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kelchu Asked November 2017

My mom is obsessed with going to the bathroom. Any advice?

My mother is 79 has various medical conditions including very mild dementia. She is currently on some medications that cause her to have to urinate and have bowel movements more often than normal; however that is not where the problem is....She goes to the bathroom or asked to be taken to the bathroom literally every 10-15 minutes. She has to have assistance getting to the bathroom and often will not wait. On Wednesday a trip to the bathroom, unassisted, caused her to fall and break her leg. While in the hospital she has asked to use the restroom so much that they finally put an external catheter. Well that has become entertainment for her and she "shows off" to visitors by urinating and telling them to watch! She will ask to have a bed pan as well, with company, and try to have a bowel movement with them in the room. If she's not asking to go to the bathroom or using the restroom she telling everyone about it...in detail. I'm over it and get very frustrated and tell her I don't want to hear about. Sometimes I just leave the room. I'm wondering several things: 1) is she using it as way to get attention and have people constantly in her room. 2) is it a way to have physical contact from others and 3) if we should limit how often she goes (within reason of course). She normally likes a lot of attention and this definitely gets people's attention for a sustained period. So frustrated!!

Rainmom Nov 2017
Kelchu- keep in mind that people with dementia can often put on a show - hence the term “show timing” - and keep it together for varying lengths of time - when they need to. Keeping it together for doctor appointments and visiting family members is very common.

As her dementia progresses this will become increasingly difficult to do - but between now and then things will also grow increasingly difficult for you - to understand, tolerate and address the strange behaviors.

Take good documentation on what you’re seeing so you can talk to her neurologist and/or PCP about it. If the PCP doesn’t seem to accept of address what you’re saying - find a new one who specializes in geriatric medicine.

As well - take some time to learn about dementia. If you find yourself right now thinking “yeah, right! I’ll squeeze that in”, know that if you are the one who is going to continue to look after your mothers care - it will be the best time you’ve ever spent - in investing in your own sanity.

Hugemom Nov 2017
I have the feeling that your mom’s actual need to go doesn’ t have much to do with actual need to go. She may be back in her own toilet training days and looking for praise for going. When she insists on putting on a show, whoever is there should make the excuse that she needs her privacy and leave. If she becomes angry with her uncooperative audiences, so be it. Many of the people I’ve seen and talked with at my mom’s NH and my husband’s rehab who were elderly obsessed about the food and their toilet habits.
It’s also been my experience that doctors at facilities don’t interact much with the patients and almost not at all with their families. The only thing the doctor did for my husband in rehab was put him in medication that cost us $1000 a prescription.

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kelchu Nov 2017
Mom has been rotating between the hospital/rehabs since September 5th due to recurring hip dislocation and now the broken leg.  She is on medication (due to CHF and high ammonia levels) that cause her to have use the restroom more than a normal person. I understand the frequency issue and the causes for the amount that she has to use the restroom. What frustrates/concerns me is her feeling the need to "share" her bathroom activities with others. She was diagnosed with "Adult Onset ADHD" by a highly recommended neurologist but all 3 rehab centers have felt there is need for more investigation into her "forgetfulness and confusion" but she has to be out of the hospital/rehab for this to take place. I agree that there is more going on but when I discuss with her PCP and neurologist they blow me off and technically can't treat her while she is in rehab or the hospital.

Sunnygirl1 Nov 2017
I agree about getting her evaluated by a doctor who regularly treats dementia patients. Her symptoms don't sound unusual for someone with dementia, but, I'd keep notes of all you observe, so you can share with the doctor.

My LO had obsessions with other things like her cat. She was constantly calling to the cat, asking that the cat be fed, worrying over the cat, etc. She was so obsessed with the cat that she would just start crying because of her worry over the cat. Her dementia caused other types of obsessive behavior as well. Medication really helped her a lot. She lost the obsessions for the most part.

SueC1957 Nov 2017
Your mom should be evaluated by a geriatric neurologist. Her behavior is not normal and is not consistent with "very mild dementia." Has she been 'diagnosed' with dementia by a doctor or is "very mild dementia" just your observation?

Since a UTI has been ruled out, I would look for other signs of infection in the body. She should also be seen by her regular medical doctor and have a CBC (complete blood count), a Chem Panel (checking for electrolytes) and a Creatinine (kidney function tests). These, at the very least, should be checked.

Was her behavior this "off" at any other time in her life? Does she suffer from a mental illness?

I would make the doctor appointment ASAP and talk to him/her about being evaluated for "staging" (finding out the level or severity of her dementia).

Sometimes medications can make older folks "wacky". Please bring all of her medications with you to the MD appt. and go over them with the doc to see if they could be the cause of her strange behavior.

Does she take medications on her own or does someone give them to her? If she's taking them, I would relieve her of that duty.

It seems your mom is fixated on showing everyone her "ability". If she's not responding to your explanation that her behavior is inappropriate, she will need outside help. Please make the appointments right away.

Also, you said, "Is she using it as a way to get attention and have people constantly in her room?"
Does she ever get OUT of her room? Where does she live? Are their activities for her to do? Maybe it's a desperate cry for attention. Can she socialize with others with the rule that the visiting stops when she starts with her elimination "show".

My mother (94yo/stage 6-7 Alzheimer's) also wants to go to the bathroom frequently. (No UTI) In her case (and confusion) I think it's just something to do because she's anxious. She takes Ativan (Lorazepam) for that. Does your mom take any anti-anxiety medication?
Maybe one would help her calm down.

Good luck

jeannegibbs Nov 2017
Obsession with toileting is not unusual with dementia. I'm so glad not to have experienced it with my mother or my husband, but I know many people in my local caregiver's support group deal with it with their loved ones.

Many, many people who like attention do not attempt to get it by obsessing with toileting. That, I think, is the role dementia is playing. Her filters are gone or going and she no longer recognizes that this is not a socially acceptable topic. Think of a child being toilet-trained and how proud they can be of what they've produced. And how obsessive their parents seem to be about the entire subject! Children "outgrow" that fascination by learning culturally approved filters. Older people with dementia are going in just the opposite direction, losing their ability to filter their conversational topics.

That doesn't make the whole experience any more pleasant for you, of course. I think the best you can do is try to redirect her to other topics and to give her lots of attention on other subjects.

kelchu Nov 2017
She has been tested for UTI and its negative. I understand, to some extent, the frequency due to meds. My frustration is in her obsession with going every 10-15 minutes and wanting to have an audience. She literally gets offended if you don't watch her urinate through the cath or stay while she has a bowel movement. She also seriously doesn't understand why no one wants to know how many bm's she has had that day, how much she went each time, and what her poop looked like.

Rainmom Nov 2017
“very mild dementia”?

The behavior you are describing falls far from the “very mild” definition of dementia.

As you look for answers to this problem you should first start from adjusting this assessment.

Beyond that - has your mother been tested for a UTI?

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