Can we talk INCONTINENCE?

Hi. I live in the UK and have bought my mum a completely waterproof, breathable mattress. I also use a Kylie sheet underneath the cotton fitted bed sheets.
Mum has TENA incontinence pads and netted pants as well.
Have you considered a commode chair next to her bed (if it's possible for her to transfer to it easily)?
We used one for mum when she first moved in with us two years ago, but now it's not necessary as the pads are a godsend. (Even though she still goes to the bathroom as it is an ingrained habit I think).

If she doesn’t already wear incontenence pull-ups or briefs at night, I would start now, along with the washable bed pads. If she sleeps from 3 am to 1 pm can you wake her up in the morning for a bathroom run when you’re getting up and ready for work in the morning? Then she can go back to bed. If she doesn’t want to get up, you could change the disposable brief and the bed pad if needed while she’s in bed. Theres a method to this (you can google it) that the cnas at Moms NH use by rolling her on her sides and she barely wakes up if she’s napping. It just takes a couple of minutes.

Blue chux underpads = you chuck them in the trash afterwards! We use 3-4 large ones under mthr all the time, and when one gets wet, it goes. Not all get wet everytime, but it protects the furniture, the wheelchair, and the bed. Cheap at Sams. You might want to put her in depends overnight since that is the problem time. That's how we transitioned mthr from panties to depends full time, started with night which was worse for her.

If she's afraid to walk but still capable of standing she may be able to use a bedside commode with a sturdy bed assist rail to help her transfer. I'd also recommend some physical therapy to make sure she retains as much ability to stand, transfer and walk a few steps as is possible, if she loses that it will be nearly impossible to care for her at home. I would encourage her to use a walker/rollator as often as possible.
As for the laundry - I assume you already have a waterproof mattress cover. Washing the bed pads with bleach is usually not recommended as it will ruin the waterproof layer - check the label.
What kind of incontinence pad or pull up is she wearing, there are many that are more absorbent than those commonly found at the local drug store.

Dear willnotorcannot,

Your mom's doctor is correct that there are side effects to medications. While I do not have any medical background, I would respectfully argue that incontinence and staying in wet pull-ups for long periods also has negative side effects, UTIs for one. My m-i-l in assisted living has nighttime incontinence. Staff had her on a toileting schedule waking her 3 -4 times per night to help prevent "accidents" but the sleep disruptions were having a negative impact on her mental health. With her frequent UTIs her MD prescribed a medication called Methanamine which can have negative side effects. However, the medication has greatly decreased the frequency of UTIs which in turn has decreased her nighttime incontinence. Now staff only has to get her up once a night.

Honestly sometimes I think it comes down to deciding between the lesser of two evils. M-i-l is 86 so for us it is about her quality of life.

I am so sorry you are having to deal with this.

We put in a Poise pad in my mother's nighttime diaper and that actually keeps her pretty dry at night. we also have a incontinence pad underneath for potential accidents and leakage. but this seems to do the trick. just a depends diaper is definitely not enough.

We have heavy-duty tab-style briefs with maximum absorbency & leak control from NorthshoreCare.com  At night booster pads or liners are added, and over them a diaper cover ( like the old-fashioned rubber pants, but not rubber).

My 92 y/o mother is urine incontinent 100% of the time and bowel incontinent about 20% of the time. She lives in an ALF and wears Depends; at night, she uses a 'doubler' pad, with chux underneath her. Nothing works, really.......because if a person urinates a couple of times a night, there ain't NUTHIN' gonna absorb that amount of fluid. Sorry to be a debbie downer, but that's the honest truth. I would stop washing pads and reusing them......it's way more convenient to use disposable products, and more hygenic too. Do whatever it takes to make YOUR life easier, ok?

My mother also has what she refers to as 'severe' neuropathy in her feet & legs; the neurologist disagrees and says it's not that bad (since she can feel the pin test). She's been advised to stay OUT of a wheelchair because exercise & physical therapy is best for a condition of this nature. Once they're wheelchair or bed bound, that's IT......they'll never walk again. I pay lots of extra $$$ at the ALF to have the PTs come and work with her about 3x a week. She hates it, of course, but it keeps her mobile. Like CWillie said, once she becomes bed bound or wheelchair bound entirely, you will NOT be able to care for her at home & she'll have to be placed in a skilled nursing facility or an ALF that's willing to take her (not all are willing to take wheelchair bound residents); it's their prerogative.

