Need help managing restroom use for my mother-in-law who has Alzheimer's.

Hello, i know it has been a while since i posted my original question. Just wanted to add an update. Since this time, it was discovered that my mother in law did have a UTI that was resolved but the bleeding continued and got worse and worse. As the bleeding got worse, the use of the toilet increased as did the toilet paper and again our restroom was clogged and had to be taken apart to resolve the issue. Upon discovering the amount of blood that was being expelled and her increase hyperactivity and not wanting to eat and noticable bruising. She was taken to the ER and it was found that she had a kidney stone and her blood thinner medication had been to high and so she was hospitalized to stabilize her blood and resolve her kidney stone issue. Which thankfully was done over a matter of days.

There could be a number of things happening:
#1 Unknowingly over using of tp.
#2 Fear of using a public restroom (this WAS my mother).
#3 Not really "going."
#4 Loose bowels.

Have you considered a toileting schedule for her? For residents with hollering issues, the staff takes them to the restroom every 2 hours so that they can monitor their behavior. Could her frequency have anything to do with bladder spasms or a low grade infection? How much fluid does she consume? What about a toilet tissue dispenser that controls the amount of tissue dispensed? If she's getting the toilet paper on her own, how about only you two refill the toilet paper thus limiting her access.

When my mother returns from day care, we have two types of afternoon: she either "settles" into her lift chair to read/watch tv/nap or she wants to visit the bathroom every 5-10 minutes and starts wanting to call her brother to resolve a family issue that happened over 40 years ago.

It took me a while to realize this behavior was only happening after day care. Mom likes day care these days and doesn't seem anxious when she returns, she has a bathroom visit before elevating her legs in the lift chair but after 30-45 minutes would start the bathroom break marathon. Sometimes she has even wanted to go back to the bathroom before she can return to her chair! I eventually decided she is becoming a little dehydrated at day care. At home, I keep a cup of coffee or a glass of water or lemonade by her side all the time. At day care, they only offer a drink during lunch or at break time. Mom doesn't like the juice cups the day care offers at breaks so at my request they now offer Mom water. I now make sure to serve (not offer as I did previously) coffee or lemonade (her favorites) with a snack when she returns home. She consumes her snack and often takes a nap.

I am astonished about how small things can have such a big impact on our elders with cognitive issues. There must be something causing your MIL's anxiety but she probably will never be able to tell you.

You may be able to moderate the frequency of bathroom breaks by using an old fashioned sand timer. When I'm cooking or working on the computer and need some less interrupted time, I set a sand timer somewhere Mom can easily see it and turn it whenever I finish helping her "Is there anything you need? No? Then I'm turning the timer because I need a few minutes to respond to an email. If it's not something you need right now, please let the timer run out before you call for me." My mother has cognitive problems and almost no short term memory, but her dementia symptoms are not constant so this may not help with your MIL.

I found out when Mom was in the memory care home she had taken her Polident tablet and pushed it up her bottom. She was a nurse in her working days, so always took care of any problems she had. We forget, decisions a person with Alzheimers makes can be as bad as a young child makes.

Talk with sister to see if this is an issue under her care as well. If so, make sure MIL does not have a UTI - causes feelings of urgency, frequent need to pee, and pain. If that is not the problem, then MIL has a thought "do loop". Her brain fixates on toileting. Try diverting her through conversation and activity away from toileting. Offer her the toilet on a schedule - every 3 or so hours - so her actual toileting needs are met, but she is not using up all your supplies. Please make sure to put disposable undergarments on her in case of accidents.

The Tissue Monster strikes again! When mom first moved into MC, they required us to provide TP. That was not fun - despite getting the big multi-packs from BJs, it was running me ragged! Thankfully they rescinded that.

It is wonderful that you and hubby help your SIL by taking her in on weekends. So many siblings don't step up (or stick their nose in, making trouble WITHOUT helping at all!)

I did like the suggestion Yogamermaid had regarding disabling the toilet (shutting the water off might be easier, but accomplish the same thing.) It might just be that she is in an "unfamiliar" place - even though she is at your home every weekend, it is still an interruption in her "routine" and familiar surroundings. It is one reason we recommend moving to MC and skipping AL, depending on the level of decline, as every move can impact the person negatively.

