Please can someone help us. My husband is incontinent, I have tried everything I can think of to keep him dry at night. I am using two depends, have packed the inside of the depend with guards, everthing I can to keep it from leaking through with no results. I have to strip the bed every morning.
Jane ... I have no experience with this, yet, so there may be better suggestions. But in the lab, we use plastic-backed adsorbent pads to cover the lab bench. When there's a spill, then we can just pick up and discard the pad. Maybe there's something similar you could use to protect the bed on your husband's side.
Jane, I am sorry you are at this stage, it is so much harder when you don't get a good nights rest. Here is what I did, mattress cover that is waterproof, moisture pad X 3 under him at night, diaper type depends at night, that way you can put on 2 at a time, buy the extra large for the outside, seperate blanket folded above his midsection. I would still get up in the night and change the depend and always had a little basin handy with cloths to clean him up a bit. This way I got lucky and just had to launder the blanket and the underpads each day and the rest of the bedding every 3rd or 4th day. Good luck kathy
When my wife started being incontinent at night, in addition to "Depends", I would wake her each time I got up to go to the bathroom (2-3 times per night) and have her do the same. This has worked - no more bedwetting since I started doing that. But maybe women don't get up as often as men do!
Thank each one of you for your response. Marsh I have been doing the getting up also, sometimes he will get up and sometimes he will not. Even when we do get up this still seems to happen. Northstar, I have been doing all the things that you suggested. I guess the thing I am looking for is not as much the bed protection, I have conquered that a long time back, it is just this leaking through to where it is on him and his pajamas. I don't like his clothing or him to be wet. The pads are as you say excellent for protecting the sheets but it does not protect him. Even two depends that I use it seems to still leak through at the leg. I guess this is something that no one can help with. I even called a medical supply house and they say plastic outer underwear but then it will hold the liquid in and it will still be wet on him. there is no way to win this one.
Jane and Northstar, I don't know about adult diapers but baby diapers have something on them that retards bacteria and chaffing so the baby doesn't need changing during the night. I imagine the wet diaper stays body temperature and doesn't make the person cold. That's the way it works with babies. If you could find a diaper or combination that doesn't leak I don't think I'd get up to change the diaper. Am I wrong? We haven't reached that stage yet. Also if your husband urinates that much, I'd talk with the doctor and maybe he could prescribe something like Detrol so you both can get a good night's sleep. But like I said, I haven't been there yet so I probably shouldn't be offering advice.
Bebe, you are correct in not getting up to change them if they wet. The problem is when it leaks through they are wet, the pajamas are wet, the skin is wet and there is not protection. The diapers to have the protection if it would just stay there and not leak out. Tonight I am going to try this: One depend, then one more depend with another type diaper inside the second depend. I am going to use one of the tab diapers and put it in the second depend, that will be three layers, I will see what happens. I am at my wits end. The Detrol might not be a bad idea. I will considere asking about it.
Jane, you probably already thought of this, but since no one has mentioned it - I understand it helps to cut liquids for some time before going to bed. I, also, am not there - YET, so may not be of much help. Something funny that happened to us a couple of months ago - we do Yoga warm up exercises every other morning. My husband said he must have urinated since his exercise mat was all wet. When I checked there was NO WAY he could have caused all that moisture. It seems our water hose to the ice maker came loose and more or less flooded the carpet! I definitely was relieved!
My wife is also incontenent and I have her on scheduled visits to the bathroom during the day. Four times to be exact. First in the morning when she gets up, then again around 2 PM, then 7 PM...then again just before she goes to bed. I cut her liquid consumption down in the evening so she won't have any accidents while in bed.
Just incase she does have an accident, I put a waterproof, soft, mattress cover on to protect the mattress. To keep from having to do sheets everytime she has some seepage, I picked up a water proof crib pad with fabric on one side and lay it across the bed. Now if she has an accident, I use paper towel to dry the pad off, and leave it uncovered to dry out. I wash it one or two times a week.
Jane, last night, as I sent my wife off "to pee", I thought of your problem. Here is another suggestion, which works only for men - the "Texas Catheter". Basically, it is a condom with a drainage tube connected to it. This can then be connected to another tube which drains into a bag hung on the bedside. If you "Google" "Texas Catheter" you will find several places to buy them. Prices range from under $1 to over $110. The cheaper ones are designed to be disposable. Your local medical supply company will probably have them. If you have any questions about their use, check with a nurse (preferably ICU) at your local hospital.