Perhaps you can help your mom by restricting her carbohydrate & calorie intake, since she's not very mobile & probably can't get her own food....? If that's the case, she can lose weight & thereby help herself with these conditions.

Best of luck; you're on a rough road, my friend.

DW at times will remove her protective underwear and then everything gets wet. I remove what I can and immediately rinse them off in the bath tub and hang them up to dry before I wash, unless and most of the time I need to strip the bed shets. In that case I wash them immediately so I can remake the bed. Protective cover for the bed needs to be done first in my case. Clothing, rinsed and hug to dry can wait.
Carpet needs to be clean, by hand, real quick witha wet&dry vac and cleaned with a spray carpet cleaner, then covered with an old towel to soak up what the vac missed.

Hi, I will look into a breathable waterproof mattress - that sounds like a good idea. She has a commode chair - and we may need to get that back out for nighttime use - but ( not to complain but complain I will ) emptying it is the pits - even with the expensive drawstring bags. I guess for now as she can dispose of her depends on her own that makes it easier for me. Thanks for the mattress tip !!

I purchased an allergy, waterproof, bed bug proof, dust proof mattress cover that zips over the entire mattress, then I used an elastic waterproof mattress cover, the sheet, the washable pads and then on top of those the disposable pads. I know this was overkill but the disposable pads would wrinkle up with movement at times. Sometimes I got lucky and didn’t have to strip the bed but if I did I just wiped the waterproof sheet down with Clorox wipes and let it dry and then was able to remake the bed.

Willnotorcannot,
We also had a mattress cover and then on top of it we purchased a dollar store tablecloth (lightweight plastic). We would keep that dry and then dispose every so often. Then we made the bed with fitted sheet and multiple waterproof bed pads.
One thing you may be able to do is one hour before bedtime, stop her drinking? Be very careful that she does not get dehydrated (be sure she drinks plenty of fluids before that) and also, let her toilet well right before bedtime. Maybe that would help, but at any rate if she is sleeping on that schedule, chances are that she will be wet. My mom slept from 7 pm to 6 am in the morning- and awoke always soaked. Sometimes her pillow too!
We did do the drinking before bedtime and toileting and it did help some but when they sleep long like that, it happens. Her sleep is most important, too. Just be diligent to keep mom clean and dry!
Thank you for your hard work! You are a blessing to your mom!!!

It sounds like you need a caregiver more than once a week. Have you thought of AL or NH?

I use the dollar store tablecloth(s) too; they are useful to cover the carpet (plenty of duct tape), and the bed! I have a plastic floor protector (like you see in office settings under the chair) in heavily used areas (under the bedside camode). I have the waterproof mattress cover and I put disposable chux only on top of it. On top of the washable pad, I put two thick bath towels. The washable pad and towels get soaked thru every night so in the morning I put on my rubber gloves and wash those. I usually do not have to strip down the bed, just the towels and the pad. I live with my mom and do not work so this may not be possible for you. It’s a lot of work but so is a fall.

My dad has incontinence following a prostectomy 3 years ago. What he’s found works best for him are depends briefs with an Always overnight pantyline tucked inside. He says the pantyliner draws away the moisture keeping him dry and unirritated, and when he has accidents, it works to help catch the majority of the liquid so things don’t get messy.

My Mom is completely incontinent. She wears diapers with a pad liner at night, believe it or not we like the CVS drug store overnight super plus over the name brands. Try it! Her diaper is full every morning but the bed is dry!

Have her go to bathroom every 2-3 hours during day. Helps keep bladder empty. Change wet gerri pads immediately and keep chucks handy. My Mom is totally incontinent so is in pull ups plus pad. I use 3 gerri pads overlapping on the mattress to keep bed dry. Be sure to clean her daily to prevent UTIs or yeast infections. Also make sure you use a plastic mattress cover to protect it. Check with Social Services to get in more help. If she qualifies for Medicaid you should be able to get help, otherwise you may need to bring in a caregiver for a couple hrs in the morning. Sometimes the church will help with costs. Check out caregiver.com too. GOOD LUCK!