If she is not in the habit of doing this at SIL's, it likely is the issue OR it could be related to a UTI. I was skeptical of this until we had to deal with it! First time it resulted in severe sun-downing, the second time it was night-time bed wetting. Resolving the UTI stopped both issues. I would request a culture test - the dip test might not catch the issue and the culture test can provide better choice of treatment.

While turning off the water/flusher allows you to monitor better, she could still put too much TP in there every time, which could lead to issues. Is this a spare bathroom? If so, leave only a little TP available, not a roll. Perhaps you could lock the door after she goes in the morning, and take her at appropriate intervals to go - she may get antsy if the door is locked, but you can tell her someone is in there, it is being fixed, or something. Doesn't help much with nighttime though.

I used to take my husband into the handicapped stall and assist if needed. When he had a bowel movement, he used a ton of tp as he wanted to be sure he was clean. Wet wipes helped with that. Good luck.

I'm 67 and I can't remember a time that I didn't have to "tinkle" every 20-30 minutes. I always thank God that I can still tinkle, even going that often.

My DH used to laugh at me - 30 years older and I had to go more often than him. The flipside is I could sleep straight through 10 hours without having to get up at night and he had to go every 2 hours.

Life is definitely a challenge sometimes.

Does this happen at your sister's?
If so how does she deal with it?
If it does not happen it could be anxiety.
When a person with dementia is taken out of their close environment can be very distressing.
You could also go into the bathroom with her.
Place a roll of toilet paper that has a small amount of paper on the holder and you can hand her more if it is necessary. More supervision is often necessary with dementia and this is just another phase/decline. How does she do in the shower? More supervision may be needed there as well.

Is constipation a possibility? With my situation, I discovered my 88 year old ’roommate’ (I’m a live-in caregiver), could not answer correctly if she had gone #2 when asked, simply because she could not remember. Not her fault...just the disease 😢It was not practical to follow her into the bathroom EVERY time, so I disconnected all the toilet handles for approximately one week. I told her they were broken and we were having a plumber come to fix them. This way I could check how often she was going and adjust her stool softener or miralax accordingly until we reached a ‘regular’ schedule and dose. I would manually flush the toilets and eventually re-connected them. I know this sounds a little strange, but I could also see if bowel movements and urine color were within normal limits. Crazy as it sounds, she did catch on a little bit and I had to constantly reassure her the toilets were going to get fixed, but it was definitely easier to verbally repeat that information than to be constantly hovering over her privacy in the bathroom. I have found in my experience (and through advice here), that sometimes repetitive behaviors are a signal that they ‘need’ something. It could be boredom, constipation, UTI, or maybe even the fact that she is not at home that is causing her to act this way.

Have you consulted your sister in law? This may be normal for your MIL or it may not, but you need to know.

If it's unusual for her, and especially if it's recent, it would be worth somebody's checking that all is well "down there."

It may also be that the change of venue makes your MIL anxious about her continence.

Do you accompany her to the bathroom? If you can do so diplomatically (as close to "don't worry about me, pretend I'm not here" as you can get), that would be an opportunity to prompt her through a normal routine. Of course you won't want to intrude on her privacy, but reassuring her may help.

Has she been checked for a bladder infection? That can make patients feel like they need to go frequently.

I'm sorry, sometimes you just have to laugh, but the plumbing bill could make you laugh all the way to the bank! Maybe instead of leaving the full roll, you could portion out several stacks for her to use....although sounds like she will use them all at once. What would happen if she ran out????

Repetetive behavior of all kinds is very common with Alzheimers. When you see her heading for the bathroom for the 10th time in an hour, see if you can distract her with an activity or a snack. And, like Jo Ann said, go in there with her to see exactly what's happening and to monitor what's being flushed down the toilet.

She has ALZ, no rhyme or reason why she does what she does. At this point I would go with her. I doubt if she is cleaning correctly. It may just be she forgets she has gone. The TP would bother me. TG my Mom counted the squares and when she got to 8, she stopped.