Mom’s hospice nurse called me today. Mom is beginning to have an issue with double incontinence. I have zero experience in this area.
Hospice will let Mom’s MC know, and will make sure it’s on her chart.
I have emailed the DON and asked about procedures for her facility.
In the meantime, what have your experiences been?
Mom is ambulatory, but I don’t think she can manage to get herself cleaned up after a bowel episode. I don’t think she will ask for help, either. I also imagine that she will give the caregivers a big problem, if they attempt to get her cleaned up.
So, some questions come to mind. How often did your Loved Ones get checked?
How often did your Loved One get changed?
What on earth did you do about getting your loved one to allow the caregivers to help?
I will remove Mom’s regular underwear, so that Mom will hopefully use the pull-ups. She is NOT going to be happy.
This is so very hard. My stomach hurts, just thinking about dealing with this. Big sigh.
And, as always, a big thanks to you all.
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Once her underwear is removed, mom will have no other choice but to use the pull ups. If she's angry or agitated, hospice can handle that too.
Hospice provided my mother with ALL of her lotions, potions, barrier creams, chucks, pads, everything.
When I worked at the memory care AL in 2020, we had a few residents who screamed bloody murder when it was time to get changed. The caregivers changed them and cleaned them up ANYWAY. It's part of the job. The residents have good days and bad days with the behavioral issues AND with the incontinence issues. She'll be fine, your mom. If things get very bad with her agitation, the nurse can increase her Ativan a bit to calm her down. Comfort is the name of the game.
Try not to internalize this too much. Leave the matter in the hands of the MC and the hospice team to handle for you.
Sending you a hug and a prayer for peace
I did a work placement in a Memory Care with a full range of patients. It was a small very caring place with wonderful staff. They knew each resident well & had a range of tactics to try if the first attempt failed. Residents had a wide range of levels, skills & behaviour - from mobile & chatty, withdrawn with angry outbursts, inappropriate behaviour & extremely stiff with Parkinson's. All were changed on regular schedules but also extra checks & as required for bowel. All had intact skin & were kept clean that I saw.
It may not be perfect everyday, but will be ok.
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The caregivers look at ghanging diapers as no more of an event than changing clothes, so it'll be OK. When your mom sees that they aren't making a bid deal of it, she probably won't either.
People have an adverse reaction to using actual diapers on an adult. Sometimes you also need to put a urine pad in the diaper too. Pull-ups are really not for incontinence. They're more of a precaution for a person who still has sense enough to use a bathroom but maybe can't always get there in time.
I had a client who used to get fixated on getting in her diaper. We used to duct tape the diaper so she couldn't get in it. When she needed to be changed, we cut the duct tape off with a pair of round-end bandage scissors.
There are ways to keep urine and crap off of furniture and to also keep incontinent people clean. It just takes more work.
Just pull-ups in her closet.
If you are ok to shop online, search for 'washable incontinence pads" You may have to take them home to bathe them, but they work better than the disposal paper ones with a plastic liner.
Ask hospice if they provide a no rinse skin cleanser for the perineal area, and a barrier cream to protect her skin. Sometimes a memory care has a preferred product, so that can make it easier.
Hopefully the memory care staff and hospice staff can collaborate on this. Won't be perfect, though.
Your mother will be angry. Best that you not try to toilet her or go with her when an aide takes her to the toilet. Go out for a walk, come back in 15-20 min.
Being a witness to her distress will be very upsetting (naturally) but she will adjust to having help with toileting fairly soon.
Take care.
Your mother needs to be in a diaper with adjustable tabs.
Normally a person is supposed to be toileted every two hours. Of course it could be more frequently as needed. Your nose will always let you know when someone needs to be toileted more frequently.
Your mother has no choice but to accept caregiver assistance if she can't do for herself in the bathroom on her own. It's all about the approach.
The aide should tell her that they're going to help her get to the bathroom. They check her diaper and if she's clean they can leave and give her some privacy. Then go in to help wash up if necessary.
Your mother's Memory Care facility no doubt deals with double incontinence routinely. Prayers and hugs sent.
Ohhhhh! I appreciate that detail about the diaper with the pull-tabs! Wowza! I hadn’t even thought of that!
Eeeek. And, I just want to cry. This is all so sad.
Grief, like Alva reminds us. One grief after another.
I know. It is one grief after another, but what can we do? L'chaim (to life). It's one day at a time when you're dealing with addiction and elderly people.
It's trial and error too. I've been in caregiving a long time and I know what works and what doesn't.
I always lined an adult diaper with a trimmed down baby one for the overnights. Baby diapers are paper thin too. They hold a lot and the surface stays dry. One of those lining a diaper and it helps to keep the person dry.