Is it wrong to let an Alzheimer's patient sleep through the night in soiled diapers?

1 answer | Last updated: Sep 29, 2016
A fellow caregiver asked...

I care for a woman who I feel is in mid severe stage of Alzheimer's. disease 67 yrs. Totally gone mentally. She does urinate a lot.. Which at night time can be adjusted to the amt of liq. you allow her to have. If she is wakened every 2 hrs or so to put in a potty chair she #1 gets very angry and may start yelling loudly for who knows how long. #2 she is very unstable on her feet so she gives absolutely no help with holding up her weight. Not to mention if you move her the wrong way she will start to fight or bite or punch. Why put her through so much trauma and lack of sleep to use the potty. At this stage is it wrong to just diaper her up extremely well and pads on the bed in great thickness and just let her sleep soundly all night. Shes gets a more peaceful sleep and I get a more peaceful sleep. In the morning she has a shower and the bed gets stripped and washed. Yes, she does get soaked sometimes but that washes off. Am I wrong for this theory or should I be getting her up more often and keep her dryer and just deal with what comes?

Expert Answers

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

Reading through your question, I do agree that there are times when toileting someone in the night can be too much of a hassle. In your situation, I agree that toileting is causing you and her more trouble, especially since she is fighting you the entire time. So, I do believe it is OK for you to manage her incontinence at night with briefs. With that in mind, I do not think "diapering her up extremely well" and letting her sleep all night is a good plan. I am worried that eventually this will harm her skin, meaning that she will develop a rash or bedsore on her buttocks.

What I would recommend to you is to change her brief at least once or twice during the night to make sure her skin is OK. I would also recommend using a protective ointment (like A&D or desitin) on her backside after you cleanse her skin to help protect her from developing skin breakdown. Hope this helps!