I'd talk with a doctor before cutting back on liquids. It's pretty easy for an AD patient to get dehydrated, which can lead to a lot of serious problems. Maybe scheduling lots of liquids early in the day and then tapering off, or something like that. Provided, of course, you can get your husband to cooperate.
About 5 this morningmy DH woke me up to say he got up to pee and didn't remember where he went! Of course, I jumped up, and finding no urine anywhere figure he actually used the toilet but forgot. HOWEVER, I have read about AD folks going anywhere, and I wonder if anyone has dealt with that and if there is a way to handle it? The problem is the caregiver being so tired heorshe doesn't wake up when the AD spouse rises in the night. I THINK I am usually awake and once last night I got up and turned on the bathroom light to help him. I'm thinking the night light isn't enough now, though I'm not sure I could sleep with light all night... I think the first time urinating somewhere rather than the toilet would be the time for Depends at night. Am I right?
I would definitely say yes to the Depends, maybe even in the daytime too. Any of the caregivers here who have been up all night with this problem (or any other) will tell you that sleep deprivation will wear you down more quickly than anything.
Frand....I think the Depends would be a great idea. My husband refused to wear them so I had lots of laundry to do....LOL! He was one of those who peed anywhere and everywhere...in trash cans, in corners, down the heating and cooling registers.....I never knew where I would find the stuff! So, good luck and I hope dry days and nights are in your future!
wheatleygirl-several suggestions: Sam's Club has them by the case, medical supply stores can order them for you by the case, and of course there is always EBay
I ordered supplies from a website called Home Care Delivered, Inc. They were reasonable, I thought, and if you spend over $100 there is no delivery charge. They were prompt on delivery, too.
Don't forget about The Alzheimer Store - on the left side of my website. They have all kinds of pads and bed protectors. Not Depends, though. My guess is, as bluedaze said, Sam's or one of the other warehouse stores (BJ's, Costco) are probably the cheapest for Depends.
I was so glad to see this topic come up as it has been the toughest thing to deal with so far. My husband has to get up once or twice at night to go to the bathroom. During the day, I try to get him to sit on the toilet to avoid urine spraying all over since he has a lot of the muscle jerking (myclonus, I think). It's becoming really difficult as his motor coordination and balance are really off. But at night he is really out of it and I can't get him to sit at all. He has peed on me, the wall, the floor, and sometimes doesn't wake up and pees in the bed. I usually wake up when he gets restless, but we just wind up in a battle with urine all over the place. So...I decided I needed to start with the Depends. The first night he got up and picked it apart trying to get it off to use the toilet...do you know how many of those littel crystals are in those things?! The next time he got up to use the bathroom so I pulled down the Depends and got peed on. Last night, he got up and I told him to go in the pants. After some pacing and mumbling he did, but it came out down his leg and some puddled on the floor. If he can still use the toilet I feel guilty making him pee in his pants, but I can't take this anymore. Between not sleeping well and the battle to get him to pee in the toilet and the cleaing up of him and the bathroom during the day....there has to be a better way!! Should I just be putting Depends on him all the time or taking him to scheduled bathroom visits during the day and use the Depends at night. Maybe they work better if you're laying down to pee in them. Or what about a bedside commode so he doesn't have to go far..but I don't want him to pee on the rug in the bedroom.
Sorry to go on, but this has been a tough one for me.
Flgirl, i would try all of the above, using depends all day and giving lots of fluids earlier in the day and less at pm, plus try using the potty seat next to bed. in my case i use two depends all day long one smaller tighter one then one larger over that and sometimes a mens guard pad in as well at nite. its working well for me so far. also i would like to know about your DH myclonus jerks, mine also starting this this yr. usually happens right after awakening, took to ER and they said no loss of conciousness etc so its not seizure but like 'brain spasms'. scary as heck and he looks as if hes 'falling' and his arms /hands go out -i feel so badly for him they seem to subside after a while of being awake. i am journaling them for the neurowhen we visit next, he said if they become worse may need an antiseizure type med but that could be worse with side effects etc.as long as they arent too serious or last too long, i will just observe- i personally think its the brain misfiring wiht all the electrical impulses that must be in turmoil. i have heard this could lead to a granmal seizure at some point. if you have any other info please post. my best to you, divvi
ps i dont sleep at al well either and choose to get up each time he goes (which due to treating an enlarged prostate can be every two hrs),so he doesnt fall getting there. its so hard but i know if he fell it would be worse. plus yep i get the sprays all over the place too and clean up each day..
