I have posted about this condition before, but would like to ask again if anyone has encountered this condition in their OL. DH has been dx with this complex condition and has been perscribed Ditropane to try and control the incredible urge to pass urine every 20 minutes or so. He started the medication two 1/2 weeks ago and has improved to nearly normal during the day, but not at night, he still has to keep getting up and down all night. I have been bringing him home for two nights from the NH, but two nights without any sleep is all I can manage with looking after him all day too. Has anyone had this problem and if so, did it come right in time with medication. He could come home from the NH that he hates with a passion, if he could sleep either day or night, but I can't manage all the normal Alz. behaviors plus the Overactive Bladder problems without any sleep at night. I am a retired RN, but I never came across this condition in any of my nursing , it is a new one for me.
My husband needs to go frequently because of prostate issues. He wears a condom catheter and leg bag at night so he doesn't have to get up. He only wears it during the day if he is going out somewhere where a bathroom won't be easy to get to. I expected more resistance when I first suggested the idea; he likes it because it saves him embarrasment. He can't take anticholinergic medications like Ditropane because he takes Aricept.
My DH wants to go to the bathroom every 5 minutes when we are out. As soon as we get into a place he has to go. It happens at church, restaurants, grocery stores, our daughter's house. I now know the location of every bathroom in town. At home he can sit in his recliner for hours without going. He only gets up once at night. I think his problem is not physical but has to do with not being home.
maryd----interesting observation. My DH has to use bathroom frequently when we are out. He gets up at least once (sometimes 2 or 3 times) at night but I've never paid much attention to how often he goes in daytime when at home. But I don't think it is as often as when out . . . I shall have to watch. I know we stayed recently with a relative (retired nurse) and she was very concerned about the frequency (and urgency) after spending a few hours with us shopping and visiting a park. Family dr. checked up and couldn't find anything wrong such as pre diabetes etc. Problem when we are out is that my hubby will just suddenly vanish on me . . . I assume he's gone to a washroom which is fine in some locations. But not good when I don't know where the washroom is and he doesn't either. He sometimes has been gone for quite awhile looking for a bathroom. He's okay to find his way back but meanwhile I have no idea where he's gone.
I take Valerian root for sore muscles but I find it also helps me make it through the night only getting up once. I also take ibuprofen and it will do the same thing - I guess blocks the urge. If we are going out I will take it too so I am not going constantly cause with the weight I have put on the pressure on my bladder is even more.
Thanks for your replies, but no one really gets what I'm asking about. Overactive Bladder is a medical condition, and I'm wondering if it's a rarety or has anyone else had to deal with it. DH is really struggling with this condition and I would like to hear from anyone who has any solution to the problem, which is one reason he has to be in the NH.
Sylvia, I'm a retired nurse, too, but have only heard a little about this condition of over-active bladder, which is caused by spasm and needs an antispasmodic med such as Ditropane. I think that the John Hopkins Newsletter had a piece about it within the past year, and if I remember correctly, one of the approaches is to train the bladder to hold increasing amounts of urine. This entails keeping a diary of fluid intake and output and aim, 15 mins. at a time, to hold the urine longer, eventually reaching a more livable normal interval. I would think that this would be impossible to do with an Alzheimer's patient, at least it would have been with my husband. It's encouraging that your husband's days are better. I know that doesn't solve your problem of wanting to have him home. Here's something from Google (you may have to work with your doctor on this one): The usual starting dose of controlled release oxybutynin is 5 mg to 10 mg taken once daily, at the same time every day. Depending on the effectiveness and side effects of the medication, your doctor may increase your daily dose of this medication by 5 mg each week until an effective and well-tolerated dose is established. The maximum dose is 30 mg per day. Sooner or later, it may be necessary for your husband not to come home even for the 2 nights a week. This may be the time. It's more important, in my opinion, that you get your rest, than it is that he come home.
