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We have tried PT for pelvic floor exercises and urge suppression techniques. These don't work because she has dementia.


Tried a pessary and estrogen ring which seemed to help a little but now the involuntary peeing is much worse as evidenced by VERY wet pullups. I think it'll be removed and chalked up as unsuccessful.


Are any of the meds actually noticeably helpful?


Do any of the surgeries work??


TIA

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Your next step is diapers, bed pads and frequently supervising her to go to the BR. If this is impossible, then MC is next. Your profile describes moderate to advanced dementia. So why is she still driving?
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againx100 Oct 2022
Thanks so much for responding.

Already been in pullups for years. I have pads on her chairs, her bed and in the car.

Have not supervised frequent visits to the bathroom but looks like we'll be adding that to the schedule.

Whoops - I need to update my profile! She has not been driving since the beginning of the year and was told officially by doc NOT to drive in March and her license has been turned in for a regular non-drivers ID.

I have aides 5 days a week and keep increasing the hours. I know MC is our next step and it won't be long.
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Incontinence comes along with dementia. In fact, my mother became incontinent before we even knew she had dementia!! We were on the elevator at her ALF one evening, she & I, and she 'couldn't hold it in' and peed full on, all over the carpet on the floor of the elevator! She was mortified. From that evening on, she wore Depends pull up's 24/7. And she was diagnosed with progressive dementia shortly thereafter; that was 2016; she died in 2022, with her incontinence worsening the entire time. No meds helped her, she had no surgical procedures, and did no exercises; the dementia prevented that from happening.

When she went into Memory Care, the CGs toileted her every 2 hours, and woke her around 4 am for a Depend's change and/or a trip to the toilet.

It is what it is, part and parcel of the dementia and that whole situation.

And yet another excellent reason to get mom placed in AL where others take on that duty too. Getting her toileted and changed out of soiled Depends.
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againx100 Oct 2022
Thanks for once again sharing your excellent advice.

I'm bummed that this sounds like I should basically give up on one more thing that I've hoped there was help for. Ugh. While she's still home, I'll ask the caregivers to help her with a toileting schedule.
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You can ask her doctor about meds but I would think thats the first thing that would have been tried. I would even wonder how they thought she would be able to do pelvic exercises with Dementia. My Mom forgot what it meant to "push". Really, she is incontinent. It comes with Dementia. They either forget how to "hold" it or the brain can no longer send messages to the muscles to "hold" it.

What I suggest is if she drinks coffee, tea or sodas, cut them out. They irritate the bladder and make you go. Cut out liquids an hour or two before bed.

The only operation I know of is the sling. The bladder tends to "drop" as we age. This causes the bladder not to void completely. Which causes UTIs. So they use a "sling" to bring the bladder back up. Not sure if it helps with that "urge". I think the meds are more for the urge. If she no longer has control of her muscles, she is going to pee constantly. Maybe trying to take her to the bathroom every two hours will help.
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againx100 Oct 2022
Thanks for responding.

When we first started this incontinence journey, she said no to meds. Now that she's worse and my POA is activated, I'm wondering if saying yes could make life better for everyone involved. Or if they're just basically useless. Like so many meds are.

We did cut bladder irritants - caffeine, carbonation and booze. Made no noticeable difference, unfortunately.

I'm thinking that the every 2 hours toileting schedule might help. She's NEVER had a UTI, which I find amazing. Was just tested last week due to the increased weight of per pullups.
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