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Recent Reader Question About Dotty And Urinary Incontinence

Posted Apr 15 2010 10:44am

Trust me. Noone wants to pee on themselves. Not even someone suffering from Alzheimer's disease....
By Bob DeMarco
Alzheimer's Reading Room

Just so you know. I don't mind when readers ask me questions via email. I do not find the questions intrusive in any way. I hope the information helps.

Question: Does Dotty wear Diapers?

Dotty does not wear diapers?

Years ago, we were having an enormous problem with Dotty and urinary incontinence. I tried to use diapers, and inserts that went into her panties. Dotty rejected both. She would take them off or out almost immediately.

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I was advised that sooner or later Dotty would adjust. She did not. I could not get Dotty to stay in the diaper or to keep the inserts in her panties.

My solution in those days was to buy 14 pajama sets, and around 24 panties. I just washed away like crazy. Pee pee accidents were frequent and were occurring during the day and over night. The biggest problem was overnight. Big problem.

As I matured as an Alzheimer's caregiver and started to learn more about my mother's patterns of behavior I did come up with a solution to the problem of urinary incontinence.

I make sure Dotty pees every two hours and before she goes to bed. We have an occasional minor accident overnight but it is minor. She is not wetting the bed. Of course she has on pajamas and panties so minor accidents never make it to the bed. I can best describe this part of the solution as -- keeping the tank empty at all times. When I say never make it to the bed, I mean never make it to the bed since I implemented the solution to the problem. Never.

If you are an Alzheimer's caregiver or caring for someone with dementia, you won't be surprised to learn that my mother does not know when she has to pee. When she says, I have to pee, it is too late.

As a result, I remind my mother approximately every two hours that it is time to pee and lead her to the bathroom. In the beginning she would fight me all the way saying she didn't need to go. Now she only fights on rare occasions. It took a while to get her use to going so often.

I want to make this clear. We did have an enormous problem with urinary incontinence and it was driving me crazy. I really didn't know what to do. I asked and the only solutions I heard were get her to wear a diaper and put in the pantie inserts.

Finally, I decided I had to fully understand the problem before I could do something about it. I started writing down what was happening (when the accidents were happening during the day), and soon I saw the pattern of peeing. For some reason this pattern was not apparent to me until I started writing down what was happening.

The solution became obvious to me. Implementation of what I knew needed to be done with Dotty did not happen overnight. It was not easy to implement the solution. Dotty resisted my efforts to get her to pee over and over -- all day long.

She would tell me she just peed, and resist. She would tell me she didn't need to pee, and resist. She would try and take off in the opposite direction, and resist. Often she would get angry.

Finally, we got a pattern established as I described in these articles and the problem was solved.
I should mention that Dotty gets up during the night, gets out of bed and pees. Sometimes she doesn't make it -- causing a minor accident. As a result, I have extra pairs of panties stacked up on the back of the toilet. I also have extra pajama bottoms in the bathroom, and at the foot of her bed -- at all times.

Today is a good example of how well my solution works. No pee pee over night. Nothin. Nada. Nimbus. Zero.

As the result of the implementation of the pee pee solution even if we get a pee accident it is minor. The reason? I make sure that the tank never gets full or even close to full. I can also tell you this, if I let Dotty sit or lay around for three hours there will be a minor accident. If Dotty says, I gotta go, its too late. When this happens I blame myself. Or lets put it this way, I really don't blame anyone. Nobody is perfect.

After you read about how I "beat" urinary incontinence you might conclude that it seems like it is a lot of work to implement this solution. It is not. We just incorporate the "pee" into every move me make. Once you get the pattern established it is just another part of the day. I guess I should mention here -- it is you the caregiver that is implementing the solution. And, it is you the caregiver that is doing the learning.

I can say this with confidence. This solution is easier then doing wash every day, and less stressful then feeling like you are going nuts. The solution is better than living with the problem every day for what seems like forever.

By the way, the issue is not if the Alzheimer's patient knows or remembers that they pee on themselves.

The issue is not if they admit to peeing on themselves.

Peeing on yourself is embarrassing. This falls into the category of understanding how a person suffering from Alzheimer's disease might be feeling when they repeatedly pee on themselves. If they are, in fact, feeling bad about themselves they are never going to tell you in words.

However, the patient most likely does get frustrated and feels bad about themselves. This will translate into bad behavior that is hard to deal with. If the patient feels disconcerted, they will act disconcerted.

You might wonder how I came to this conclusion. When Dotty stopped peeing on herself, and I stopped complaining about it, Dotty's behavior improved. My behavior improved right along with hers. Ca-jing.

How do you react when you are frustrated, embarrassed, or ashamed of yourself. Bad mood? Nasty behavior? Mean spirited? Lash out at others for no good reason?

I think it is best to assume that a person suffering from Alzheimer's disease might be frustrated, saddened, or embarrassed when they pee on themselves. This could explain why they then start expressing mean or difficult to deal with behaviors.

Trust me. No one wants to pee on themselves. Not even someone suffering from Alzheimer's disease. If you are blaming them for doing it, chastising them for doing it, or engaging in any mean spirited behavior when they do it -- shame on you. Change.

If it turns out you are having a rotten day after yelling at someone suffering from Alzheimer's look in the mirror -- you are victimizing yourself.
Bob DeMarco is the editor of the Alzheimer's Reading Room and an Alzheimer's caregiver. Bob has written more than 1,350 articles with more than 9,000 links on the Internet. Bob resides in Delray Beach, FL.

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Original content Bob DeMarco, the Alzheimer's Reading Room
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