needn't wait for the one he is wearing.)
3. Better yet, encourage pants without belts, like sweat pants or cotton knits or short with elastic waists, etc. Much easier and quicker to manage in the bathroom.
4. If you typically stay up later than he does, remove his dirty clothes from his room after he is sleeping, and return them only after they are laundered.
5. When he first developed dementia my husband wasn't very sanitary in the hand-washing department. I switched from using hand towel to having big baskets of wash clothes and a small hamper in each bathroom. These are single-use hand towels. As a bonus, folding the colorful little towels with their interesting texture has become a standard activity for my husband. It is a way he can see that he is contributing to the household.
6. Disposable pads in regular underwear may be more acceptable to him than full incontinence pants. In my experience the underwear nearly always has to be changed along with the pad, but if caught quickly the outer garmet is spared. If this might seems more dignified, it is worth a shot.
7. It is well and truly Hubby's turn to take reminder duty and cleanup duty. Even if he is frustrated. Even if he doesn't want to. Sorry, your turn, Dear.
8. You can set some rules and gently but firmly enforce them. He must wear clean clothes each day. He must change his clothes promptly if he soils them.

And a little advice outside of the practical realm: Try not to think of this in terms of FIL not having enough pride to keep himself clean. This man has tangles and plaques in his brain that prevent him from thinking and functioning as he once did. As you stated so well, this isn't his fault. Think of it as not having enough functioning brain cells to remember the importance of keeping himself clean. That won't solve any of the practical aspects, but it might make being civil just a tad easier.

You and your husband have been/are wonderful, caring adult children. Bless you. I hope you find some relief for this very vexing problem.

First of all, I would like to apologize for sounding like such an uncaring, heartless, nasty, old wench in my previous post. I wrote that at the end of a few very, very looooong, especially trying and frustrating days and I am sorry I was so negative. Like I did say, my father-in-law is the sweetest person and I love him to pieces, but the AD and heart issues have created a few unpleasant problems. Without a doubt and I thank him will all my heart, my husband has been a blessing through all of this; I would have been in a fetal position under a desk without his support, love and strength.

I am a retired nurse and, usually, I can keep a pretty understanding and positive outlook, but for the past 20 years, starting with my sister-in-law being diagnosed and passing away from ovarian cancer, we have been dealing with and directly caring for immediate family members major health issues 24 hours a day and, quite frankly, I get a titch burned at times. I also have Grave’s disease and fibromyalgia, so most days are rather exhausting and taxing. Again, I am so sorry for sounding awful and like I don’t care, because believe me I do care very, very deeply for the comfort and happiness of my entire family.

Next, I want to thank you, Jeanne, for your fantastic and well written response. It is gratefully appreciated and I will see if we can give the urinal a try. Not sure we will get any further with it than the Depends, but, I have learned each day brings a different sunshine. :-) I always carry hand sanitizer wipes in my car and I will have to stock the other one with same. When my mother was with us, I did have an “emergency” bag with me at all times. I will offer your other suggestions to my husband and see if we can revisit some again, as well as, implement the new ones. They were excellent.

As you well understand, there are times even the best laid plans go out the window with AD patients. All we can do is continue to share our experiences, taking deep, deep breaths (outside in the fresh air), keep putting the smiles back on our faces, putting one foot in front of the other a nanosecond at a time and trying again and again because we do love and understand this is not their fault and they certainly wouldn’t be like this either…………….if they had a choice. It is a heartbreaking illness for everyone.

Hugs and love to all of you who are walking the same mile as my shoes!

