Incontinence question(3)

RobertsBrown

Two accidents so far.

In both cases it was mid day, spouse was up an around and in both cases she was standing up.  Her reaction was confusion followed by extreme distress that 'something went wrong'.  Also in both cases self recrimination was immediate, along the lines of 'I am a horrible person', and 'you are going to hate me'.

The question part is this:  Is this a case of the brain not understanding and interpreting the feeling of a bladder that needs relief, or is the brain not getting the signal at all?

I realize that it's all the same outcome, but part of my new caregiver career is trying to understand the 'why' of things.  Should I have been more insistent that she use the bathroom?  The habit to note the time between bathroom visits is getting pretty imprinted, and I did know that a few hours had passed.  We have had a few arguments about going to the bathroom, and when she is sure she doesn't need it, she gets bristly when I ask. I have to assume that in both cases she genuinely did not know she had to go until it was running down her leg.  That's not good.

Brain not getting it....brain not understanding it....just not sure.

towhee

I am not sure either which one it is either. Sometimes standing up can cause leaking, like a sneeze or cough does. It is a good idea to try to take her to bathroom every 2 hours or so especially after meals. Try asking her to go towards the bathroom for another reason, sometimes just seeing the bathroom will trigger a need to go and you won't have to argue about it.

Ed1937

I'm not sure anyone will be able to answer that question. It really doesn't make too much difference how it happens, the result is the same. My wife has been urine incontinent for some time, and now at times fecal accidents are happening. Sometimes she doesn't even know she had a problem, but I can smell it, and take her to the bathroom for cleanup. 

When her urine incontinence started, I went out and bought her some incontinence underwear without even discussing it with her. I brought them home, and asked her if she would try them. She said she would, and that was very surprising. She wore them the rest of the day, and I immediately took her underwear out of her drawer, and she never saw them again. I'm not saying this will work for you, but I am saying that you will at times be surprised at what they are willing to accept, even if you don't think there's a chance of that happening.

harshedbuzz

RB-

For dad, the onset of incontinence was insidious. Initially, I feel like he had a signal that he needed to urinate but that it didn't come in sufficient time to get to the powder room which was a hike from the living room where he spent his time. At this time, he was more like a toddler who didn't make it- he got the signal but not in time for him to act on it.

As the incontinence became a more regular thing there was a phase where he was kind of surprised to find himself wet. He found this horrifying, especially if anyone but my mom was present. As the disease progressed, he seemed less and less aware of having wet himself and would often claim he hadn't in the face of obvious evidence to the contrary. By this point, I don't think he was getting a warning at times. 

My mom and I disagreed about whether dad was continent or not. For me it was purely for the sake of protecting furniture, reducing laundry and noting disease progression for his neurologist if asked. The transition into this phase really upset my mom (in fairness, I can see where a partner would parse this with different emotion than a child would) and it became a hill upon which she was willing to bleed. As such, she fought my suggestions to protect the mattress (a 6-sided waterproof cover is the best foundation, you can put pads over that) and sofa (pet covers are useful here) as well as switch to Depends which meant a lot more work for her. 

Dad was not an easy-going PWD and suggestions to visit the bathroom where automatically met with refusal and laundry. Sometimes mom had success by wordlessly leading him to the bathroom rather than asking or suggesting.

HB

DrinaJGB

We have dealt with this issue for a dozen years now since viral encephalitis ravaged DH's brain.

  The micturition reflex is interrupted due to damage to areas of the brain which control urination. It is a complex working but includes the cortex and an area called the pons. The brain signals are getting confused. Actually after all of this time DH has better control now than he did the first years after. It is an ongoing struggle.

dayn2nite2

At least for the ladies, this is often a good time to get some sort of pull-up brief on her "just in case of an accident" and she should be getting toileted at least every 2 hours.  Don't announce it's time - just grab her hands and pull her up from where she's sitting and lead her to the bathroom.

There should be underpads on all the furniture and in the bed too.  I never bother to understand the "why" of anything, it doesn't help solve the problem.  Just know that she can't control it, she needs more regular toileting and furniture needs protection.

Cherjer

I know I should start a new thread but I do not know how to do it!!

My DH urinates just fine at night in the toilet, but during the day it can be anywhere. Our caregiver was here yesterday and he decided to pee on the kitchen floor. Then today he got up from a nap and peed in the hallway. Tonight when getting ready for bed I asked him if he had to use the toilet and said he can do it  so I walked away for a second and he peed in the sink. I can deal with most things but this is getting the best of me. He does have depends that look just like underwear and never as an accident in them...I am thinking thinking this is just more progression in the disease. Between my husband and puppy I am going crazy!

loveskitties

Cherjer,

near the top of the page, just to the right of center, is a green box which says Add Post.

Click on it to start a new thread.

Ed1937

Actually you need to be on the forum page where you can see all the names of the threads (for this board it is the "Spouse or Partner Caregiver Forum"). Once there, look for a large green button  "Add Topic". Clicking on this will allow you to start a new thread.

Jo C.

Since this is a newer dynamic, also have her checked for a "silent" urinary tract infection.

Also possibly "urge" incontinence. That can happen to women dementia or no dementia.  Do need to do toileting more often before bladder gets full.

Here is a good link from Mayo Clinic that discusses all of the urinary incontinence causes.

https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808

J.

Cherjer

Thank all of your for the information!

Gig Harbor

Good memory care facilities take them to the bathroom every two hours. It might be worth it to try to do this before incontinence even starts but if you can get her into the routine hopefully she won’t fight you for too long. I would also transition her into depends for when it doesn’t work.