Hi all, My DH will sit on the edge of the bed during the night, with the intention of going to the bathroom. He has to have his slippers on, but can't figure out how to do that. So, while he is working on the problem and cussing, he does go to the bathroom in his Depends. Now, that means I have to change his Depends, which requires that I remove his lounge pants, in order to put on the new Depends. His apraxia makes him unable to lift his foot or follow a command, when I ask him. So it does take a while, but at least I don't get sprayed with urine! I didn't realize I had it so good!!! Nancy
I have had my wife in Depends day and night for at least a year. She generally does OK during the day, but once tried to wash out the Depends - What a Mess!!!!! At night I try to wake her to "go pee" every time I have to get up (Men with prostate enlargement have to get up several times). When we are in our apartment, she does OK - going to the bathroom off our bedroom. When we go to our "camp", where I have a bedside comode, she has problems figuring out how to use it. Once she sat down on it without lowering the Depends, so filled them. Now I have to go through each step with her, and make sure she lowers the Depends. It takes some time, but beats having to wash the sheets every day. On occasion, even with Depends, the bed gets wet.
My DH has a bad back, so fortunately, he has been sitting to pee for quite a while. Before that I was having a problem with pee all around the toilet, so I'm glad he's sitting. Listening to you folks, I'm wondering how I will handle this when the time comes, which I'm sure it will.
I don't know how any of you are able to deal with the incontinence and AD. I looked after my mom and she had depends, but she didn't have AD and was very cooperative.Bless you!
Divvi, the muscle jerking is definitely getting worse. The neurologist says that it's just one more symptom of AD. It started just as small twitches, but now sometimes his hand/arm really moves quite suddenly and frequently. I have noticed some scarier things lately...he frequently closes his eyes when he eats or when he is sitting still (when we're in a restaurant I figure that people must think I'm really boring him), but he snaps out of it when I talk to him. However, I've seen him close his eyes and start to fall several times lately. The first time I thought he was having a seizure but he did come out of it and seem OK. We go up to the neurologist in 2 weeks and will ask him about it.
Thanks for all the advice on the bathroom side of things. He actually had a much better day today, but I know that it always temporary.
Well, I first started this thread and I see it is still a problem for many. Well, first on the myoclonic jerking, my husband has also been having them. When we talked with the Doctor he says that it is a sign of the progression of the disease. He said we will need to watch and make sure there are no seizures. For the incontinence problem, I think I have conquered it. Of course at first we were doing all you folks are doing, getting up in the night, sometimes would and sometimes could not get him to, I found myself wishing that he would just go in the depends. FINALLY when Hospice came in they told me I needed to be using the diaper, the one that tapes, they showed me how to put it on while my husband is standing, I first put it on the bottom, then press my body up onto him in order to hold it there while I tape the sides. It was so easy after they told me how. I make sure everything is pointed down, then I tuck it in I also use a pull up over the diaper, and tuck some Depend PADS, NOT GUARDS in the area that sometimes leaks though, we seldom wake up with a leak through now.
I also order pajamas that are the jumpsuit type that zip down the back in order that he does not pull the diaper off at night, we were really having a problem with that.
Thanks ladies on responses to the myclonic jerking. its very scary. i hope non of us have to deal with the seizure issues but more than likely it can progress. like others our neuro says as long as they dont lose conscious and can still talk during etc like mine can its not a seizure-its still scary as heck to witness it. he has had more this week than normal and always seem to be after awakening. he had only a few mild ones then they disappear-will discuss with neuro too at next appt unless i need to see earlier. thanks again, its kinda comforting knowing we are not alone in these issues. Divvi
Jane, thank you for the perfect description of putting the diaper on. I know I will need it in near future for my MIL and in the far off future for my DH. And I hope you're getting better rest.
