How can I deal with my mother's incontinence?

6 answers | Last updated: Nov 16, 2016
Flcaregiver asked...

My 72 year old mother in law who has dementia also has bathroom accidents. It's to the point that she is going through at least 5 pair of pants per day as well as underwear. I've tried to get her to use pads but I think she gets confused and will remove them without my knowing and then we are back to having accidents. She refuses to wear the incontinence underwear! I also have 3 young children as well and laundry has become a very frustrating issue for me. Im overwhelmed at times! It's a sensitive topic and I don't want to embarass her but she refuses to help herself by attempting to avoid wetting her clothes!

Expert Answers

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

I first want to acknowledge the hard work that you are doing.  Taking care of children along with your mother-in-law must be very hard on you.   Would it suprise you to learn that the development of incontinence is one of the major reasons people are placed in the nursing home?  This is because it is not easy an easy problem to deal with! 

First, I would ask you to take your mother-in-law to her health care provider , tell them about her incontinence, and see what they can do to help her.  There needs to be an investigation into why this is happening to her.  Many times, incontinence can be made worse by medications, diet, and constipation, so she needs an entire health review.  She could also see a specialist in Urogynecology.  They would do a more extensive exam of her pelvic area to see if anything there is causing her problem.  They can also recommend medications and treatments to help her incontinence, which may lessen or eliminate the problem all together.

As for you taking care of her at home, it sounds like she will not allow you to help her yet.  If she would understand, tell her you know that incontinence is embarrassing, but she needs to know that this is not just her problem, especially since she lives with you and you do all her laundry.  Tell her that you are going to help her look for a solution (by taking her to the doctor), but she needs to help you by wearing the pads or briefs.  Hopefully, you can work together to make this problem bearable until a solution is found.

Maybe your mother-in-law and you have a strained relationship, which may be another factor in this problem.  Perhaps hiring a part-time caregiver (temporarily) will help.  Sometimes, an outsider who has experience with dementia and incontinence can find solutions that you never would have considered.  Also, to be honest, your mother-in-law may listen to a caregiver tell her what to do, as she is not "family".  I know caregivers are pricey, but you are already stressed and this may offer you a few hours of peace and sanity.

Good luck.

Community Answers

Terrysmith700 answered...

My mother wears Depends because she does not realize it, or perhaps just chooses not to discuss it. I just purchased them and gave her a pair in place of her underwear to put on the next day. I have read your expert advise and I believe that because I speak firmly and assertively as I go about giving my mother instruction, she may be more compliant. After all she does not know that I am her youngest daughter. She responds like a child either compliant or rebelling. I read to often that the caregiver is trying to comply with the patients instructions. Why, knowing that they have diseased minds? If they could make their own choices we would not be needed. I love my mother and that is why she is with me...but let her run the show..I think NOT. Just for the record...she does not suffer with incontinence yet, only two accidents in 5 months... but heck, I have great new carpet ...why let it catch me by surprise. The Depends are cheaper than replacing the carpet.

Jade1961 answered...

Hi, I am writing to you from a different perspective than the other people here, so please bear with me as this is difficult to write.

I am the Mom with incontinence problems. I am seriously disabled with a multiplicity of diagnoses, I had a TIA recently and ever since that I started having accidents. This is an embarrassing thing and a difficult subject for both my husband and my adult son (20) to deal with. I need to purchase adult pull-ups "I'm a big girl now" ... LOL. If I don't use some levity I would cry, I am only 42 years old.

