how best to cope with continent spouse who needs help 5x per night to pee

blues

Wondering how others have dealt with this situation. My husband is probably around stage 5 (late) or early 6, but not yet incontinent. During the day, he needs to pee every 3-4 hours, and we halt all fluid intake at 6 pm. I don't go to bed til midnight, but I am having to wake and get up to help him about 5 times each night. He has somewhat compromised mobility, so I'm helping him to swing his legs over the edge of the bed and sit, then stand on the floor, and then pee in a urinal, or sometimes we go to the bathroom. He is not wearing any kind of adult 'diapers' because he still knows (and wakes up and communicates) when he needs to void. The problem is that my sleep is now very interrupted (up every hour or two), leaving me exhausted, even if total sleep hours have not changed. I've read that people pee more often at night because lying on one's back makes the kidneys work more better, and also leads to swollen feet "unswelling", which means more liquid to void. I'm guessing this is why his frequency is so much higher at night. Should I put "overnight" diapers on him and urge him to "pee in his pants" when he calls out for help at night? My worry is that if he learns that night time behavior (if he can learn it?), he'll be peeing in his pants in the daytime too, and I'd just as soon hold off on the step of using diapers 24/7 for multiple reasons. Any thoughts?

jgreen

Hi @blues

Welcome. So sorry you had to join us.

Have you spoken with his doctor? I am concerned your DH could have a low grade urinary tract infection (UTI) or perhaps have prostate issues. The frequency both during the day and at night could be a sign of something going on. Does he seem to have a full bladder when he goes, or is it a small amount and he just has the urgency. Is urination painful? Is the pee clear and light colored or is it cloudy or dark in color?These are things the doctor will ask.

Stay in touch and let us know how you both are doing.

blues

Thx for the concern. Just to clarify — he has clear light colored urine (normal), and he does have a somewhat enlarged prostate and takes Flomax (all discussed w his doctor). He does not have pain. His first voids are about a cup, and then the amount declines thereafter. THis has been his pattern for a year or more. What's new in our household is his not being able to get out of bed and go to the bathroom on his own, due to mobility issues associated with his disease. Before, I would lightly wake up, and go right back to sleep… but not so now.

SDianeL

Sadly not much you can do. I don’t think I would put diapers on him because that will come soon enough. Many with dementia get agitated and aggressive when they become incontinent and have to be changed. Have you considered help so you can get more sleep? I would talk to his doctor anyway. Maybe change the timing of his medication? Please keep us posted.

tonyac2

I knows it’s a bit of an expense, but the Purewick external catheter system has been a game changer for us. To have my DH sleep through the night is worth every penny. I noticed him using it while in the hospital and I purchased one for home use. Well worth it in many ways.

trottingalong

My husband uses a urinal at night. He actually rolls on his side and pees into it and then puts it on his nightstand.

RetiredTeacher

My husband gets up many times during the night and goes to the bathroom to urinate. He does have an enlarged prostate but had to stop Flomaxx because it tanked his BP. We have a urinal in the car for outings and he uses it everytime we go anywhere...very useful. His legs are weak and although he is still walking, I wake everytime he gets out of bed because he refuses to use a walker in the house and I want to make sure he gets to the bathroom. I like the idea of using the urinal at night but our urinal just has a snap on cap and I would prefer a screw on one. Does anyone know of a urinal with a screw on cap. I'd be afraid hubby wouldn't close the press on top securely and would knock it off the headboard or worse. His plastic water glass is up there and I would hate to have him get them mixed up!

Chance Rider

I tried to post a link but it didn’t work. I just searched Amazon for screw top plastic urinals and found several.