I am the caregiver for my mother in law, age 92, who has ALZ and lives with us. She has very little bladder control has severe nueropathy in feet and calves and diabetic. She can walk and uses a cane. She uses the disposable underpants and pads. When she started loosing all her urine when she would stand up it was a flood. I changed her fluid intake from having a large glass of drink with her evening meal to a small glass. He has a bottle of water next to her at her easy chair and only take a sip now and then. She has her big glass of drink in the middle if the day and a couple of cups in the mornings. Also any significant sudden changes in bathroom habits indicate a UTI. She can't explain any symptoms so I need to be somewhat of a detective but this is what I have found out about her. Everyone's is different tho so keep trying things. Also we removed all the carpets so floors are easy to clean.

My mom has had incontinence issues for years, kept putting off surgery but has now reached the point where it doesn't make sense anymore as well as the point where it's worse. She just doesn't get enough sensation for the need to pee to wake her up or even know a fair amount of the time when she's awake.

She has the pads for the bed as well and a waterproof barrier/ mattress pad on the mattress as well. When she was sleeping on a bed (long story) we had the mattress plastic encasement, mattress pad, incontinence pad, sheet, incontinence pad, sheet incontinence pad down every time we made the bed. That way when she wet it we could often just pull off the top layer (pad and bottom sheet) and still have a dry set already on the bed so we didn't have to make it every night. She wears Depends, yes they have simply worked best for her, all the time and we have now discovered the nighttime Depends, which when she remembers to put them on before going to sleep keep her dry through the night and the bed/couch dry in the morning! Fantastic believe me! They are more expensive so she uses the regular ones during the day, I get them at Costco when they go on sale a couple cases at a time and have now found the nighttime to be cheapest from Amazon so I have them on automatic delivery for her. Again it takes her remembering to put the right one on at night for it all to work but she is fairly good at that because waking up to a wet bed and having to wash everything is miserable.

The other issue of course is UTI when they wear incontinence undergarments all the time so even though she worries about the expense we minimize that so much and help it by buying in bulk so she doesn't try to save money by leaving them on too long. We are fortunate so far though that she doesn't have regular issues with defecating in the undergarments, she seems to get and pay attention to that urge most of the time, since we added fiber pills to her regiment so she isn't bound up that is.

I found these great small plastic garbage bags that have a light lemon scent (other scents as well) and got her a small metal garbage can with an auto close top (step on foot thing) for the bathroom and she puts the used Depends in there and ties it up each day or two to put in trash can outside so the smell isn't bad in the bathroom and when she does wet her bedding she has some powdered Oxyclean that she can either put in the washer and pre-soak everything with that and a little white vinegar (neutralizes the smell) or she can pre-soak in a big wash bin or bucket. Your medium trash can would work just fine, the sooner you get it soaking at least the better and you don't need to bleach everything then. I also gave her a spray bottle of white vinegar and water 1/2 & 1/2 to clean the waterproof barrier when she gets through to that to take away the smell and disinfect. She has a shower curtain down over the couch and then a sleeping bag on top of that and then bedding or not because she prefers sleeping on the couch or just falls asleep there and that makes clean up when she wets stuff a bigger drag especially with the sleeping bag but so be it and the shower curtain at least protects the futon mattress/couch. The spray vinegar/water cleans the shower curtain when this happens well.

Good luck and remember while this is a PIA and often embarrassing for us it's 10 times worse for them, god I hope this doesn't happen to me! But I try to look at this experience as a method of learning what to do do in case it does, the things she does or doesn't do that make it harder I will know not to do if it happens to me!

They double up on Depends during my Dad's incontinence cycles so they can pull off the wet one without having to change his pants. In addition to the pee pad, we also have a child-proof mattress cover that can be washed. I switched out Dad's pants to elastic waist to make it easier for him and the aids to get him to the toilet on time and they now know his general schedule so can be proactive asking him if he needs to go.

Your Mother has an idiot for a doctor.

Look into in-home-care for help....NOT THE STATE, NEVER THE STATE OR REVERSE MORTGAGE!! You will be required to pay down all her savings BEFORE their assistance kicks in and then you will be given a bill once Mom leaves for greener pastures.

In-home-care has MANY services they provide if you can afford. You may need to become Mom's guardian/conservator as it sounds like Mom cannot legally sign for you to become POA. You can also get "EMERGENCY" guardianship and Conservatorship.

It is SO IMPORTANT THAT MOM IS "CLEAN" AND DRY" IN HER NETHER REGION!

Her doctor should know that if she isn't she can get an infection all of us women have suffered from at least once in our lives. BUT SHE CAN GET ONE THAT CAN ACTUALLY KILL HER!!! IF SHE HAS DIABETES IT IS EVEN MORE IMPORTANT THAT THE NETHER REGION(S) ARE CLEAN/DRY!!

