Why is my Aunt forgetting how to use the toilet properly?

1 answer | Last updated: Oct 02, 2016
Kay c asked...

My mother is caring for her 90 year old sister in our home. She is in pretty good health, but does have symptoms of early dementia. She is a very quiet lady and is most times very compliant. The problem we have seen is that she often urinates in areas other than the toilet. It is usually at night even though we leave the bathroom light on so she can see where her way to it. She will use it in a box, or on the rug which are just a few steps away from the toilet. It is not until my mom discovered the wet box(es) and/or the evidence that this has happened in that place before. What bothers my mom the most is that my aunt won't mention the wet rug or anything. Is that guilt or spite? Should I just get one of those portable potties to put close to the bed, or is it something more. She never has a problem getting up and going to the bathroom during the day, and doesnt have to wear absorbent undergarments.

Expert Answers

A social worker and geriatric consultant who specializes in dementia care, Joyce Simard is based in Land O' Lakes, Florida, and in Prague. She is a well-known speaker and has written two books, one focusing on end-of-life care and the other, entitled The Magic Tape Recorder, explaining aging, memory loss, and how children can be helpers to their elders.

Urination trouble with people who have dementia is not that unusual. Now to problem solve. If she happens to urinate in "inappropriate" places many times within a short period of time, she may have a urinary tract infection, so have her see her physician. If she has problems holding urine (not unusual for a 90 year old woman) have her seen by a urologist to see if something can be done to help her.
Make sure she can find the bathroom...door open, light on, sign of a toilet on the door. I like your idea of a portable commode by her bedside, that may help her at night. During the day, remind her every several hours to use the bathroom. If your mother gets up at night to use the toilet, have her wake up her up her sister also.
I do not believe this behavior is spiteful. Your aunt has lost the ability to "think ahead" and when she has to go, she has to go- right now! She will not mention the inappropriate urination to her sister because she no doubt doesn't remember that she urinated on the rug or in a box.
If all else fails, see if she will wear an adult diaper at night.
I hope some of these suggestions work for your mother. Caring for someone with dementia is not easy she is to be commended. Joyce Simard MSW