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My mother-in-law is 85, has no sensation of needing to go, or of being wet. Will wear depends, but does not have sensation of wet, urge to go. Refuses to believe that she has wet herself, saying that she must have sat in something wet. She will wear adult diapers, but forgets to change them and leaks. The doctor has said that there is nothing he can give her if she doesn't even have the sensation. She is very stubborn and becomes very agitated if her smell or wetness is pointed out to her. She even hangs up dirty clothes to wear again.

She has no short term memory or focus, but is otherwise healthy.

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I say panties, Mom uses th pullups. I worked as a secretary for a visiting nurse assoc. and one of the nurses hated the word diapers.
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Willows, I think they are great words. You brought up a very real point. Why don't staff at hospitals, rehabs and nursing homes have the professional courtesy to make sure the patients can keep their dignity as long as possible, just by having the courtesy to not use the word "diaper". I really hope "undershorts, panties or pad" become the politically correct term that all staff must use!
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I agree. The word "diaper" is so demeaning. I had to call this to the attention of the nurses and aides at a rehab my husband was in for three weeks. I had to educate them as to how the person with dementia or some other problem feels when he/she hears this word. Why didn't they know this already? Anyway, I refer to my husband's Depends as "undershorts." Why not? And this pleases him, I can tell. If the patient with dementia is a female, then why not refer to them as "panties?" Why do caregivers feel they have to refer to them by what they really are? What's the point?
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I really wish we could all agree on a different word than "diaper". We have so many great minds on this site. Everybody think about it. I know when my mother heard from hospital staff that they were going to change her diaper, sometimes she would get very angry, and other times she would cry because this is where her life has come to. We should have a politically correct word or phrase that would make our loves ones feel like they still have some dignity left. Maybe we should say "It's time to change your pad, or padding" When they ask what is that, just say when you get older you sweat between your legs, and the pad keeps the irritation under control. Maybe I'm just too sensitive, but I think that's what i would like to hear. Just saying.
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My husband doesn't have the sensation for number 2. He will be shocked when he goes to the bathroom and has it in his attends. Most of the time he is cognitive enought to be extremely unset about this. At this point he is able to clean himself but he will deny it happened many times. but I can tell. He absolutely refused to go on any kind of schedule for either 1 or 2. If we are leaving the house I won't leave until he consents to go to the bathroom, This has made us late for appointments but it is better than an accident at the doctors office.
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Mom has no problem with holding urine but seems she has lost the ability to hold #2. She gets the feeling but tends to wait if she thinks I'm busy or knows I've gone out on an errand. I tell her to just get up and go and then call me. But, there is no set time to catch her.
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Another factor that affected my mother's incontinence challenge was that as she aged it got harder and harder (and slower) to get around. When she realized she needed to 'go' she couldn't get there in time because it was taking her longer to get out of a chair and walking was slower, etc. so she would have 'accidents.' And just as you get through this phase, another one pops up. You have entered the world of constant adjustments. And depending on your home situation, living arrangements, proximity to bathrooms, etc., your adjustments will differ from those of others. That's why all we can do is make general suggestions. As mother aged, walking slower, but still able to get around, I made sure there was a small light on in her room at night and a bedside commode (with sturdy handrails) positioned right next to her bed. (Along with a waste basket, toilet paper & hand wipes) All she had to do was stand, grab a rail, turn and sit. It was also a bit higher than the standard toilet, so it was easier for her to use. The loss of personal freedoms to a previously fiercely independent person is devastating. I tried to keep her as self-functioning as possible for as long as possible, for both our sake's. She liked the commode because it moved the bathroom closer to her. For the dementia, I labelled cupboards, drawers, etc. She liked that, because, once again, it helped to restore some of her loss. It worked for a while - Then we moved onto another phase and adjustments.
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Yes, I just observed the caregivers at Dad's place doing this, and then asked them 'why'?? Because, you know, we don't always wash our own hands before dinner....but when we were kids, and played outdoors, with pets, etc, our Moms did this....so with dementia, people seem to be in that same frame of mind....and, since their hands 'get everywhere' too....it's a way to clean, sort of without cleaning. I watched the caregivers go right under the fingernails and be chatty and if there is resistance, they just say, well, time for a little hand massage. That, of course, works really well with ladies...sometimes not so well with the men...
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joannes, thank you for the hand wipes & hand massage info. My mother picks her nose at night, so she constantly has bloody/snotty fingernails. Pointing out she needs to wash her hands doesn't help cause she can't see it, and gets irritated with me. I keep her nails short, but needed an assist for the hygeine. Thanks!
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In Arizona, I was just informed that Medicaid for my Dad, will pay for Depends BUT there must be an order from the MD that says the incontinence is the result of his disease. I am not sure if they are also going to cover the clean up clothes and barrier cream that his facility uses or not, since this is a new policy. If Mom won't or doesn't want to wash her hands, then use wipes. Keep a jar every where, and periodically, just pull one out and wipe her hands and under her fingernails while chatting to her about something else. Tell her you want to give her a 'hand massage' or something, and follow up with lotion. Accomplishes the important sense of touch that the elderly need too.... Dad's facility does it this way before all meals even....wipes or warm washcloths, followed by a quick application of lotion and hand massage ending with a hug before sitting the patient down at the table.