Sonce Mom sleeps so long, doctor should have her on meds that will help her better with her day/night issues.

GET HER TO ANOTHER DOCTOR. ONE WHO SPECIALIZES IN SENIOR CARE!

My Mom is in assisted living now and the owner has 3 of these facilities, BUT HE ALSO HAS A CONTRACT WITH A SPECIALIST WHO EXAMS EACH RESIDENT EVERY MONTH AND HIS STAFF IS ON CALL SHOULD SOMETHING HAPPEN.

I have a patient portal to asked any question(s) once I am given the panels. I can also just give my opinion about the meds (daughter is my interpreter as she's an RN) and he will call me without charge!

DANG!! No one should ACCEPT this condition EVER.

Research Mom's medical benefits if she has any from her former employer, Medicare/Medicaid.

Research in-home-care. You should be able to get at least 32 hrs a week from Medicare and then the difference from in-home-care. Many in-home-care companies will do the billing to Medicare for you. JUST MAKE SURE THEY ARE BBB AND HAVE A GREAT STATE RATING TOO.

You can get a list from AgingCare to start. Do your homework.

Try calling a good local medical supply store and ask them about their incontinence products. They probably have incontinence products that are better - more absorbent and better fitting - than Walmart products (even Depends). They may have a specialist on staff who can recommend good solutions for the bed issue as well. They may even deliver!

Secondly, certain physical therapists specialize in "pelvic floor dysfunction" - the muscles that support the bottom of the pelvis, including the muscles that assist with continence. There are therapies to strengthen those muscles and hopefully regain control. I couldn't say what the possibilities might be for your mother, but it would be worthwhile to get evaluated. Start by asking her primary care doctor if they know anyone. It may take some digging to find one.

Hope this helps!

I agree with dkentz72! You need to get her to a Geriatric Urologist, or just a better doctor! UTIs are so dangerous, and cause problems in old adults that young people don't realize. Falls, weakness, ...so many they always test for it in ER!

Realize that she may not feel the urge to go until her bladder is very full. Also anything that spikes blood sugar will increase her urine volume! Steroids can be a major cause!

First let's talk days! In grad school my Professor was part of a study at a NH where grad students simply offered to assist people to the bathroom every 20 minutes. They did Not Ask, " Do you need/want to go to the bathroom now?"
They asked, " Would you like me to assist you/ go with you/ bring you..to the bathroom?" Doing this, I this manner consistently decreased incontinence by 80%!
This less intrusive question, and it's frequency & routine let them to say yes before as well as when they felt an urgent need! 80% improvement!!!

I sleep the same hours as your mom. But my service dog wakes me when she needs to go out, and sure enough my bladder is full. No one likes being woken from a deep sleep. A baby monitor will allow night help to see if she is restless, and choose a time to wake her for a quick bathroom trip. A cammode at bedside is very helpful here. One of those large entry way rubber backed rugs or puzzel like pads of 1/4 inch rubber foam..for kids or workout areas can be set under it for stability, then moved in the daytime.

Yes, you need well trained help at home. Staff that will add this routine to their schedule of duties, and develop a rapport with your LO.

Also there is a medication, DPPA???, that is often given to incontinence children to keep them dry at school. You should discuss using this at night only with your new doctor. Even a good Promt Care doctor may be able to get you started on a plan until you can change primary care Doctor's.

Then institute the every 20 minute offer to assist plan and stick to it!

most UTIs are caused by stooling in the diaper. if they are bed ridden, don't use diapers but a disposable chux, but if they are still ambulatory you will have to establish a bowel program to minimize "accidents". If they go put them in the shower and do a good cleaning of their privates before it sets in. I would say incontinent bowels are 99% of the stress of caregivers. Do note frequent administration of antibiotics will render them useless and superbug infections easily set in. Antibiotics are not without risk.. but UTIs can cause blood infections too. just do the best you can and keep them *clean*.

Do you have a waterproof matress protector? Id get a couple of those to change out along with the chux. Get ones that are breathable and comfortable. I got one that had too much plastic and it was too hot.
I dont know why your doc thinks this problem isnt that bad???? Huh??? It IS. Time for new doc.

