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My mom with Alzheimer's has started having more urine accidents while we are out and about. She won't go to bathroom before we leave ALF; says she doesn't have to go. When out, if we do find a restroom she urinates before reaching toilet or urinates all over her clothing if no toilet available. I've shown her how to use incontinence pads but she keeps telling me she thinks they are for her feet. Any ideas on how to get her to use pads? She denies having accidents and so is very resistant to even listening to me about pads. I will be putting together a 'go out kit' to keep in my trunk that will have a change of clothes for her but I am hoping for ideas for prevention of this embarrassment for her.

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PRIDE is said to be the downfall of men, but actually some women have JUST AS MUCH pride. They DENY needing any kind of help or change in life's routines. I have a neighbor in my senior building who is 85, and who sometimes falls. She has gotten into non reportable accidents in her car and STILL INSISTS on driving. She WON'T GIVE IT UP. For me, when I saw driving was more nerve wracking than fun, I called my granddaughter and said COME AND GET THE CAR. I gave it up in a HOT second. I saw my mother, in her 80's, NOT LEAVING THE HOUSE. Why, because it would mean she'd have to wear incontinence underwear. So, until the ambulance had to drag her out of the house for her breathing and heart problems, she was a recluse for YEARS, just staying home to be near her bathroom. She was so unhappy. So, when I became incontinent, the first thing I did was to HAVE AN APPOINTMENT with a urologist. He SCARED ME into wearing incontinence pants. How? He DESCRIBED the choices: OPERATION to pull the bladder up with mesh or pigskin, or wearing a BAG that collects the urine and having to change it and re-insert the tube into the opening of the urethra. Given those alternate choices, I chose to do the INCONTINENCE underwear. But I found even that didn't hold all the pee. So, I began using PADS inside the incontinence underwear. Even THAT didn't hold all the pee, so I tore up old t shirts, etc and folded them with old socks inside and rolled them up and called them burritos, and put those between my legs before pulling up the extra padded incontinence underwear. Does it ALWAYS hold the urine in with no accidents??? NO, not always. I still have to take extra clothing when I leave the apartment for just in case, plus plastic bags to hold the wet clothes just in case. But, it still works better than doing nothing.
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Try Pull-up disposable underwear. They make them fancy so it doesn’t look like diapers.
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Substitute 'pull up' incontinence briefs for her regular underwear.
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I agree with those who say replace her regular panties with the new 'panties' - take them out of the packaging so she doesn't see the 'depends' or 'tena' labeling. Hey, I am only 66, have a small bladder and a total hysterectomy ('things' tend to shift downwards after one) so when we have to go on a longer drive - i.e., 2 hours or more, I always wear a Depends...have gotten stuck in traffic with unpleasant end results...I also have a change of pants along and extra depends - just in case - AND, I always have at least 5 doggie pee pads in the car with me as well... (One time we got stuck on a major interstate for 3 hours - without moving an inch - and nothing but flat land all around....I can't aim into a jar very well while sitting in the car, but I can always slip a doggie pee pad under me).

My 95 yo mother was incontinent since the age of about 75. She wore the Depends 24/7 and always carried an extra one if she had to go places.

When she was in an afh, I was asked to not call them diapers but instead call them 'women's briefs'.
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My mom started out with incontinence pads. We soon realized it was time for disposable underwear. These companies make cuter underwear nowadays. Be warned, my mom had Dementia & didn't understand why I wanted to throw them away. Desitin was a must for her bottom & other areas where there is heat friction.
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Although my mother wasn't really incontinent at the time (bigger issue for her was being unable to get undressed fast enough!), we (one staff member and I) decided we're just going to remove all the underwear and put disposable briefs in their place. I also put some in her night table drawer as well as a storage bin in the bathroom. No staff ever mentioned any complaints and mom never said anything to me (even when I brought supplies in.)

I would recommend you just swap out the undies for the briefs, when she's not in the room. No discussion, no explanations, no arguments, just do it. IF she knew what the pads were for (her feet? really?), she could likely handle it, but pads tend to bunch up, which can lead to leaking, and I honestly don't think they can handle full on urination, despite claims - a little leakage, sure, but a full load? During a UTI, mom was night time wetting the bed. That was after being toileted before retiring to bed, AND wearing not only MAX briefs, but with a MAX pad inserted into the brief.