Recently I have been suffering from kidney stones and in the past, when I was a child, had pylonephritis. My doctors think that this is part of my problem now. Just a few days ago I had an accident while sleeping, this is the first of this type of accident and I didn't realize what had happened until I awoke freezing in my own urine. My husband was fast asleep but I had to get him up to help me clean myself and our bed up. Since I use Depends® Underpants for incontinence. My husband suggested I put a pair on to go back to sleep. I felt small & helpless as well as terribly embarrassed. The Depends® that I purchase are expensive but have tear-away sides making it easier to change one if I have an accident. I have a caregiver through an agency who contacted the program I am in to see if there is anyway that my Medicare or Medicaid will pay for the necessary incontinence supplies. It is all covered under both insurances. You do have to have your physician order it for you under durable medical supplies which needs pre-approval. Then they send you a case every couple of weeks. Now, I am not being ungrateful for the help, but the cases are huge and there is not a place in my home to store them with the exception of a shelf in my bathroom. This allows anyone who visits to see that I have to wear basically a diaper of some sort. Remember that this is your Mom/Dad and they have feelings (pride). As the saying goes, Pride cometh before a fall, I know this was true with me. I am in a wheelchair (it took me 3years to accept the chair) as well so when an accident happens there is a whole lot more than some panties and pants or skirt to get washed up. When you don't have control over your bladder or kidneys it makes you feel very helpless. I do not know how to get someone who is unwilling to help themselves to wear an incontinence product. I was against it until I wet myself publicly and then realized I had no choice. It was a rude awakening to how bad I was affected by the TIA, this TIA was a result of a stroke I had about 2 years ago. I wish I could give you answers on what would help you in your situation. Everyone is different. I just thought that maybe if you heard it from a patients perspective it might give you some ideas that would help you understand what it feels like for your Mom.

Caterinamaria answered...

My MIL, who has Alzheimer, has lived with us for four years. Even before she came to live with us she had a problem with "accidents" as she called them but pads were enough. Three years ago she needed to change to adult diapers and the struggle began. She refused to wear them since she hand washed her panties. Eventually I just said they are in your pantie drawer if you need them. I had already begun to remove her washed panties from the bathroom each night and would place them in the wash but now I would not return them to her drawer when clean. Once a week I told her that her panties were all in the wash and asked would she mind wearing a pair of disposable panties today. Then it happened twice a week, every other day and then completely replaced. Even with wearing them (as is bathing), it is a problem trying to get her to change them or she will change them 5-6 times a day when they are clean. After a couple of months of wearing them I told her for her convenience she could just use them from where they were stored in the bathroom next to the TP. The cabinet already had a label on the door that said "TP and Undies" as a reminder. Kitchen and bathroom doors were all labeled at that time. For the last two years she will take both clean and soiled diapers from the bathroom and hide them in her room and elsewhere. I recently created another problem when I bought her leggings to wear under her gowns because she is always cold. Now she loves the leggings and doesn't change her adult diapers. At one point I put the day of the week on them (near the top and so she could read the day). There was a calendar in the bathroom that we marked when she had a bath, shower, and or shampoo. I would tease her that it was like when we were young and we had the days of the week on our panties. I have always told her that even if they seem clean that she needs to change them daily just like her panties. Life is like reinventing the wheel daily.

A fellow caregiver answered...

I can sympathize with the first poster, FLcaregiver...I am dealing with exactly this with my 73 year old mother. My mom is advanced Alzheimer's, probably stage 6 of 7. She refuses the Depends, but it's not because they're adult diapers. I am confident she doesn't know what they are. She just doesn't like change. And she doesn't like people (even family) telling her what to wear. The fact that it's an undergarment, next to her 'privates' obviously makes it even worse. My mom angers if I suggest a warmer coat...imagine how mad she gets when some nurse on staff (my mom lives in a senior's housing complex) asks her to wear different panties. My mom's unwillingness to accept help in this one area has now forced us to look at nursing home care or a dementia unit in an Assisted Living complex. She is physically well and gets around great, but has a body odor and is difficult to deal with in all things hygiene (showering, hair, teeth brushing, changing undies). It is such a miserable disease and I find it very difficult to get good advice/help. We have done all the obvious...replacing her own panties, calling the Depends panties, used different staff/caregivers/family to approach the tough topics, doesn't help. She doesn't want them on and once they're finally on she doesn't want them off.

A fellow caregiver answered...

I understand the frustration. My 86 year old Mom with some type of dementia hasn't showered in 3 years and now I don't even think she cleans herself at the sink. She doesn't shampoo either, is incontinent but WILL NOT wear depends as according to her there is nothing wrong with her. I wish her dementia would progress so she would be completely clueless but she has been stuck at this level for about 5 years. It can be agonizing at times and I no longer think I'll find an answer anywhere. I just try to go day by day.