Caring for elderly aunt with incontinence and dementia. She rarely toilets. The time intervals between toileting or having accidents is quite excessive (she's also averse to drinking much). When I try to suggest she go, she continues to say "I'll go when I have to go!" and "I never have an accident!"
Every 2 hours get her on the toilet this will do a few things.
Repositioning if she is just sitting in a chair this will get her up and moving and getting blood flow to areas of pressure.
You can check the brief and if it is wet or soiled it can be changed.
If the brief is not wet or soiled a few minutes on the toilet might get her to go so she does not have a wet or soiled brief in the next few hours.
Also just changing the position can get the kidneys to function and flow a bit better. It never failed as soon as I would adjust my Husbands chair either sitting him up a bit more or reclining him he would "go"
At some stage the choice to get up and go to the bathroom is not a choice she can make it is one you have to control.
She has a phone alarm that goes off when it's time to take her meds. These are generally every two hours. So I'm trying to get her to go then, based on "instructions from the hospital" that she was given during her last UTI visit. (I retyped them to read "every two hours, even if you don't feel the need." It helps to have something in writing to point to. But even then, I hear, "I just went 20 minutes ago!" If I continue to try to persuade her, she'll usually get mad and go just to prove to me that she doesn't have to. But I don't want to always be arguing because the one thing she doesn't forget is bad feelings.
As someone mentions below, I'm also trying to get her to go and wash up for dinner as an excuse. That usually works without too much difficulty. Every evening she gets an M&M snack. This is her addiction and used to sit eating them all day long before she came to live with me. Last night she saw them laying out for her and I asked her to go to the restroom before she took them and she agreed almost cheerily!
I have an upcoming fight on my hands because many mornings I go into her room and find her PJ bottoms and panties hanging on a door knob drying. So I'm going to insist she start wearing Depends at night. She doesn't wet the bed, but she can't make it to the toilet in time once she's on her way.
I wish I had good advice to give you! But I've mostly just vented here to someone who understands because I'm stuck in the same spot! Sorry.
Drink something and time yourself how long after you have to go. Then use that as your guide with her. See if that works. Or time her Then adjust.
Try a potty near the bed. That might be easier and faster to get to. Or distraction techniques to get her up thinking about something else. If you say it's time for the bathroom, she'll probably argue no it's not. Say it's time for your show, or to put your shoes on, or a snack etc. She wont be thinking about arguing about the bathroom.
If she has a history of UTIs try a probiotic and cranberry tablets and as much water as u can get into her. One problem with Dementia is the brain no longer tells them they are thirsty. The every 2 hour thing is good. Let her sit. UTIs are also caused by not completely voiding. As woman age the bladder drops and it doesn't completely void. The last time Mom was in the hospital for a UTI, she was catherized and they got every bit of urine in her bladder. Make sure a culture is done for the correct antibiotic. When on an antibiotic, a probiotic should be given. This is when Mom started the cranberry tablets. Its not so much sitting in urine that causes UTIs its sitting in #2. Make sure she cleans up real well even if you have to do it. I used a handheld shower head when I bathed her. Some recommend soap but that can cause infections if soap gets in the urethra. I buy Huggies wipes they are big and thick.
When Mom went into LTC they took her every two hours. Eventually your Mom will be incontinent. She just will not know what "holding" it means. She won't know she has to go.
If they are combative, they are tryng to retain their dignity and a trick is to
just go with her when she has to go to bathroom and get personal care done.
Accidents are messy but if using diaper pullups, even with accident, you can remove by tearing diaper on crease while on toilet. We use a bidet and you can install a portable one for 99. dollars.
Put infectious waste ( dirty diaper) into plastic bag and tie.
Use a bucket with
a little bleach and soap to wash out clothes
Use chucks aka paper liners for bed and chairs.
Be sure you use gloves.
Once you have a person on toilet, if you have access to shower hose and no bidet, you can rinse perianal area and flush.
Use incontinent care products for geriatrics (spray body wash, toilet paper, and wipes) Do not flush wipes into toilet.
Hope this helps.
The invite to walk them to the bathroom every 20-30 minutes works better. Please see my post.
Nursing would consider this too hard to keep to...but it worked and made their jobs easier.
Every 20 to 30 minutes, timers were set for consistency!, all staff and volunteers offered to walk patients to the bathroom.
" Would you like me to walk you to the bathroom"
"I am going over by the bathrooms now, may I walk you over."
A simple invite, low key...
Never asking if they Need/want to go now!!!
Just an offer, every 20 min worked better, but keep it as consistent as possible. Have any visitors looped in to the routine and protocol!
When there were accidents, it was cleaned up, nothing said, just back to offer, even if it was during clean up or just after an accident.
This being treated with respect, as an adult, no shame, kindness becomes their routine. Often they go through the motions due to the attention. Improvement in days to a week, by 6 weeks 80%-95% reduction in incontenience. Reduced UTIs.
Staff kept up the protocol and we're monitored for a full year. Results held! Just ask them to walk with you! Use your phone timer or a kitchen timer. Only during waking hours! Their body will start to adapt and less issues during sleep!
Please pass this on!!!
You can set them to dispense as few or as many as you want. A couple of M&Ms 10 or 15 times a day is far better than 1 UTI.
Best of luck, such a difficult challenge.