I, too, am having a very difficult time with my fil and his unsanitary ways. My husband and I are lucky, if he even changes his clothes once a week. We have to remind him ( we have had to accept the fact that he will only change once a week ), up to three days to wash up and wear clean clothes. He has severe emphysema/copd and I know just walking three feet wears him out.
I did place a chair in the bathroom with a thick pad of clean towels on the seat. I keep all his combs and such, cleaned and laid out. ( I cannot even get him to comb his hair most days ) . He did agree to try these disposable wipes to clean with and body wash that does not have to be rinsed. My husband has offered many times to help him, but my fil always says he is too tired/too sick to change.
We have even had to tell him that social services will investigate, if he does not take better care of himself. He, too has incontinenet issues ( not too severe yet, but very noticable ) and smells. He also chews tobacco and drinks everynight. Interesting to note that he always manages to make several mixed drinks everynight, but cannot be bothered to clean himself.
Every week , I remind him, it's time to change his linens and that I will not do that until he washes up and changes his clothes. ( he sleeps in his clothes too ) I always put two piddle pads between each layer of sheet ( i don't even think he notices ) . I usually have to begin the reminder a couple of days before. It is a constant issue and he never changes voluntarily. I know it gets disgusting. I have had to be a little stern at times because he just starts to smell like and look like a bum on the street. His bed is in the living room, so he never sits any where else, thank god and he has his own bathroom.
It's just one of those things that you and your husband have to be very consistant about and keep reminding him.
I do place either bowls of unused coffee grounds or vinegar on white bread ( in a bowl ) to absorb odors. It does help. As far as your fil in the kitchen, I keep my fil's utensils and plates, bowls seperate and any type of snack, such as chips or fruit, goes into it's own container. I seperate what he touches and eats from my own. I have never seen him wash his hands, ever. I know he does not use soap, because he has had the same bar in his bathroom for over a year.
We are at our witts end, but are in the process of getting either pallative/hospice to help with the bathing and changing. The man has not been in a bath/shower for five years, just takes a weekly birdbath!
When he does clean up, I always compliment him and reaffirm that I know he feels better.
Good luck, and no, you did not sound too harsh. It is a difficult situation and you are doing a wonderful thing!!!

Kudos to you for caring as much as you do for your family members. It is never easy, and many with the diagnosis of dementia remain resistent to what we think are basic issues. One suggestion might be to remove all "regular" underwear from his drawer, explaining to him that his doctor wants him to wear the Depends until they can help him with his incontinence. Another key suggestion is to get a urine sample to ensure that he does not currently have a urinary tract infection, common in the elderly.

Please consider looking into getting a caregiver in the home. You can initally contact your Area Agency on Aging to see if your family member qualifies for financial assistance based on medical need. Otherwise, there are agencies ready to assist with a private pay option. They do not have to qualify for hospice at all to receive this care. Just one word of caution-ask the agency if their workers are bonded and insured, as well as FBI and backgroundchecked/drug screened. The only way to go with that, IMO.

My father has Parkinson's and I feel quilts foreven writing this but, I am staying in His home for a while. Their house has three rooms thre baths. Each room has its own bathroom. Well the bathroom where I have all my stuff he insist to go in there and shave and pee ALL over the seat the floor bath mats. So when I go in there it smells like urine. I clean it everyday wash the mats everyday and make no fuss about it. I know when I was a child I must have been worse. So I just see it as my turn to take care of my parents piss and all. I just wanted to know if there is anything out there that I can connect to the toilet or should I just install a urinal?

i am also having trouble with my father after he fell and broke his left femur a year ago rehab put him in a wheelchair and diapers and they tried to get him to walk and he fought them all the way he said rehab rehab rehab that is all i hear i don't want to and aint going to he has no health problems doc said he healthy as a horse and could walk if he wanted to but he won't he just sits in that chair and pees his pants and won't get out of bed in the morning till he pees the bed full and i put 3 diapers on him and still soaks himself and the pad and whole bed he is 82 and lazy if we talk to him about it he gets fighting mad runs over my toes with that chair and broke one of my toes what can one do

My dad is 84 years old, and i totally hear what you are saying!!!! I had a major argument with him yesterday all over washing his hands after he had emptied his catheter bag in the toilet. I was taking him out for shopping and he came out straight afterwards as he usually does and went to get straight into the car. He does this and prepares meals, touching kitchen utensils and items that we all at some point put our hands on also. The thing is, i am a caregiver! I feel i should know how to handle these situations but with my father! no way!!!! he told me that it was silly talk and that he was not going to put up with it any more. I think it is disgusting and unfair to the other caregivers that come to his house. I really dont know how to handle it at all, i am very angry at his selfishness as i see it. BUT, one thing i wonder about your father, is that has he had his prostate checked???? please do this if he hasnt. My dad had alot of the same symptoms and was found to have prostate cancer, after refusing to go to the doctors for years, he had to go after he had to go to emergency. He is at his home now and doing well but he has a real stupid issue with washing hands even when there is evidence of nasties on them.