Jane, I'm not quite clear on the Depends application. So do you apply it to his bottom first, then tuck it through to the front and then tape? I sure would sound much easier than taking off his PJs to put on a clean depends in the middle of the night. Thanks for your help. Nancy
Yes Nancy, It is easier if they are standing up, but if not it is the same process. I would never have thought of holding the bottom back part on by pushing myself against his body to hold it while I did the tape part if the Hospice nurse had not shown me how. You would think something as simple as putting a diaper on would not be that difficult but it sure was for me until I learned this way of doing. The Hospice people furnish the diapers. She told me they ordered Large, rather than small ones in order to have more wrap around. You might play with the size to see what works for you.
I had bought the medium in the tena senerity brand but Hospice just orders by the bulk, don't know what brand but in any event they are the diaper and not the pull up. I do use a pull up over them but you could also just use two diapers that tape on at night if it would be easier for you.
Something just caught my eye. If he is in Hospice, and Hospice doesn't start until Stage 7, how do you get him to stand up? I thought Stage 7 meant they couldn't stand up. I thought that was one of the definitions of Stage 7. In fact I thought it was the definition of a late Stage 6.
<glyph of a woman scratching her head in total confusion>
Starling, They do not absolutely not be able to stand up in stage 7, the prompting and leading when walking is considered needing assistance walking. The speech is not gone in stage 6, my husband's speech is gone. The speech is gone is sub stage 7a my husbands speech meets sub stage 7b.
Not all symptoms will happen in stage 7, some patients never get to the non ambulatory part before dying. The guidelines for Hospice are not cut and dry but they do require that you have entered stage 7 which with the speech my husband has.
Let me add, when I said not all patients get to the non-ambulatory part, I meant before actively dying. You can get Hospice before you are actively dying, meaning bed bound and crisis care.
2... normal older adult Personal awareness of some functional decline.
3... early Alzheimer's disease Noticeable deficits in demanding job situations.
4... mild Alzheimer's Requires assistance in complicated tasks such as handling finances, planning parties, etc.
5... moderate Alzheimer's Requires assistance in choosing proper attire.
6... moderately severe Alzheimer's Requires assistance dressing, bathing, and toileting. Experiences urinary and fecal incontinence.
7... severe Alzheimer's Speech ability declines to about a half-dozen intelligible words. Progressive loss of abilities to walk, sit up, smile, and hold head up.
In the above if you notice it says progressive loss of abilities to walk. These things progress while already in stage 7
I've done a lot with the stages, but it is really only Stage 5 that I'm fully aware of. My husband has ALL of the Stage 5 symptoms. He has had ONE Stage 6 symptom ONCE. It has not repeated. I now consider him to be late Stage 5 at the Stage 6 border. The next time he doesn't know me, or when his speech gets worse (it is already very bad) I guess he will be considered to be Stage 6. I'm pretty sure that I had the increased confusion because he had been sick a couple of days earlier. He seems to have gone back into Stage 5 at this time.
Having described that, do you agree with my assessment. I don't have a Stage assessment from the doctor. But when I asked them to help me stop him from driving, they finished the exam and then did as I asked. In Pennsylvania I could have pulled his license, but it goes better if it is the doctor who is doing it.
Am I correct that as soon as there is a single one of the listed symptoms, the patient is in the new Stage.
By the way, if I hadn't known he needed to stop driving it was shoved in my face today. I took him to the barber for the first time. I stopped at a red light. There was no traffic around us. He asked me what I was doing. The cross street can be busy and the people coming past would not have been able to see me. I realized that he probably had stopped stopping at red lights if there was no traffic.
This may sound like I stupid question...but I would like to know. My DH has been having leakage problems every day for the last week. This is something new and has never happened before. Is this considered incontinence or is it a beginning sign of incontinence or neither? Sometimes I wonder if I am looking for things when they have no relationship to his AD.
I don't have the answer to your question, but the question of a urinary infection came up with my husband because of the sudden Stage 6 symptoms. It turns out that dementia patients get them with no warning and half the time with no pain or other symptoms.
I think this might be an "ask the doctor" question.
Oh, and the urinary infections SOUND like they have no relationship with AD, but they do. The brain does wierd things with this disease.
