What can I do?

ImMaggieMae

My DH is somewhere around stage 6 and we’re dealing with a repetitive behavior which I can’t seem to break. He goes through hours long periods at different times of the day where he constantly gets up to pee. Usually he just goes through the motions and doesn’t go. This happens every 2 to 5 minutes. He’s has other repetitive behaviors in the past, most resolved with a twice daily dose of Risperidone, but doesn’t seem to affect this one.  I’ve limited his water to 8 to 10 glasses for a while, but that made little difference. He usually tells me when he’s going to use the bathroom and I’ve even gone in there with him, but reminding him 5 minutes later that he really didn’t have to go does little good, because he doesn’t remember. Distraction works for short periods of time, but this goes on for hours and I run out of entertainment for him. He can no longer read, which is something he used to do a lot of. He no longer knows how to use his iPad or phone. 

He wears Depends but usually only has accidents at night. I hate to discourage trips to the bathroom, but this behavior for 5 or 6 hours per day or more is driving me crazy and sadly makes me lose my patience. I am with him 24/7. Has anyone else gone through this? Any ideas about how to deal with it?

Ed1937

Frequent urination is a sign of a UTI. It might be worth having him checked for that. If you have him checked, please ask for a culture. If there is an infection, that will tell them which antibiotic to use for the particular strain of infection.

ImMaggieMae

Ed, already checked and ruled out UTI.

M1

Maggie, an enlarged prostate can cause a sensation of urgency even if he's not urinating. Flomax (tamsulosin) is a pretty benign drug, dosed usually 0.4 mg twice a day. Ask his doc for a trial, you'd know in a week if it helped.

ImMaggieMae

M1, he already takes another prostate medication that he’s taken for a while. This seems more like a compulsive behavior. He has probably been in and out of the bathroom over 100 times today. Sometimes he’s only in there for seconds, long enough to flush the toilet. It’s become a “thing” like repeatedly brushing his teeth was several months ago. Sometimes playing music and singing with him helps for a while or taking him out for a drive (45 minutes in the car isn’t a problem) but as soon as the activity is over, he’s right back to the bathroom thing again. I don’t mind being around 24/7 keeping an eye on him, but I have to find ways for him to entertain himself. He can no longer read the paper or a book.

NylaBlue

MaggieMae, I share your exasperation, my husband has the similar behaviors; not quite as intense in a short period, but averaging 20 - 30 trips to the bathroom in a 24 hour period, over half unproductive. Often he just stands over the bowl, spitting and throwing in toilet paper. Last year his urologist said we were welcome to schedule an annual update visit but there is nothing he can really do for DH as his overactive bladder doesn’t have a discernible physical cause. It’s just another of his dementia driven obsessions {that last sentence is my diagnosis}.

Marta

If this is compulsive behavior driven by anxiety, perhaps the risperidone dose can be increased.

ImMaggieMae

Had another Urine test yesterday, just in case. No UTI. Doctor won’t increase Risperidone. Things feel like they’re spinning out of control here. No violence, just constant talking, arguing,running to the bathroom, trying to drink more water than he should have so having to patrol that. Arguing does no good of course because his short term memory is only minutes I don’t know where to turn. I feel like I’m losing it.

jmlarue

Has your DH had a blood glucose test to check for high blood sugar? This could certainly cause the desire to drink more water than usual and also the need for frequent urination. High blood sugar is a possible known side effect of Risperidone even in individuals not previously diagnosed as diabetic.

harshedbuzz

IMM-

This sounds really difficult for the both of you. 

In addition to having his blood sugar checked, I wonder if it's time to see a geriatric psychiatrist to oversee his psychoactive medications. They are the specialists for this kind of thing. 

It might be time to bump up the antipsychotic or trial something different instead or in addition to see if it helps with this behavior which has a real anxiety feel to it. 

If you're on duty 24/7, it may make sense to either bring in an aide to get you a reliable break a few times a week or consider a day program.

HB

JDancer

I'm sorry you have this situation, it sounds difficult. I think you should be certain there isn't a physical problem. Urine retention is very common in the elderly, especially men. You mentioned he is taking a prostate med, has he been checked for urinary retention? A simple, non invasive ultrasound, called a bladder scanner, can tell you if he 's retaining urine. If the bladder is full, the urge to urinate is constant. Full bladders can also cause the constant leak of urine, "overflow" incontinence.

ImMaggieMae

Thank you for all of the suggestions. He has had bloodwork done in the last week and glucose isn’t a problem and his bladder was scanned and not retaining. I really believe it is just another compulsive repetitive behavior, just like the requests for lots of water. harshedbuzz, I have asked about adding some type of medication but his geriatric gp is hesitant to do that. He is taking .5mg of Risperidone in the morning and at night and also takes Namenda twice a day.

 It was slightly better today. It’s hard to refrain from yelling at him sometimes which clearly doesn’t help. How do the rest of you handle this type of behavior?

jmlarue

I learned to walk away and let him rant out of view and earshot. It's too easy for me to just lose it and try to defend myself against accusations of being a liar or gaslighting or worse. I found separating myself from him ( to another part of the house or out in the yard) for 10 minutes or more will stymie his rage. It may take as much as a half hour for him to forget what he was mad about and, of course, he never remembers the vile things he said. After some quiet time, he'll ask me if I'm mad at him. The big fib is, "Nope. I'm not mad. I just needed to take care of something." As far as the repetitive behavior, I just let him have at it for awhile and then try to distract him with something that takes us out of the house - even if it's just a trip to the grocery store.

JDancer

I think you did the right thing by exploring possible medical issues, sorry you didn't find an answer.

You asked how others handle this type of behavior. Frankly, I don't handle it well at all. I get so tired of the repetition. I get frustrated by the lack of control (that I have over his actions). And it makes me sad because I think it must be terrible for him, also.

NylaBlue

I handle the behavior by trying to accept it and limit the associated damage because I can’t prevent it. As advice goes this is p-ss poor (pun intended) but it’s all I have. I’m so sorry you have to deal with this.