My hubby doesn't have an overactive bladder but he does drink a lot, which in turn, contributes to his need to use bathroom more frequently. It's seemed to me that he drinks to fill in time. Large glass of water followed by large mug of coffee (sitting in easy chair for half an hour while drinking it) . . . mid morning large cup of tea (also sitting for another 30 to 40 minutes) and on through the day. By "large" I mean two cup capacity. Today he's had 12 oz water / 16 oz coffee / 8 oz milk / 8 oz hot chocolate (before lunch) / 8 oz water at lunch followed by 12 oz hot chocolate following lunch. Bathroom at 7 and 8:45 (at home) / bathroom at 9:30 and 11 (while out) / home by noon and bathroom at 2. Much longer stretches between bathroom at home than while out. He's napping now but will get up and have another 2 cup drink (30-40 minutes in chair) followed by something at supper and then another drink after supper and one more before bed. All the drinking (and going to bathroom) gives him something to do. After reading mary75's comments, I probably should keep track of his fluid intake (and associated time to drink it and bathroom visits) for a few days to share with doctor. Not so much for a physical diagnosis (because dr has already run all the tests for that) but more to let dr know how much time is consumed by this in an average day.
Sylvia - at night my bladder will spasm which is why I will have to get up every hour if I don't take the ibuprofen. It is probably not bad enough for anything else and besides I don't have medical insurance so do not go to the doctor. The ibuprofen is an anti-inflammatory and pain which is why I can sleep thru it - I am not feeling the spasm.
I would keep talking to his doctor, but as said above - it would be better for you to not bring him home, at least not overnight. the only other option I can see is have someone come in to watch him all night while you sleep in another room.
Thank you Mary 75 for your input, DH is taking 5mg of oxybutnin three times per day which as I've said has improved his condition during the day. It would be very difficult to do a fluid balance on him, but I don't think he drinks a lot of fluid during the day, when he uses the toilet at night, he passes large amounts each time which may or may not be caused by the OAB condition - strange !!! He enjoys his couple of days at home each week, when he can go to Day Care, and whilst he is able to do that, I feel that I can cope with the two nights night duty - there will come a time when he won't be capeable of attending anything. I would love to be able to bring him home permanently but the nights and a couple of behaviours stop me.
That is strange. So his bladder is really not going into spasm at night, but the amount of urine he needs to pass has increased. I'd be interested in what your doctor has to say about that. What does OAB stand for?
Nocturia becomes more common as we age. As we get older, our bodies produce less of an anti-diuretic hormone that enables us to retain fluid. With decreased concentrations of this hormone, we produce more urine at night. Another reason for nocturia among the elderly is that the bladder tends to lose holding capacity as we age. Finally, older people are more likely to suffer from medical problems that may have an effect on the bladder.
Sylvia, could it be the time the medication is given? If it's given three times a day, which could be 8 a.m. 12 noon and 4 p.m. (or 10 a.m., 2:00 p.m. and 6 p.m., depending on when the nurses make their med. rounds), then he's not really covered for about 12 hours, the time of his greatest activity. I can't go into Google now that I'm online here, but it would interesting to see what the "life span" of the drug is. I'm thinking that is you have him home for 2 days, that you could stagger the med. so that he gets it spread out more evenly over the 24 hour span. Let's say he gets up around 8 a.m; give 5 mgms. at 8 a.m., 5 mgms. at 3:00 p.m. and the last dose at bedtime, say 10:00 p.m.
Okay, OAB means overactive bladder. There is an Extended -release form of Ditropan, which would cover him over the 24 hours. I'd ask the doctor for it. This is from Google: DITROPAN XL® (oxybutynin chloride) is an antispasmodic, anticholinergic agent. Each DITROPAN XL Extended Release Tablet contains 5 mg, 10 mg, or 15 mg of oxybutynin chloride USP, formulated as a once-a-day controlled-release tablet for oral administration. Oxybutynin chloride is administered as a racemate of R- and S-enantiomers.OAB means overactive bladder.
Ditropan XL should be used with caution in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.
Thanks for your comments, mary 75 I am going for a much needed break over Easter, but when I get back, I will certainly look into your advice and help, thank you so much.