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I attended a dementia workshop recently and it was discussed that if caregivers have set times to take the patient to the bathroom, there will be less incontinence. Think of how you potty train a child and match the times with how most people routinely 'go'....before or after a meal, first thing in the morning, last thing before bed, before leaving the house, upon coming home from being out...but basically every 2-3 hours while awake. No long discussions...just take them and get them on the toilet. And periodically, as needed wash the area, apply barrier cream and check for redness or breakdown. Physically, it's not that the person cannot stay continent, but it's that the brain doesn't send signals of a full bladder or bowel fast enough for them to get there by themselves. Often the signal comes through just prior to having to 'go'....so no time to make it to the bathroom. And remember, getting an infection, from sitting in wet clothes, WILL almost always cause a huge increase in dementia symptoms, so worth avoiding at all costs as much as possible. And, consider that 'of course' she is going to tell you she doesn't have to 'go', because her brain is NOT telling her she has to 'go' until just as it's ready to happen. So just say, 'it's time' and take her hand and lead her. If she argues, and she's prone to the doctor being the authority, just tell her the doctor told her and you, that she needed to go in and try, every 4 hours or whatever timeframe works.
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I'd put her on a 'toileting' schedule, that way you can assist her in changing if she's wet, she can sit on the commode while you change the depend/pull up. If she has some dementia, you can contact your local chapter of the Alzheimer's association and ask about how to deal with behaviors & toileting. Make sure she is drinking plenty for you don't want her to have a UTI. It's a game of trial and error, you keep trying approaches until you find something that works for her. good luck
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You can avoid your mother wetting her bed due to a leaky diaper by diapering her more than you evidently are. I put male Depends on my husband, and here is how I do it, and in the morning, except for his Depends, everything else around him is perfectly dry. I insert TWO pads inside a pair of Depends and then on top of that I slip on another regular Depends without a pad. He is secure for the night, and there is no way in the world he can leak. Good luck!
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I have the same issue with my mom. There are days when she will fight me or her health care provider about changing but its not getting any better. Normally she will sense the urge to "go" and get up to visit the bathroom. But often she will soil her diaper on her way to the toilet because she cant hold it. Some night she just wont get up to go to the bathroom like she does during the daytime and so she wets her bed due to a leaky diaper. Again, not every night but I can see it getting worse. I stopped giving her liquids after 7pm but that doesn't seem to help and if she asks for water I will give it to her despite the time.

I have yet to try a potty schedule. I would like a schedule but I'm not sure how often I should get her to go to avoid accidents. She used to have diarrhea accidents all the time until the doctor cut her diabetic medicine to half the original dosage. Once doctor put her on a low dose anxiety pill, not only did it stop her panic attacks, it also caused her glucose reading to drop! Little did we know that her anxiety was spiking her sugar levels. Now that she's so much calmer, most other things are better with my mom!

Finally, my mom doesn't get diapers via medicaid or medicare or the supplemental insurance either. I used to buy them at Walmart until I was told I could buy them at the local Flea Market at a greatly reduced price. It's true! So it might be worth your time and effort (and pocket book) to visit your local flea market for adult diapers.
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My first clue that mamma was having a problem -the urine smell on my once fashion plate mother. After her rapid decline and admission to a memory care unit I have her on the incontinence package. A flat monthly fee and she is DRY - IF she needs changing 1 or 25 times a day. A UTI can cause all kinds of problems for dementia patients - you will have to be strong and make the hard decisions. This problem will not going away and will only get worse. Most dementia patients- have lost the sense of smell and feeling wet or dry. Good luck and lean on your support system.
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I thought Medicare paid for Depends/Tenas. My daughter, the RN, said something about ordering them thru a company and Medicare pays. I know they do if on Hospice.
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You have all been so great to add your experiences and encouragement. This has been a great help and makes me feel so much better to be able to talk about it. My husband is not ready to fully deal with it
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Sometimes it's the expense that stops them from changing personal hygiene products often enough. That, and they THINK it's dry because the surface doesn't feel wet, but underneath it's full. Add the two together and they see no point in changing. Have you tried a mail order service like HDIS? (No connection - we have had good experience with them, they even turn the shipping box inside out so the neighbors don't see you're getting a carton of Depends.) But the other posters are right - unless this addressed, she'll end up with a UTI, and because she has little feeling, the first symptom may be a seemingly altered mental state.
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oh sorry....mother-in-law!
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dgolden...you are the only one that can make that decision. if your emotional health is at risk because it's tooooo much to care for your mother...and she has medicaid...you should NOT feel guilty, or try not to...but DO what is best for you! if you read these boards...you can clearly see that people are losing their minds because they are caretakers...and cannot afford to put seniors in a facility. so, if you have that option, you are VERY LUCKY!!