Hope this helps. Stage 5 (Early Dementia) Moderately severe cognitive decline.
Patient can no longer survive without some assistance. Patient is unable during interview to recall a major relevant aspect of their current lives, e.g., an address or telephone number of many years, the names of close family members (such as grandchildren), the name of the high school or college from which they graduated. Frequently some disorientation to time (date, day of week, season, etc.) or to place. An educated person may have difficulty counting back from 40 by 4s or from 20 by 2s. Persons at this stage retain knowledge of many major facts regarding themselves and others. They invariably know their own names and generally know their spouse's and children's names. They require no assistance with toileting and eating, but may have some difficulty choosing the proper clothing to wear.
Stage 6 (Middle Dementia) Severe cognitive decline. May occasionally forget the name of the spouse upon whom they are entirely dependent for survival. Will be largely unaware of all recent events and experiences in their lives. Retain some knowledge of their past lives but this is very sketchy. Generally unaware of their surroundings, the year, the season, etc. May have difficulty counting from 10, both backward and sometimes forward. Will require some assistance with activities of daily living, e.g., may become incontinent, will require travel assistance but occasionally will display ability to familiar locations. Diurnal rhythm frequently disturbed. Almost always recall their own name. Frequently continue to be able to distinguish familiar from unfamiliar persons in their environment.
Personality and emotional changes occur. These are quite variable and include:
delusional behavior, e.g., patients may accuse their spouse of being an impostor, may talk to imaginary figures in the environment, or to their own reflection in the mirror; obsessive symptoms, e.g., person may continually repeat simple cleaning activities; anxiety agitation, and even previously nonexistent violent behavior may occur; cognitive abulla, i.e., loss of willpower because an individual cannot carry a thought long enough to determine a purposeful course of action. Stage 7 (Late Dementia) Very severe cognitive decline. All verbal abilities are lost.
OK, he has some of the Stage 6 symptoms on your list. He doesn't know what year it is, or what day it is or what month it is. Although he is still writing it all down every morning from the newspaper. I think he might have some problems telling time, but sometimes he can. He didn't recognize me as me last week. He asked the person at the computer (me) where I was.
I just helped him make lunch. He has forgotten that frozen bagels go into the toaster. I don't think he knows what a toaster is anymore.
He no longer can make choices from a short verbal list, or even two items. He can make a choice from a menu IF I limit it to one small section.
He is rapidly losing language. He uses the same words for the mail, newspapers and putting out the garbage. At this point he recognizes the words when I use them.
He thought I had stolen some money from him yesterday. We found the coins (he called them pennies, but they included a variety of coins) in the pants pocket he had just put into the hamper.
We moved here 4-1/2 years ago. At that time we didn't think anything was wrong with him and he might have been at Stage 2 or 3. He never learned our new address or our new phone number. The Cognitive Therapist tried to teach them to him last year with limited results. We did succeed with the address but not the telephone number. He lost both almost immediately once we stopped therapy.
He absolutely wasn't anywhere near this bad a year ago when he was diagnosed. A year ago he was having mild word finding problems and the therapist was attempting strategies that work with people who have had a stroke, but are getting better. A year ago he really was safe driving. He went to the therapist alone a year ago and it takes half an hour to get there through the streets. The Strategies actually worked for him, but he "didn't care" to continue to use them. Outside of telling him to show me, none of the strategies now work.
All of this sounds MUCH faster than what a lot of the rest of you are experiencing.
Starling, I'm with you, but my DH is worse. He only says yes, no, fine, very good, and an occasional word here or there. He can't say what he wants. He doesn't know his name, nor my name nor who I am. He can't tell time and this week, he's lost the day of the week. He has taken the trash to the curb every day, and I've brought it back when I get home (trash day is Friday - so tomorrow he'll be right!). He forgets to eat one day and nibbles all day long the next. He can't use the toaster or microwave any more, and doesn't try. He crashes my computer every couple of days, but I recover it when I get home. He can no longer choose items on a menu. I just ask him if he wants the usual and he says yes. I think he is entering early stage 7, but he can still walk (though he shuffles his feet) and if I put the clothes on the bed for him and give him 10-15 minutes, he can dress himself. He has gone downhill much faster than most of you are experiencing. He was diagnosed Feb. 2007.
