Wondering how to better help my Dad who is in moderate cognitive decline, lives alone and is having urinary incontinence. (I have cameras in the apartment, visit a few times a week, and have 2 church volunteers who visit at dinner time Mon- Fri for medication reminder and chit chat for a half hour)
He is under the care of a urologist who is treating him with a long term antibiotic for a bladder infection for a few months now. Dad also has had prostate cancer and has some damage from the radiation.
Dad has been wearing Depends for over a year now but these last 4-5 months he’s not noticing that they are wet. He will make several trips to the bathroom at night and at least 4-5 during the day. I have two reminder notes in the bathroom stating to ‘check your underwear and if wet change them” and even lay out a couple new Depends near the toilet in plain view. I’ll ask him if he feels wet and a-lot of the time he’ll say no when he really is ( I can see that his pants are wet) or he tells me he’s wet but lets the Depends become over saturated to the point they leak. I have pads/chucks on his bed and his usual chair but instead of changing the depends and pad he’ll move to another chair or sleep on the couch.
Aside from adding a pad in his Depends for more absorbency, Any advice on how to help him realize he needs to change? With dementia is there a way to make the reminder notes stand out? My hubby feels he needs assisted living but I feel like he’ll have the same problem there.
He now requires more help and should no longer be living by himself. And he's probably past qualifying for assisted living, but more than likely should go right into a memory care facility.
It's time that everyone faces the sad truth that your dad is declining and now needs full-time help, whether in-home or in a memory care facility.
As your Dad's cognition worsens you seem to think he still may be able to "learn" to adapt to things if you only worked hard enough on a solution, but learning is no longer possible for him. He now needs either full-time in-home aids or a facility. My MIL is in an excellent facility where she gets all the care and attention she needs, and has lots of opportunities for social interaction.
As an elder in my church, I can tell you that it's awesome they are helping you but it won't last forever. Volunteers are fickle and not really trained to deal with people with dementia. Your Dad needs to be around people who understand his dementia.
I learned a lot about dementia from watching Teepa Snow videos on YouTube. I highly recommend them to you so that you can also understand how dementia is changing your Dad and what proper expectations for him are going forward.
He needs help with his incontinence care . My father in law did the same , first he wasn’t changing it often enough because it was too hard to get his sneakers on and off himself and he refused to wear slippers . Then as dementia progressed he would say he’s not wet when he was.
This amount of not recognizing he’s wet means his dementia is too far along to be living alone. He needs 24/7 supervision .
He may not know how to respond in an emergency such as a fire .
AL/ MC is definitely in his future, but am trying to keep him in his home of over 70 years as long as I can.
The only thing to prolong prolonged wetness may be literally more hands on checks of him by someone....
Regarding this, from my experience..
When my LO spent time in care temporarily (after a hospital stay or something) the staff assisted to the toilet on schedule. LO kept much drier overall & changed once overnight. Skin excoriation reported on admission cleared up.
But as a quality of life issue, for a younger person with disability, returning home alone (with risk) was the choice they made in preference to aged care living.
** Is this neglectful? **
** Or respectful of choices? **
I had had incontinence issues that lasted months after childbirth. I found it embarressing & distressing at times (in public) but could self-manage. Based on that experience, I would personally move myself into supported living to be assisted to be clean, dry & smelling nice rather than stay in home home lacking hygiene.
I hope raising this topic has helped in some way see more angles.
At the least, someone needs to remind your dad to do it or even help him do it.
I have heard about reminder notes working for some for a period of time. They never worked with my dad. He wrote himself dozens of notes per day and as far as I could tell, never acted on them either.
The big question is. when does possible turn into not possible.
Incontinence is that line for many.
But, IF there are no other issues, IF Dad is still SAFE living alone.. it is only the incontinence issue - what can be done?
If Dad cannot manage to check & change underwear as required - then he can't. No use being stuck in futile hope or in denial.
Let's problem solve instead.
Problem: Dad cannot manage his continence.
Situation: Dad stays as he is until the next caregiver visit.
Solutions:
Obtaining good products that wick away moisture (as you already are).
? More caregiver pop in visits.
Eg 1 x am + 1 x pm
Have realist expectations on the help he already has.
Cameras cannot assist here until there is a person watching that is ON CALL to attend.
Continence matters are beyond the scope of Church volunteers.
You, as caretaker now for Dad must decided if staying soiled between caregiver visits is acceptable or not. Yes there is risk of skin breakdown, but it can be done.
I may have an unpopular opinion here on this but I have a LO living with disability with this situation. Caregivers morning & night. It is how it is inbetween & overnight.
Been going on for years now. Many living as quadriplegia would be similar. The difference is some conditions are stable.
Is your Father's condition stable? Or progressive?
I say moderate decline as this is the term the drs use.
In the Dr mini assessment …He still draws the clock and time with no problem, but doesn’t remember the three words.
There are times he does change his depends on his own … he does go to the bathroom multiple times during the day and night … but then there are times he just doesn’t respond to the fact that his depends are saturated and needs to change. It’s just so strange that at times he does change and then there are times he doesn’t….guessing this is just part of the progression.