RetiredTeacher

Ty CR, I will check it out.

ronda b

If he had a bedside comond could he transfer his self to it?

blues

https://alzconnected.org/discussion/comment/262291#Comment_262291

Thx for suggestion, but unfortunately no: he cannot always even sit up in bed on his own, much less swing his legs over the edge and then stand on them. So I am having to get up to help him move, even this small amount.

iowagirl1961

my dh’s urologist recently doubled his flomax dosage because night time urination was becoming a frequent issue - he had trouble voiding enough to not have the urge to get up multiple times to go. The increased dosage has definitely helped and we are both sleeping better.

trottingalong

https://alzconnected.org/discussion/comment/262233#Comment_262233

I ordered my screw on cap urinals for husband on Amazon

JulietteBee

Rather than starting him on a habit of peeing on himself, I would quicker suggest you discuss the difficulties you are having at night with his PCP or a urologist. Ask if one of them could order "Condom Catheters" to be used at night with a leg bag.

You apply it externally, just like a condom, which reduces the risk of infection. The other end of the tubing is connected to a leg bath which is secured on hubby's thighs. He can sleep throughout the night with it on. It is emptied and removed in the morning. Hoping you will ask about it. I know it will be a game changer & will afford you improved sleep. 💤

blues

https://alzconnected.org/discussion/comment/262329#Comment_262329

Thanks for this suggestion. It is like the Purewick exernal catheter suggestion in this thread. I am glad to learn about such options. However, I am also skeptical that my husband would accept these… he is very sensitive about toileting/peeing issues generally, and I can imagine easily that he would try to pull it off? How "able" is your spouse that you were able to make this system work? For example, is he ambulatory? My PCP could help only by having me speak with a nurse-practioner, and she was also concerned that an external catheter would be more suited for someone who is incontinent, rather than just unable to get up from bed to use a urinal on his own?

RetiredTeacher

https://alzconnected.org/discussion/comment/262210#Comment_262210

DH is not there yet but I know it's coming. I have questions about the purewick catheter. I saw it online but wanted to ask someone who has experience with it. It says to shave the public hair so it can stick to the body to minimize leaks. My husband struggles with bandaid sticking to arm and finger hair. Not sure how he'd tolerate the collection bag being stuck to his body. Does it also stick to the scrotum? Can men still sleep on their side and roll over on their back while it is attached? It sounds like a good idea, just concerned about something stuck to his skin knowing how he hates to use bandaid or anything sticking to his body. Ty for any info you can provide on how your DH tolerates it and if there was an adjustment period to get used to wearing it.

tonyac2

https://alzconnected.org/discussion/comment/262485#Comment_262485

I had lots of questions before purchasing. I called customer service many times and they were good and knowledgeable with their answers. Before I made the final purchase, I asked them to send me a sample catheter to see how my DH would tolerate it. You could do the same. I had a learning curve with putting it on but finally worked out the kinks and no longer have issues. If the adhesive gets stuck together or twisted, it’s easy to straighten it out and try again. The bottom adhesive does adhere to the scrotum area. As far as rolling around, that would be a question for customer service. My DH is immobile, so he doesn’t roll around. Before Purewick I had to put him on the lift, change his brief and put him back to bed. We both had rough nights because he was laying with a wet brief on. Not anymore. The catheter collects all the urine throughout the night and we can both rest. The first night he used it, it had 1200 ml of urine in the collection canister. When I saw that I wished I would have purchased it sooner.

harshedbuzz

@blues

Some people address this phase by hiring an overnight aide and sleeping in another room. Your sleep is the critical to his care. Where this isn't possible, a daytime aide or day program can give a caregiver time to nap which isn't as restorative but still helpful.

I'm curious do these external catheter systems actually drain the bladder itself, or do they just collect urine that is intentionally passed or leaked? It seems if it's something that would need to be learned, it might not be different than suggesting he pee into his incontinence briefs.

HB

tonyac2

The system draws the urine away from the body and collects it in a canister connected to the catheter. The part I had to learn was proper application. This took three tries. My DH now sleeps through the night which means I do as well. And his skin is not compromised by lying in wet urine - UTI’s have decreased as well.

sandwichone123

External catheters do wait until the person urinates and collect the urine. The most important differences are that these devices protect the skin from moisture and breakdown and make cleanup much easier, with no rolling and removing soggy, stinky bed linens or clothing from under the person. They also help the house smell more homelike by limiting the urine smells that can become pervasive and make it even more difficult for family and friends to want to visit.