Starling, It is hard to answer these questions. I am by no means the person who would know these things. I just tell you how it is on my end with my husband and I try to also look at the chart and place him. My husband was in stage 5 by the time we realized it and he was diagnosed. He has dropped a stage each year. He was diagnosed in November 2000 and is now in stage 7.
As far as being in a new stage as soon as one thing on the list happens, It would be my guess that Yes, as long as the new thing that has happened does not leave, it stays. Sometimes they can drift in and out of stages until boom they are in a new stage. That is also how it happpened with my husband.
my dh is 52. he has eoad and it is progressing. he has not been able to use the phone or remote for the tv for a long time now. he is having some trouble with his speech. he forgets and just stops in mid sentence. he called flowers in our yard the other day "those things",when i said"roses?" he said yes. he wanted to pick some roses. my dh is still very strong and looks healthy. he doesn't know the year,time of day[can't tell time anymore],season,month,day, doesn't know his age,year he was born,birthday,phone number,address,any numbers,can't do simple math and hasn't been able to for some time [this is from a man that was a math wiz and percise and a perfectionest in everything he did.] he can usually dress himself,but sometimes needs help dressing and putting the proper things on or in the right order. he still knows my name and ou 3 childrens' names and both our grandchildrens' names.he does have the myclonic jerking. he has been on anti seizure meds[kepra] for about a year. this has helped with the worse ones but he still has them.before he was on kepra,he would sometimes fall when this happened. he also said it was like a lightening flash in his head. he has alot of headaches,his dr. said alz patients have alot of headaches,his other neurologist says kepra can cause headaches,but you know,he has always had headaches,i wonder if something has been going on in there for a long time? he goes to the bathroom and showers himself,but the other day he disposed of the toilet paper inproperly,he put it in the sink, he hasn't done this again,but it stressed me and just broke my heart. just the simple things,we take for granted,are striped from them and it just isn't fair. he says "what did i ever do to deserve this"? and i can't help but think,how wonderful,honest and trustworthy,and smart he has always been,and now this. he has lost most of his willpower and did try to hit his brother with a metal object,about 2 weeks ago.his brother had to knock him down 3 times before he would quit. this greatly distressed his brother and he told us he was sorry,but he had no choice. dh has never been a violent person,and he certainly would never hit his brother. dr. put him on abilify, and that has seemed to help. he has some symptoms of both stage 5 and stage 6. some days are better than others. i don't know what stage he is considered to be in,although,i try not to think about it often,i know there are things i need to take care of before things get any worse. i just keep putting things off and i know the time is here for me to take care of legal aspects of our lives. i just hate to do it. i know i ned to contact an elder care attorney. surly there is one in our area. i just needed to talk. jav
Jav, I remember so well when my husband started not disposing of the toilet tissue correctly. He would drop it into the waste can right beside the toilet, no matter how much I tried to show him he still did it. He became angry when I tried to tell him so I gently removed the waste can and started helping him in the bathroom. That was when I realized he needed help with the toileting. This started about one and a half years before he entered into stage 7.
I'm glad to hear someone else has had problems with toilet tissue. For the past year my wife has been putting the toilet tissue in a waste can. At first I thought this was a throw-back to our time in the Dominican Republic where we had to do that (the sewer system would not handle tissue). I tried removing the waste can, but then she would keep the tissue and carry it around until she found one. She doesn't get angry with me when I try to get her to put the tissue in the toilet, but just acts puzzled. Other than that she can still handle toileting OK most of the time. She does have occasional "mistakes" at night which wet the bed even with Depends.
Jane, where did you get your stages list? It is different from the one at the Alzheimer's Association website. The two lists are similar, but the particulars are different and I'd like to see what else is available from your source.
on the toilet issue, i think its good they want to put it into a waste can at this point instead of flushing. mine not only flushes toilet paper but small kitchen towels, toys, or anthing else that will go down, so beware they dont remember its not only for paper:) i think my DH is in the later 6stage, but still feeds himself - can dress with assistance and talks but mostly words togethr that are non sensical, and still walks ok by himself, sometimes incontinent then other days goes himself. he does go back/forth between degress/progress alot depending on his health issues.