How do I get my grandmother to stop denying her incontinence?

Junek8 asked...

How can I get my 85 year old grandma to deal with her incontinence? She has been a smoker for over 70 years and constantly coughs which causes her incontinence. She also has diabetes and refuses to wear a pad or any type or protective underwear. Her bed, her chairs, and her clothes all reek of urine. She can't smell so it doesn't bother her, nor can she feel the wetness. I have bought tons of pads and other stuff to protect the furniture but am constantly washing it because of her accidents. She does have vascular dementia but is still high functioning just unbelievably stubborn. I don't know what else to do. I told her that if she wants to smoke then she has to wear a pad because it is just so dirty but still denies her problem. Help!

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Reading your question, I know this is a tough problem, as I have dealt with many older ladies who are incontinent and do not realize it is a problem. I know that you have probably talked to her until you are blue in the face, but she just doesn't get it. Since she has some dementia, she really does not notice the wetness and odor, which is what would typically signify that there is a incontinence problem. Since she doesn't see it or smell it, why would she think there is an issue? She probably thinks you are making a fuss for nothing!

First, I would sit down and try to talk with her calmly. Tell her that she is having urine leakage when she coughs. Acknowledge that she doesn't notice it herself, but you do. If you have tried this and she doesn't listen to you, have another family member she trusts or even her health care provider talk with her. If you are able to convince her to wear a pad, great. If she still doesn't listen, you will have to manage her incontinence in other ways.

If she will not wear a pad, I would try to get her to wear incontinence briefs instead. One thing you could try is to get rid of all her regular underwear, replacing it with the briefs instead. Or, you can buy panties with areas in the crotch wear you can put a pad into so she won't see it. You can also buy plastic panties that may keep her dry. Try looking up "incontinence products" on the internet, and you will be amazed what is available out there. You can also get plastic furniture covers to protect the furniture and mattresses. Or, you can replace her regular furniture with plastic furniture instead.

I would also see what you can do for her incontinence by taking her to see her health care provider. She sounds like she mainly has stress incontinence. This means that everytime she coughs/sneezes/laughs, there is a little urine that leaks out. You can try to take her to a gynecologist too, to see if there is anything they can do to help this problem. I will also say that if she didn't cough from her smoking, this problem would be much less. Getting her to quit would really help reduce the coughing.

So, I hope these suggestions help. Good luck!