How do I deal with a husband with Parkinson's who is now using a urinal in the living room? I can't have company and he won't wear any kind of diaper or even his underwear. He says it's because he can't get it out in time.
Expert Answer by Laura Beltramo
I am sorry that you are struggling with this difficult situation. It sounds as if your husband may be having some cognitive changes (changes in the way his brain is processing thought) in addition to the Parkinson’s disease. Parkinson's disease affects a part of the brain that is related to motor function and thus causes physical symptoms such as tremors, slowed movement, and problems with walking. However, 15-30% of people with Parkinson's do develop dementia but it is normally in the later stages of the disease. I have no way of knowing if your husband is affected by this but it may be helpful for you to consult with a psychiatrist and a geriatric social worker to find out what is underlying your husband's lack of participation. You do not have to handle this on your own. Getting more information and support will be helpful for you.
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I went through this and finally decided on talking to a doctor about a catheter. My husband was very unhappy at first, but after stopping the bathroom trips 3 0r4 times a night, complete bedchanges and urine on the floor he accepted this and the situation was calmer. Catheter care is very important but not as hard as the alternative.
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My husband has a similar problem. Getting a good nights sleep helps everything. He was getting up (which was very difficult for him) to go several times a night into a urinal and that was getting harder and harder for him to do because he does not move well at night when he is less medicated. NOw he is using a condom catheter with a bedside bag at night only and this works great. (medicare covered) Took a while to learn how to put the catheter on correctly but we both know how to do it now (I am the back up putter onner). He sleeps well and that means he has better days, less accidents during the day. Now that we have the condom catheter thing down maybe we could transition into this for day use later if needed. They make them with leg bags and I would think most people would rather not wet their pants, right. A lot of folks with wheel chairs use these and theri are several kinds out there. We like the ones that call the condom piece a gizmo, they seem user friendly, also the liberty pouches they work well and can be left on for quite a long time, but you have to soak them off. Good luck!
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My husband has lots of accidents and has, so far, refused to wear pull ups. One thing that has helped is cutting off liquids a couple of hours before bedtime. He doesn't have to get up as often and we've had fewer accidents. It is an ongoing struggle, between this and constipation.
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I have a Mom with PD. She too struggles with bladder incontinence. In the begining she would walk around with her pants unbuttoned and partly unzipped so she could get them off faster. That helped a little but then she was unable to hold "it" from her chair to the bathroom. So we started to use a pull up with extra liners which work quite well. If you go this route, use liners that are designed to "stack up". The ones that have a plastic liner, like Poise, do not help because the urine flows over the top and out the leg. The stackable liners hold a lot of liquid before they go through to the next liner. It is easy to change the liners and not have to remove the pull up each time we go. We get them by the case through the mail and it is a bit cheaper than buying them for the hospital supply shop. The only problem we have had is frequent bladder infections. We now need two liners almost every time we go to the bathroom and it is getting quite costly. Are disposables covered by any insurances or medicare? Does anyone have any experience with a catheter for women? I am worried about infection, discomfort and her feeling embarrassed at wearing this. Is it easy to hide it under pants? I must say that even though it is costly, we can travel outside the house in confidence and we have had no night accedents. I am thankful for these disposable "underwear". Sending blessing and love to you all. rk
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Similar problem w/father during a particularly difficult phase of disinhibition exacerbated by one of the newer PD meds. I must ask you whether he is becoming immodest as well. This is a well documented side effect of one of the meds and it took research on my part for weeks after discussing w/ neurologist then switching to Mayo clinic B4 someone agreed w/me and put him back on Sinemet. Mayo was horrified that my father was allowed to suffer and create havoc. This symptom stopped within 48 hours of being off the medication and back on Sinemet. Tremors are not as well controlled, but he's behaving appropriately. Prayers and all good hopes to you...BB
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My husband is in endstage parkinsons demintia and has urinary problems. I am now using an external catheter for him. It is so much better than him wetting the bed every night. There are many sizes of drainage bags. I have a large one for night and a leg bag for day. He is unable to put them on himself, but he can sure pull them off. I have finally had to tape the external catheter on him to keep them on at night. They are a very good investment. I work during the day and getting a nights sleep is a blessing.
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For the person whose Mom has PD, I found a mail order company that has overnight pads. We put them inside her pull ups. It was cheaper than using the stackable pads and her pull-up usually stayed dry. My Mom also was prone to urinary infections so we made sure she was changed several times a day. Your Mom is probably eligivle for Hospice. Hospice care is for "terminal" illnesses-not just end-of-life care. They usually pay for incontinence care and some of her meds. There are pros and cons with doing this so be sure to weigh them thoroughly. Good luck to you!
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TooYoung4This: I'm very interested in your answer re the condom catheter. My father's problems are mainly at night, he wakes up several times feeling he needs to urinate (and does, in fact). Since he had another small stroke in June, I've had to hire someone to stay all night with my parents, so that I'm sure he's safe and that my mother gets some sleep. Did your husband have difficulty adjusting to "urinating in the bed?" I'm thinking my father would -- even a couple of years ago, when he had to have an indwelling catheter briefly after a prostate procedure, he kept thinking he needed to get up to urinate. But I can't afford to pay for a nighttime companion forever. Have even considered the condom catheter + some type of sleeping med so he doesn't wake up & worry. Anyone else have input? My 91 yr-old Dad has vascular dementia, moving my parents in with me in a few weeks, this is the biggest urgent problem!



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