For your peace of mind and in the interest of comfort and staying clean and dry, swap the undies out. She questions them, just nicely "remind" her she's been wearing them for years! It can't hurt to have any "emergency" pack in the car, change of clothes, spare briefs, etc.
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Replace any underwear that she has with a pull up type incontinence brief.
She will have no choice but to wear them.
Pads probably are not absorbent enough alone anyway and they do minimal for bowel incontinence.
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chlswc: Imho, ditch the idea of feminine pads as she NOW requires Depends/an adult diaper. There are some new ones out on the marketplace that do not look like an adult diaper; I only used the term for purposes of clarification. Also, if you do go with a feminine pad, you could suggest that you, too, wear one (true or otherwise).
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usjet333 Sep 2021
Yes, my mom insists the "feminine pads" are a workable solution. They are not. But for her, that's far less humiliating than having to wear "diapers", (Depends). It's always a tricky situation to discuss her bathroom habits/issues, because I'm a man, and she has only sons, no daughters, and no husband.

She throws a child-like temper tantrum any time I explain this to her. I understand it must really suck to get old and must really be humiliating for someone to know he/she requires "diaper-like" garments to function (of course we all know by now the term "diaper" must never be spoken).

Nonetheless, this causes an enormous amount of stress because she doesn't want to speak of this at all, and when I do she gets extremely egoistic and defensive, claiming she doesn't need it, and "You're just trying to control me. You're not my boss."

Of course, I'm not trying to "be her boss". I'm just trying to protect my property and save her reputation and avoid embarrassment for her.
If she insists on peeing all over herself and her own clothing and embarrass herself on her own time in her own space and property, that's her business. I advise, but never try to control her life. I wouldn't want anyone trying to control me either. But when it comes to my property, I'm not required to let her destroy it just to satisfy her own ego, and while I tolerated these accidents for a while, I can no longer do it. It's destroying my relationship with her.

It's a situation in progress. She's a proud and arrogant woman. Always has been. She just can't seem to come to terms with her urinary incontinence issues. There are many great suggestions/tips here on this thread that I'll try.
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Maybe try the incontinence briefs instead. They have some that look very similar to regular briefs.
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Not a substitute for Depends, these “period underwear” are washable and re-usable: https://period.co/collections/all/products/the-high-waisted

I bought some for my mom, they have them in light & extra padding. Discreet and very comfortable.
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disgustedtoo Sep 2021
Wish they'd had these (or I'd known about them) back in the day!!! I REALLY could have used them! The only thing I don't like is the high waist. Buuuut, it could've saved clothes, undies and embarrassment for me - flowed like the Nile.... couldn't get to menopause soon enough!
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Get someone else other than you to teach her and explain why, etc. and if necessary, force them onto her - in a kind way. Do NOT allow her to get away with this - do whatever you have to do. And if she does this, why on earth would you ever under any circumstances take her out of the house. And if it gets worse and worse, then she should be placed. This should not be tolerated.
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disgustedtoo Sep 2021
Since short term memory loss is usually one of the first signs of dementia, you aren't going to be teaching her anything. She won't be able to retain it, no matter how many times you stamp you feet, lose your temper or scream and holler at her.

NO ONE should be forcing ANYTHING on another person, for ANY reason.

She's not "getting away" with anything. Clearly she doesn't even know what the pads are, thinking they're for her feet.

Once again, RIF (Reading Is Fundamental). You wrote: "she should be placed." OP's original post says: "...before we leave ALF..." So, where are YOU proposing she be placed?????

It's not tolerating. Would you feel the same about a child who isn't potty-trained yet? Tolerating it OR understanding this is how it is. REAL life.

I have a cat who has "issues" and I have to "toilet" her, aka on regular intervals put her in a cat playpen and wait for her "business" to be done. There are still times I don't catch her in time. She is NOT an elderly cat. So, would YOU deal this Ms Animal Lover, or would you throw her out with the trash? I'm sure few people would put up with this, but she's a sweet loving girl who has issues. I will NOT throw her out or subject her to living miserably in the shelter for the rest of her life.

These are REAL people we're talking about. Those who come here to ask for advice CARE about the person and are not about to abandon them and leave them to rot in their room for the rest of their life. There ARE ways to get around this without your harsh methods.
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Try telling her that her accidents can cause some serious embarrassment and that she would be cleaner with them on. If that doesn't work, you might have to hire some in home help to get her to wear them.
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disgustedtoo Sep 2021
Telling her anything, even saying that if she wears them the Leprechauns will bring the pot 'o gold to her isn't going to be retained (she has some form of dementia.)