So here's my horror story. My mother is 73 years old. We are almost positive she has dementia but have had horrible luck getting a positive diagnosis. It all started about 15 years ago at least that's when I noticed. She started only bathing on Sunday's, the night before work. In the last 6 months we have moved my father and her in to our house because they really do need assistance with doctors, meds, house care etc. they just can't be on their own. She still drives but none of us will ride with her unless we are driving. It is a very touchy subject. That's just a short of where their at. The real problem is my mother where's depends during the day and takes them off at night so "she can air herself out". She sleeps from 6am until 4pm every day. So the hours that we are asleep she is up around the house without depends or any underwear at all. If she uses our bathroom in the hallway 9 out of 10 times she pees all over the floor. When we get up in the morning there is pee in the kitchen. There has been number 2 in chairs where she sits. Our carpet in the living room has been peed on I can't tell how many times. The house REEKS of urine. I have tried to reason with her to wear her depends at night. I'm at my wits end! We are fighting more and more and I'm going to snap. On top of her peeing freely in the house like this she refuses to bath! The last time she had a shower was at least 2 and a half months ago. She says she can't wash her hair cuz it's to hard but won't let us help her. So she goes to the hair dresser and let's them wash it. Did I mention the last time she went to the hair dresser was in April. She hasn't washed her hair for at least 5 months, maybe 6. She also takes 2 to 3 minute showers. She can't possibly be using soap, and when she gets out she still smells. We counted the days and she wore the same outfit for 2 weeks, stains, smell and all. She finally had to change it because she had a serious number 2 accident and had to wash it. When she does have a number 2 accident and it get all over her and runs down her legs she just tracks it in on the carpet and changes. No shower half of the time. She denies most of the time that she is peeing all over the place. The problem is we are still able to have conversations with her. She knows who we are. We have to remind her what state she is in often because she is in a different state now. She usually can't remember where she ate out at without hints. What I'm trying to say is she is with it enough that she can carry on a conversation with us but these behaviors are driving me insane and I don't know what to do. The house is destroyed. I'm starting to think that maybe we've been around her long enough that we have become somewhat numb to her. i look around at these older couples and they are so put together, hair done and some really nice clothes and I wonder what the heck is wrong with her. She goes out with her hair literally stuck to the back of her head all messed up, stains, smell and all. If I seen her on the street I'd think she had been living there for a very long time. Ive told her I don't know how many times that if she would just wear her depends and shower everything would be fine. But she won't. I don't know what to do. Sorry for the long letter here. Thank you very much for reading. Kevin

What is your father's mental health like, Kevin? What does he think of his wife who hasn't showered in months?

Do you have a wife? Anyone else living in the home? (Just trying to get a full picture.)

Your mother has dementia, or some other damage to her brain. Peeing all over the house is not normal behavior.

My husband knew who everyone was until the day he died, 10 years after diagnosis with dementia. He was always able to have a conversation. Those are not signs someone does not have dementia. With or without an official diagnosis, assume your mother has mental impairment. Stop repeating yourself to her. She is not capable of reasoning. Even if she understands you and agrees with you when you have these discussions that has no impact on her later behavior (as you have seen.) Stop beating your head against the wall. She is not going to learn from your lectures.

Here are things I think you should consider very seriously and very soon:

1. Take her to a geriatrician to whom you have sent a note about Mother's behavior. Don't clean Mom up first. Take her in in her usual state of lack on cleanliness.

2. Hire a caregiver to be with her from the time you go to bed until you wake up. You mother cannot be left on her own while everyone is sleeping.

3. (Actually, this should probably come first) STOP that woman from driving!! She simply does not have the judgement and brain power. This is not just about her safety but that of others on the road. Allowing her to drive is irresponsible.

4. Bring in a bath aide. This person comes in once a week and helps Mother shower. No discussions, no arguments, just come along, dear and we'll get you all nice and fresh. (Sometimes loved ones behave better for an outside than for family.)

5. Begin the process of looking for a suitable care center.

The house is destroyed. Yes, you have come to take her behavior for granted. It is NOT normal. I think you as a caregiver are in way over your head! That is NOT a criticism. Bless you for loving your parents and trying to do your best by them. But persons with dementia don't come with an operator's guide or a training manual. This has gotten way out of hand and you need to start to rein it in, for everyone's sake.