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I have the same problem with my mother that lives with us. She is very stubborn.I cant tell you how many times a day I am ready to vomit. I find the dirty depends on her bed, stuffed in her drawers etc. Shes now refusing to wash her hands or flush the toilet (if she makes it there) And getting her in the shower is almost a fight. I steam clean my living room furniture once a week. I wash her bedding every other day.
At what point do all of you feel its time to put someone in a nursing home?
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When this started happening with my mom, I discovered that it wasn't so much that she "didn't know" (she would also say 'she had sat in something' or 'spilled something') but she was too embarrassed to admit what was happening. Yes - denial. We can't afford in-home caregivers or a facility. I had a private talk with her, explaining that this is a normal thing at her age and started inserting TENA Serenity pads in the 'pulls ups' worked. Before her dementia - she was able to recognize the wet pad and change it. She's bed-ridden now; so I just change her every 4 hrs. It sounds as though you may have a long road ahead of you. As Mallory indicated; now would be a good time to revisit any legal documents that have already been done and possibly initiate new ones.
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My hubby, who has dementia, became incontinent quite a while ago, although sometimes he does tell me he has to go. If he is wet or otherwise, I simply wash him down and change him, chatting with him the whole time. He keeps apologizing, and I keep telling him not to worry, that other people have accidents, too. The incontinence is the least of the problems that go along with dementia, so far as I'm concerned. I didn't make a big deal of it when my three children were little, and I don't make a big deal out of it now. It's par for the course. Look at it that way.
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With the leakage I say my husband has "outgrown" Depends. I now get awesome products from Northshore on line. No more wet clothes or wet beds. My daughter brought up a good point - the products are like baby diapers in that they absorb the moisture so you can't tell they are wet. Which makes it difficult to convince someone a problem exists. I get daytime and nighttime ones and have to put them on opposite sides of the closet because he can't tell the difference. I also have to put a big red F for the front since he can't tell front from back. It's also interesting to note that sometimes he sits on the toilet thinking he has to go. I tell,him that if he hasn't gone by now it's all in the diaper and to move on. I am certainly glad we have this forum to exchange experiences and get new ideas.
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euron-info
Color changing pads in Europe.
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Tell your husband to Man Up! She did all this for him, now it is his turn to do what is best for her, even if it makes him "feel bad". A friend of mine has her Mom on a schedule and she does exactly what has been suggested. She tells her it's time to go to the bathroom. For instance, about once an hour she tells her Mom to go, after lunch before she sits back down in the living room and the same at dinner. And she limits how much fluid her mother drinks. She has one of those big 24 oz (Tervis) mugs with handle, lid and straw. She fills it up in the morning, at lunch, at dinner and after dinner Mom has no additional fluids. Mom doesn't know or care. Would be beneficial for you to learn more about dementia and Alzheimer's. Good luck. Tough road to trudge. Facing the same myself with my Aunt who is 95.
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Mom lives with me and also has that issue. I work full time so I get her up in the morning with me, just say its time to go to the bathroom, make her change and sometimes just sitting on the toliet is enough to make her go if she hasn't already. Then she goes back to bed and I go to work. When I get home, I check her. If ok then we wait until bedtime and I tell her again..time to go to the bathroom before bed. Once you establish the habit it gets easier. Occasionally she still gets stubborn and will say I don't have to go then I wait a few minute and try again. When they have no short term memory, something that didn't work 10 minutes ago gets a different reaction if you try it again because they don't remember telling you they won't do it. I have tried to get her to do something and she firmly said no, I come back a few minutes later, ask nicely again and she is all smiles and say ok. Learning that trick has saved many an argument and my sanity.
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My husband is totally incontinent. I got tired of Depends leaking, then used Tena for about a year. Now I use Abena pullups (Abri-flex) during the day and Abena "briefs" or diapers (Abri-form) at night. I found these products by reading the customer reviews on Amazon. Haven't had a leak in months. They are a little bulky, but if a person is to the point of being totally incontinent, they won't notice. For bowel incontinence, I use Fleet liquid suppositories every other day while my husband is seated on the toilet. This has totally prevented bowel accidents. These products and a good supply of gloves have really helped.
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I have this exact problem with my husband. We have tried everything for the incontinency and baths but he will not allow or cooperate with us. At a support group recently it was suggested that I ask his doctor for a prescription for him to bathe at least 2 times a week ., which he did. I'l repot if it works. Also he asked me to purchase RESONAL, youu can get it at Walmart if you ask the pharmacy. It is kept behind the counter. It is a great barrier for the incompetent. I emphasize with all of you. Hardest thing I have ever done. Hope these things will help.
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The hospital tried retraining her bladder by making her go every 2 hrs, she complained to my father in law, who complained in turn to the nurses, " its just not right waking her up every 2 hrs thru the night" so they stopped, i believe theyve started it up again at the convalescent home tho, she does some pile of complaining about what they do to her and what they dont do, (everything she complains about is things that needed done, im aware of whats going on, she wants to come home but cant. )
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