Can someone give me an idea as to how their DW or DH progressed to the point of urinary or fecal incontinence? I have read the Clinical Stages of ALZ and it talks about toiletry problems, which my DW is starting to exhibit. Just trying to figure out rougly how it progressed from forgetting to properly flush and clean to full incontinence. Trying to be ahead of the curve this time.
There are many discussions about it. I know bladder and bowel control were one of the last things he lost in his journey. Actually, it was after my MIL died and he went into a facility that he lost control. Probably more that he didn't know where the bathrooms were - I don't know.
cheval I brought up the older issue on this subject if you care to give it a read. beware its probably more than you want to know at this point, (smiling) but if you want to stay ahead of the curve good luck!
Yeah, not much of a fun read, but I need to be prepared. Took DW to PCP the other day and she needed a urine sample. Boy was that a fun job, but we do what we have to do.
Cheval, my husband is probably late stage 6 and so far we have not had consistent incontinence issues - either fecal or urinary although I think we're inching towards that now that his broken knee will not heal. Some tips to delay the incontinence; urinary-take her to the bathroom every hour or 2 and limit the amount of fluids after 8 pm. My husband drinks a lot of fluids during the day (and would all day and night if I let him). I let him drink all he wants during the day until about 5 pm and make sure he goes to "pee" every hour. He gets minimal fluids after 8 pm, just enough to take meds. Then I wake him up once or twice during the night and take him to the bathroom to pee. So far no urinary accidents because I manage it.
Fecal - so far we've had very few accidents over the 5 years since dx but now it requires me and the aide looking for signs and establishing a routine. Before he broke his knee and was very ambulatory he sat on the toilet every morning right after waking and we let him sit there until he had a bowel movement. Now that he is less mobile and not getting the physical exercise to help the bowels move, he no longer has a bowel movement every day (although that is our goal) so he gets prune juice (warmed works better) every morning, sometimes senna S and we both watch very carefully for the signs of discomfort. Now he sits on the toilet every late afternoon or early evening with the aide and me "coaching" him to "poop". Mostly we are successful in inspiring a bowel movement every other day.
"Toileting" was actually the first sign he was having cognition problems. Early in his dementia (at least 1-2 years before diagnosis) his underpants told the story...he could no longer effectively clean himself and each pair of "tidy whities" had brown stains. I threw out a lot of briefs because you cannot get then clean even with bleach. He has been unable to fully clean himself for at least 6 years now.
Hope this helps. If you are able to manage her bathroom habits and establish a routine it will help manage and possibly delay the incontinence. Many spouses never do become incontinent so you may not face this problem, but it's always wise to be prepared.
I sure hope that is the case. I try to do what we need to do for her with dignity as much as possible. She is into the early - mid 6 stage. Having trouble with putting on clothes and choosing what to wear. So far she gets up and goes to the bathroom on her own, but will not flush. Has to be prompted to brush her teeth and take showers. Her confusion is much more than ever before. Her PCP wants her to have a mammogram and pap smear, but I hadn't thought about that before. I wonder sometimes is it just to get more money or what is that going to do for her? If she wasn't in the grips of Alz, I wouldn't think twice about that.
Cheval - just a thought about the mammogram and pap smear. If you think the mammogram will be too stressful for her. I hear it hurts....not letting anyone squash my girls LOL. Have them do an ultra sound or thermo imaging instead it is more accurate. The pap smear, if her number have always been good and the same thing if it will cause her distress then why do it. I will only let them do tests on hubby that he absolutely needs now.
I don't want her to have to undergo anything more than she has to . She has a hard time understanding and following instructions. even if they came back positive, I don't think I would put her through surgery and chemo, I don't think her nervous system could take it.
I differed all the PAPs and mammograms on my wife during her illness. (Sx came on at 55 dead at 63) Like you said, I would not have treated any cancers anyway. We got called all the time from the health plan about not having it done because it kept popping up in their computer. I just kept saying 'no'. They rarely understood. . . .
PERSONALLY I think all preventative care in an AD person needs careful consideration. While she was alive, I wished for her to have a heart attack. I felt a 6 month death from cancer would be worlds better than lasting years with AD. PERSONALLY I considered her 'gone' many years before she was.
However this is another VERY PERSONAL decision for an AD spouse to make! Some people remain even hyper-vigilant about their spouse's blood sugar and blood pressures, etc. Everybody has their own reasons for accepting the treatments offered and everybody makes their own decisions.
My way of thinking when he got this disease is to make him as calm, happy and comfortable as I am able and that's it. No I wouldn't do chemo or any other life extending treatments on him.
Cheval, at the risk of sounding rude or insensitive, what's the point of the tests at this stage anyway? I know it's a difficult decision not to do preventative tests but if you wouldn't treat the condition then why bother with the tests.