One reason she may be incontinent is that her hormones have diminished. You could try over the counter progesterone cream. 1/4tsp 2x a day. Otc. Check with new doc. That saves menopausal women from serious bathroom emergencies. Its a hormone deficiency. Thats why you hold your urine when younger. Then have problems when older. Not necessarily poor muscles, altho that contributes as well. That stuff is a life saver. Wink wink. And no stupid script and compounding pharmacy and triple the price. Its ridiculous. Sells on amazon. Local pharmacies dont sell that.

I agree with the comode idea. Coffee can also trigger the bladder muscles to contact and accidents occur. If shes flooding the bed, it means not enuff trips to bathroom. Every 20mins is very excessive. Easy for students to do that. There there for a few hrs tops. Not for caretakers. Altho very good for research and papers. How about every 45 to an hour? If shes doing good, then keep moving the time upevery 10-15 mins. You will find the sweet spot BEFORE she goes. Ok I gave her fluids, 1 hour and 15 mins later its time. Its called a bladder schedule. Stop fluids in the eve 3 hrs b4 bed. Can give 1st thing in am.
Can she get up using a walker? Maybe that will help her get up to the commode? Altho I dont know her, it could be dangerous. You would know that answer.
I agree with the other poster about going to the urologist too. Should check out for uti's and also diabetes. If shes drinking a lot to urinate a lot she could have issues with her sugars. Thirst and going a lot could be signs. A doc can check that for you. I dont like your docscanswers that you have to wait till its bad. It is bad. He/she isnt the one doing all the stripping down.
You could call axwalmart pharmacy and ask what products are good for heavy urination. There might be some new product out there.
Maybe she should wear just a big tshirt to bed, so no stripping off nightgowns as well as the brief and bed, but she is still warm. Good luck.

I would suggest putting her in diapers that are strong enough to hold urine and or poop. I had the same issue with my parents as their health decreased. I started with just the pads on the bed. than I went to a waterproof sheet cover, that helped a lot. I I put the pads under the sheet and than also over the waterproof sheet cover. that gave them double the protection. that helped a lot. after a period of time it got to where they couldn't walk anymore so I put them both into diapers. that helped a great deal. once in a while the bed got wet but not to much. the hardest part for me was caring for the two of them at the same time. It never failed if mom screamed to me that she pooped her pants that dad would scream two minutes later that he did the same. it was tough but I did it .
good luck.....

My wife uses Prevail Per-Fit 360 at night. This what the rehab center was using before we were able to move to Assisted Living. Very seldom do we have a wet bed at night. You can get them on Amazon. During the day they use a pull up brief Tena Plus which seem to work very well. I haven't had to buy any of the Tena as they are using up a supply that they had for a former resident. I have seen Tena at Wally World so might be avail there or most likely also Amazon. She does take meds for the problem too. And they check her once or twice a night too. Still doesn't stop UTIs which we are fighting now.

And, yes, we just pads on the bed and the recliner.

My mom uses diapers and double ups on tena pads at night- does it stop UTI's - no. Mom doesn't get up to go to bathroom at night and usually can't make it to bathroom on time.
She is in the hospital right now, and they no longer use diapers, just a bed "potty" pad 2 of them and another one under her up around her private area. When she goes, the NA's just change the one "potty Pad" . My mom is going "commando" , since she is bed ridden. The hospital state better for the "air" to get in there and the pad absorbs all the moisture.
The other item the hospital uses now on my mom, since she isn't getting up is an device the call an "outside" cath- It is not an internal cath at all. This "outside cath" has suction tube going into a container for the urine. Every time she goes the urine is funneled up to the container. Not sure if someone could be hooked up to one of these medical devices for lifetime or not and probably only available for hospital usage, but my mom likes it cause it does all the work for her and not that invasive.. - P.S. my mom is lazy !

My husband(89yr), had prostate reduction surgery several years ago, and the result was incontinence. We gradually went from liners to diapers, then diapers with pads. His morning care is tedious! I wake him and make him get in the shower, once he is in the shower I remind him to use soap. While he stands under the warm water I take the sheets, blanket, waterproof cover and wet chuck pads off and put everything in the washer, I then wipe down the plastic mattress cover with Clorox wipes. I then have him get out of the shower and dry himself while I make the bed and take out the diaper pail trash (I put little damp rid packets under the trash liner). He then puts on a clean/dry diaper. He does go to the bathroom throughout the day, but I still make him put on a fresh diaper before dinner and before bed. His room does sometimes stink, but I just close the door, open the windows and put the fan on high.