Also, she lives in an ALF, not in the home. She HAS hired help...

There's no need to hire someone else, just remove all the underwear and put disposable briefs in their place.
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If she can't identify the need to void while you're out, it's likely happening when she's 'in' as well. Since she can't identify the pads she's not going to be able to use them. Sounds like it's time for the switch to incontinence briefs. Remove her underwear from her room and replace with the briefs. You can call them something funny like 'fancy pants'. This will be new for her so you may have to ask the AL to make sure she's set every day with switching them AM/PM. This may be a step up in her care (and charges). This was a switch we made with my mom when she was living with me. She was already using pads but they were saturated and leaking through. She had a supply of Depends because she would use them when going 'out'. Even with that, it took about a month for her to stop asking me to go out and buy more pads. I finally removed all her undies from her dresser and replaced them there as well as as filling a drawer in the bathroom with the briefs, and that helped. She used to use the CVS Depends equivalent, and I buy her the BJ's brand which is about $10 cheaper per case than the Depends and seem to hold up well.
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Before you take her out, go to the bathroom and put the pad in her underwear for her and to let her drain bladder before getting in the car. When you can see where it needs to fit in the panty, you can go ahead and place some in the panties so that when she puts them on before you go (in future) they are ready. Maybe she will get used to seeing them in there and understand she needs to put one in herself while at the ALF, too.

When you are getting her ready to go out, pack extra pads so that if she make a bathroom run, you are prepared. Talk to her about - remember last week, you had to change all your clothes? (If you think she remembers).
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I'm glad you asked the question because I have the exact same brand new issue, problems, resistance, and denials with my own mom right now. So, I'm learning from all these great answers too.

It's really causing a lot of stress for me having her in my home. I'm always worried about the furniture and my car. She seems not to understand or she doesn't notice that her clothes and nighties smell like urine. She's totally dismissive of the Depends I bought her. I'm going to have to be more firm and insistent. I'll use some of the tips I've learned here.

For my car, furniture, and her guest bed, I use the XXL puppy pads that people use for dogs. The look and smell nice, they're absorbent, and it will cut down on much of the anxiety you have that she's going to destroy your things.
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my2cents Sep 2021
You might have to remove panties from her sight. Only have depends available to use.
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If she’s to this point she should be wearing adult pull ups all the time. Maybe time to get rid of her underwear and only have those available. In the long run you’ll both be so much happier.
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my2cents Sep 2021
Good advice. If she has no regular panties and only the pull ups, she may start thinking those are panties. The only down side is when you go out, you may have to pull pants and pull up off to change. That's where the pad, for outings, might be easier.
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Maybe incontinence panties will work. I think Medicare pays for them
There are some that thin material but the pad can hold a lot. Good luck.
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my2cents Sep 2021
I never could find anything about getting them through Medicare. Can't take them off taxes either that I'm aware of.
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My FIL fought me on incontinence underwear. Yet, he was so irregular in his bathroom habits, I never knew if he'd have a blowout or a bladder leak---and this man LOVED to go places! He'd go out to eat every day!

Blowing out a 'thong' style underwear in a nice restaurant was the end of it for me. He was mildly embarrassed, but still wanted to stay to eat--just move tables.

Well, the staff had to move everybody ELSE and I had DH take his dad out to the car. I stayed behind and helped clean up. Then tipped everyone who helped $20 (this was 18 years ago--nowadays I would tip $50!!).

I bought a box of depends, and threw out all his thongs. He was mad, but never said anything. DH said I was being over-the top with this and I pointed out to HIM that dad had sat in poopy pants in HIS car, which required a major cleaning. If HE wanted to do this, he was on his own with his dad.

We think so much for the safety and care of our LO's, but I can tell you that this one incident (and there were many more) probably ruined the lunch experience for every patron in that restaurant.

Not giving them a choice makes the choice. It was the saddest part of the EOL care for FIL. By refusing to wear the depends, he made the choice to not be allowed to go out to eat. (The whole family was on the same page on this).

