LynRomesberg55 Asked October 2019

Is a bladder pacemaker a good idea for someone that is in the later stages of Alzheimer's dementia?

My Momma who is 89 yrs old and has Alzheimer's Dementia and is plagued with constant UTI's for years and who was taking PTNS (shock treatments once a month to her bladder to help prevent UTI's) Her new caregivers and her urologist is pushing for my Momma to have a surgical procedure done called a Insterstim Bladder Pacemaker put into her low back. The main device is located under her skin, but there are leads coming out of her skin connected to a battery pack that she would put in her pocket. It's supposed to provide little shocks to her bladder on it's own and would last 5 yrs.
I say that this is a bad idea, especially since Momma is in the later stages of her Alzheimer's Dementia and she is plagued with constant itchy skin. My fear is she would forget what those leads were for and pull them out potentially causing infection and other problems.
I need some advice on this matter and if any of you have any websites I could look at about Alzheimer's and Bladder Pacemakers being a bad idea, I'd greatly appreciate it. Thank you all in advance.

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I would not do it! If mom is itchy, her brain will look for a cause to explain the itch and the lump or leads or whatever will become her focus. I see no good reason to allow a person with late dementia to suffer a surgery which might push back their mental capacity from the anesthesia.

Helpful Answer (12)

I took care of my stepmother (and dad now too) who had dementia . She had constant UTIs. Found out she was wiping FORWARD when she pooped! Sooooo, guess where the poop was going? Yep. That was the cause of her UTI's.
Couldn't get her to stop wiping wrong and she was on Hospice for terminal cancer as well. Their solution was a permanent catheter. She was on meds, antibiotics and cranberry pills and something that made her pee orange to relieve the burning sensation she felt, until she passed. Thank God for the catheter. She had to dribble every 15-20 min....ALL NIGHT LONG! For 3 months I never got decent sleep because I had to carry her to the bathroom in a wheelchair. I had to explain to her OVER AND OVER AND OVER about the catheter. But it was better than going to the bathroom every 20 min. I wouldn't even think of placing something with external wires to a battery in an ALZ patient!

Helpful Answer (11)

No one understands how dreadful it is to have your sleep disrupted unless you have lived through it...it's all hard enough to deal with the daily issues, but to do it without sleep....

(13)

I would not- my husband is in late stage and I will not take extraordinary measures. In my mind, nature has a plan and I will trust it since I don’t see the benefit of prolonging this horrible disease with interventions.

Helpful Answer (11)

Mother Nature is a b##ch.

(1)

I have a friend that had one implanted, albeit years ago (and technology may have improved) who has had dreadful problems with hers. It is now removed, but the leads cannot be, nor can the leads, which implant themselves, be moved; she has had problems with it ongoing, and cannot comfortable even sit for any length of time. I am surprised this would be suggested and it is sounding awfully "follow the money to me". I could be wrong, of course.
Has she tried a daily capsule of the supplement D-Mannose? It has been magic for me. Was getting >4 infections a year, and none now for more than a decade. Recommended to 2 friends; worked for them as well. I am retired RN who doesn't even BELIEVE in vitamins or supplements, but I do believe in this. Powder or capsules. I use Source Natural from Amazon, about 30.00 for 120 capsules. Worth a try. Powder easier to swallow and tasteless. Works like cranberry, keeping bacteria from adhereing to bladder wall, but works better and without the acid.

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This sounds like a nightmare situation. I would try any and all other treatments before that. I couldn't imagine trying to tell someone with dementia not to touch wires that were coming out of her skin. My mother couldn't keep a band aid on her toe for the night.

Helpful Answer (10)

I vote with "bad idea" especially for someone with any form of dementia.

Helpful Answer (10)

I'm the caregiver for a dementia patient, who just had a procedure that involved both catheters and IVs. She constantly pulled them both out, and the nurses kept trying to explain to her that she shouldn't do it. But they didn't have much experience with dementia patients, and had trouble understanding that they couldn't reason with her. Finally, we hired someone to sit with her 24/7 to intervene every time she started to pull at a tube. Bottom line: Unless the urologist has A LOT of experience working with dementia patients, and can explain why he is confident your mother won't pull out this catheter (and why it will significantly improve her quality of life), I would really hesitate to put her through this.

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This doctor has no idea how a Dementia person is if he is suggesting something like this for an 89 yr old woman who suffers from it. My Mom was 89 when she passed and in her final stage. There is no way this procedure can be explained to Mom and to have something she could play with. No, not a good idea.

I guess u have tried everything. When my Mom had her last UTI, she was given a probiotic and cranberry tablet daily. Both continued when she went back to the LTC. She died a year later but never had another UTI. I like Alva's idea. My Moms LTC kept her clean better than the AL she was in. Grandma's ideas are good too.

Helpful Answer (9)

She was taking a cranberry pill 500 mg's once daily and a low dose antibiotic called Methetamine Hippurate 1 mg twice a day in addition to taking a refrigerated probiotic called Florajen once a day. Plus she drinks cranberry juice every day as well. She also has urinary incontinence and has to wear Depends. She used to get PTNS treatments once a month and she also gets her E-Ring placed up inside her once every 3 months. Despite all of this, she continues to get UTI's. I am so saddened by all of this.

(2)

THis is my personal opinion, without having read any other responses first. I am with you, for all the reasons you stated, and it infuriates me personally that the MD would even consider this. No, it's not great to be on antibiotics, but I'd guess that is less risky than a surgical procedure that would be rough going to being with either with a block or general anesthesia, and the risk of pulling those leads out.
If you're having trouble deciding and want advice beyond here I'd suggest finding out which is the best regarded hospice service in your area and seeing if your mom doesn't qualify...as well as a group called Curadux which has experts to objective professionals to weigh in on complicated situations. This doesn't seem complicated to me, it just seems like you are using common sense and are right. My gut tells me that the MD involved possibly doesn't have his/her patient's well-being at heart.
Stick with your gut instinct and let us know how it goes....

Helpful Answer (9)

Curious: what is the cause of your mom’s UTI? Maybe the doctor should try to fix the cause rather than the effect. I agree with JoAnn29 that a doctor and a caregiver who know about dementia would not push for the surgery.

Helpful Answer (9)

You hit the nail on the head. Focus on the cause of those constant UTIs, and go from there. There could be a much simpler way to control the recurrent infections. Technology is a wonderful thing, but there are times when it's just not appropriate, and to me, this is one of them.

(7)

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Is a bladder pacemaker a good idea for someone that is in the later stages of Alzheimer's dementia?

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