Hi, I'm Kevin's wife( Kevin of the above post). To answer some of your questions our household is comprised of Kevin and I and both of his parents. His father's mental status is a little better than his wife's.....but he is really starting to slip as well. He admittedly doesn't bathe "as often as he should" (and that is a quote from him) but he is not incontinent and he grooms himself daily, changes his underclothes but may wear the same shirt and pants multiple days in a row. He has been having difficulty balancing the check book and asks questions multiple times about upcoming events......but he is aware he has been having those issues and doesn't try to hide it. Dad also refuses to drive anymore and seems fine with his wife being the driver. Now mom, mom is a nightmare. I suspect that there is some long term mental illness we are dealing with on top of the dementia. What Kevin didn't mention in his post is that she is also a hoarder and compulsive shopper. The bathing issues were apparent many, many years ago (greater than 15), much longer than there has been very apparent (to family) dementia. Dad claims he can't smell mom, she can't smell herself (which is amazing to us), he "isn't so sure" she has been peeing on the floor, and says her driving "makes him uncomfortable sometimes". I think he has given up on trying to stop his wife's shopping, hoarding and lack of self care. She is a wrecking ball and has been for a very long time. She can't be told anything, holds grudges for imagined slights, resents anyone trying to tell her how things should be. For example, last year she took a multiple day train trip from Oregon to New York to visit her brother. She literally fell off of the train in Minneapolis (we are unsure exactly how), had to be taken to the ER, and the ER would not release her without supervision. Rather than contacting her family she called another passenger she had met on the train that got off in Minneapolis to come get her. She went home with this individual. She completed her trip to her brother's in Syracuse before any of us learned what had transpired. She claims she thought her iPad and cell phone had been stolen during this event and she didn't know how to contact any of us. However, an email was sent from her iPad to us when she finally arrived home and it auto connected to her wifi network that she had written us while in the ER weeks before. She doesn't understand why we are so upset over these events, it was no big deal to her. It's obvious to us that she in fact can't take care of herself but we can't force her into a care facility. We have been to multiple Drs with her stinking, dirty and unkempt.....including a neurologist, and they sort of brush it off. She tests normal to mild cognitive impairment on a MMSE and had neuro cognitive testing done a few years ago that they called normal. Her current neurologist is of the mind set of why bother, it can't be treated so what difference does it make. Her primary care dr discussed the driving with her and she left that appointment angry and that is all that it achieved. She has had a long term battle with her daughter because she has refused to let mom drive her children anywhere, ever, since the day they are born. Mom's answer to ANY of this is that she just needs to live alone. I do not believe from a functional standpoint that we would be able to get a conservatorship in order to put her in a care facility and she adamantly refuses to consider the possibility. Dad refuses to stand up to her or force any issues and I believe he thinks we should just deal with the situation as it is. Anyone I discuss these issues with are in agreement that mom needs to be in a care facility and shouldn't be driving. The problem is that if you take the personal hygiene and hoarding/shopping away she seems like only a forgetful old woman. We have offered to hire bathing help and that also has been vehemently dismissed by both. We know this is insanity but both parents are not far gone enough that we can force these issues with potentially alienating them completely. We could report her to the state for her driving but it can't be anonymously and if they find out it was us it will be an enormous fight and frankly, I suspect she would pass a driving test. Disabling the car won't work as they are perfectly capable of calling a tow truck and having it taken to a mechanic. So we feel quite stuck. If anyone has any suggestions on how to make any positive changes in this situation we are all ears but they are nowhere near the "come along, let's get you fresh and clean" point. That would be met with a "who do you think you are, get out" type of response. Right now we would just be happy if she would bathe once or twice a week, change her depends a minimum of twice a day and wear them 24 hours a day, and change her clothes a few times a week. The rest we can deal with.