I'm sad to this day that FIL's stubbornness made his last 6 months of life fairly lonely.
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Cover99 Sep 2021
Lol Good for FIL. He wasn't going to let an accident stop his enjoyment.
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Mother was a little hesitant about it at first. Never thought it would happen to her. A trip to WAlmart showed her a large wall full of many sizes colors and fashions and she realized this is quite common. ( In her case she learned her boy friend always wore mens pull ups- I dont want to know the details) But my wife and I are both pharmacists and she began to comply after the
embarassment passed. Just dont use the diapers; Pink pull ups fit well look nice and work.
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HAve her wear Adult Pull Ups the times due goes out in case of accidents
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Get her some pretty incontinence underwear that are the "overnight strength". If she doesn't make it to the toilet in time, just help her put on a fresh pair.

My husband recently had his prostate removed for cancer. He wears the overnight pull up version of Depends for men. He places an overnight pad inside while he is working since he has very limited continence at this point in his recovery. He has not had to change his clothing once in the 6 weeks since surgery. He makes trips to the restroom while at work every 2 hours and only needs to change the pads, not the entire set-up. At night, he wears the same set-up and has not had any leaks for over 6 hours.
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Don't use the words "pads" or "diapers". Replace her underwear with pull ups - call them the new rage - disposable underwear. Blame Covid.
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Set boundaries. No pull-ups, no outings.

It is not fair to restaurants and patrons if the seats are wet and not wiped clean.
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She needs to be in pull-ups or actual diapers now. Depend brand pull-ups work pretty well for urinary incontinence.
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Pads aren't going to work for an accident. Get her pull up briefs. Depends are good along with some other brands. Make sure they fit snugly, but not not tight. refuse to take her out without wearing a disposable brief. Other answers here are good.
Don't start calling them diapers.
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BurntCaregiver Sep 2021
Never call them diapers.
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I started with having my MIL put the depends over her underwear and then began tossing her underwear. The key was getting her use to it until all underwear were gone, then no choice was available. This took about 3 months. Every once in a while she looks for underwear.
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After a few accidents insisted on incontinence briefs when going out. Was met with "I don't need them". So I set my own boundary - no incont briefs = no outings in my car. Round one. Change accepted.

Unfortunately product not adequate for need, so professional advice sought, suggestion was booster pads & clean-up kit to go. Again "I don't need..". So again, new boundary, again no car. Round two. Stuck there.

So that's where I exited. All transport must be with Aides.

(While that sounds harsh, mobility & behaviour issues were also big factors).

I believe 97yroldmom Is correct. It is something for the OP to adjust to - the new normal.
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KaleyBug Sep 2021
I put disposable or wash pads on the car seats for mom when she was alive. We also found Tena briefs to be the best, followed by Sams club. For dad Tena prove the best for men.
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My Mom had the same issue. I bought her the new “nice” underwear. She didn’t notice the difference and it saved me a ton of frustration for her and me! I hope this works. Remember, you’re not alone in this!
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Santalynn Sep 2021
Yes, tell moms/dads these are better style new underwear; underwear.
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I like your idea of having a change of clothes in the trunk. Always a good idea.
However, this isn’t a problem with mom. I want to gently suggest that this is a problem with your being in denial of moms situation. I’m sorry. I know you are working so hard to do for her. Time to reassess.

“very resistant to even listening to me about pads” so you have learned she has lost the ability to remember that she has accidents.

“this embarrassment for her”. What about you? She has already forgotten it’s ever happened.

She is probably only embarrassed in the moment.

Don’t leave the facility w/o her wearing incontinence underwear. If that’s too confusing for her to only wear then, have her wear them all the time. If she is having accidents with you, she is probably having accidents when you aren’t there. This issue will not reverse itself. You are just kicking the can down the road by ignoring that she has reached a new level.

If this is all too stressful for you and mom, might be time to rethink any outings until she has fully transitioned to protective underwear. If she has an aide to help her dress, ask them to have the underwear on her before you arrive. Don’t put yourself through this worry each time you go out.

The good thing is that once YOU have made the transition you will soon notice it is no longer a big deal to her.
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I would not take her out under these circumstances. Your mother has lost the ability to understand the consequences of her actions.

She needs incontinence underwear, not pads.

Replace her regular underwear with "fancy pants" or whatever euphemism you use.

There is regular underwear with built in protection (the brand I see a lot is called Speax; there Depends and Teva which are disposable.
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