Wow, who knew if I typed "My Father won't wash his hands after using the bathroom" that I would find so many people with the same problem, and worse than mine. I see on one hand that there are worse problems. And the other thing I think about is what I have in store for me. I have been caring for elderly loved ones for many, many years. Beginning with my grandmother. She passed at 86 but she was always concerned with cleanliness. I can recall even when she could no longer clean herself after a bowel movement how she would direct me in cleaning her. My mother also was concerned with keeping clean. Aunt, the same ... My father (82) is the only person I have ever had such difficulty with. The same like everyone else. He just doesn't think washing is necessary, turning on the faucet to drizzle water over 2 fingers is his compromise. There is no compromise to changing clothes daily. I go in his room after he's asleep & I take the dirty clothes, put them in the hamper or washer and replace with clean clothes. He gets angry, stubborn, yells at me .... all the usual things you expect but I have control over washing his clothes & bedding so that isn't as bad. The 2 minute shower ... because its a father/daughter relationship I can't do anything about that. I've bought very fragrant men's shower gel and hope for the best. I changed the pump soap on his sink to bar soap so I have a firmer stand when he argues he DID wash his hands & the soap (sometimes even the sink basin) is dry as a bone .... but that's the most anyone can do. Just now after my partner got terribly upset AGAIN because he not only denies that he didn't wash his hands but he gets so obstinate & yells at her. I waited for dad to come out to have his breakfast and after he was done I spoke to him. It started out a loud mess because as soon as I said Dad, can we have a talk, he started screaming & the first thing he yelled was she this she that .... so he was obviously still angry at her. I put my hands over my ears and shouted louder. I kept repeating I will NOT listen to you because this is my turn to talk. He finally stopped and said Talk. (NOT the way to go about this on a regular basis, I don't want him to have a stroke but believe me, there are times I'm shocked that I don't have one) What I started with is this... Daddy I didn't want to tell you this but I need for you to understand how much this is a problem and is getting in the way of our relationship. Do you know why when you ask me to fix your cable, that I use MY own remote? I do it because you use the bathroom and don't properly wash your hands. That makes me uncomfortable and it isn't fair to me. And it's very unsafe. So I have to use my own remote. Every morning after you leave the room, I go in with the blue gloves on and the antibacterial spray & wipes. I wipe down everything including your remote, the window knob, and chair, etc then I go into your bathroom and wash down everything including light switches, shower handles, door knobs. I do the same in the kitchen after you leave there. I wipe down the refrigerator handles, sink faucets, cabinet knobs..... do you understand that this is such a problem that I don't allow you to touch me anymore, and if I do, I go wash right after. THAT is what is upsetting daddy. That I love you so much but I cannot enjoy a touch from my daddy because you refuse to stay clean.
Well, daddy said, he'll do everything I want, and he'll even keep the room neat, and blah blah blah. All I could hope for is that he might make a conscious change for a day or so. But really I feel that his answer was just the yes ma'am answer and now he feels exactly how I don't want him to feel. That he no longer is in charge of his own life. I hate that. But dad goes to a senior center and I am so afraid that he'll pick up something that he won't be able to get rid of because of his unsanitary ways. Mind you he was NOT like this until the last 5 or 6 yrs. I feel terrible and I suppose juggling & jumping around him using gloves & wipes and doing things FOR him can help somewhat but he's a healthy man thank god and I can't see me being his shadow for the next 10 - 15 yrs. In the back of my mind, after reading all these letters ... is the fear that a switch will shut in my own brain one day and I may be exactly the same way. I would hope not. I hope I follow my grandma, aunt, mother .... but who knows. Who knows WHY this happens. I do not have the financial ability to hire any type of professional aide to help with washing etc. Although it would be nice to be able to have someone else chase him and keep our environment and daddy, safe and clean .... most people are not equipped with that luxury. OK, that's my vent. Hope everyone has a better day than yesterday!!

Wow I thought my uncle was the only person that wasn't sanitary. My uncle who helped raise me has exactly the same bad smelly nasty habits, my home is getting intolerable to breath.

So, so difficult. My 96-year-old father lives with us and my hubby has stage 6 Alzheimer's, so this is a perpetual problem.

The use of urinals (with lids) is very helpful at our house. It's ok with me if Dad doesn't empty them, just put the lid on the urinal at his bedside. Less chance of his spilling when he tries to empty it himself.

For hubby, I have him use the urinal in the walk-in shower so I can wash everything down easily. I also keep bottles of hand sanitizer (pump dispenser) on every counter in the house and they are more likely to use it. Also, I can joke about keeping the flu germs away and put some on their hands. Then it's not a fight about urine.

I've also removed every carpet and rug in the house. They were stained and had residual smells. Also removed Dad's mattress, got him a new one with a good plasatic cover on 6 sides. Removed all furniture that was stained with urine. All current furniture is waterproof or he doesn't sit on it (not difficult since he has his favorite in each room).

But most of all, we have a family living agreement (not written, but it could be). The items that we agreed upon were discussed in a non-contentious discussion. ("Yes, Dad, I have an overly sensitive nose, so you can imagine how hard this is for me.). Dad didn't like using Depends, he thought he only needed shields inside his underwear. But now he wears Depends. And I agreed to go to Walmart at least once a week.

And as far as dirty clothes, i gather them up after Dad puts his pajamas on.

Finally, could your FIL benefit from an antidepressant? His lethargy could be a symptom of depression.

Blessings for all that you do,
Jamie