Options for incontinent parent

Hi, I have been caring for the elderly for more than 20 years, day and live in support. Incontinence is tricky, especially in the early stages. You have probably tried various options. The pull up pants work well initially but high absorbency insert nappy style will prevent getting wet or leaking which will help with stress. Your local authority may supply? Also as in previous replies, drinking enough is always a problem. UTI can cause delirium and agitation. Has an Occupational therapist been to do an assessment? Is a stair lift an option?They will provide all equipment free. A care home isn't your only option, support can be provided at home. It's finding what works for all of you. Happy to chat.

Thank you @FredaFox

She has carers 4 x a day, daily district nurses and tbh I've been there but I did go home this weekend for 2 nights, I am comfortable leaving her now.
When she first came out if hospital at Christmas I was getting up in the night turning her over in bed but as the sores are improving I don't need to
We've only gone to private care 2 weeks ago and they are great. District nurses think she will be back to sitting in her recliner by May so it's not a quick fix

@FredaFox my mum is currently in hospital and is virtually bedbound. Does your own mum have anyone with her at night to help her at all?

It's probably too late to get POAs for your DM but I would discuss getting both health and finance POAs with your DF.

I would ask your DM's GP for a medication review for her and a referral to the Continence Nurse/Team. Your DM might benefit from some anti anxiety medication if she's getting very stressed over this and some advice from the continence nurse could be useful.

If there's no private place for the commode downstairs, can you DF draw the curtains? My elderly DA had to have a commode on the lounge got a few weeks after a fall and this is how they coped.

I'd be worried about your DF taking her upstairs so often, it sounds like they are both at risk of falling.

I would ask for a Carer's Assessment for your DF, he must be utterly exhausted and a Care Needs Assessment for your DM. Just make sure you're there for the appointments as your DPs are not likely to explain the full extent of their problems.

Is your DF in touch with the local Carer's Group? My DFIL found our local one very helpful once he finally got in touch.

My mum has had Parkinsonism for ten years
She started with pads in her knickers due to accidents, we progresssed to Tena discreet knickers, now she has big pads from the incontinence nurse
My mum mentally is fully with it but has mobility issues so still gets the urge to go the toilet but can't get there on time though as times progrsssed she doesn't always know she has weed

You mentioned bed bound people, my mum is currently bed bound due to pressure sores incurred on a recent hospital stay. she is currently using slip pads which in effect are like adult nappies, she has carers 4 x a day to change her. hoping once the district nurses say she can start moving and get out of bed she can return to her previous pads but of course there's a risk she so won't walk again (her hospital stay was for an ankle break)

I would encourage you to speak to the incontinence service, they are great for my mum
Good luck

Just seen my bed bad link didn't paste. It's these:
https://www.ageukincontinence.co.uk/incontinence-shop/incontinence-bed-and-chair-protection/bed-pads/vivactive-bed-pads-maxi-60x90cm-2600ml-10-pack.html

Is she drinking enough water? My DM displays delirium symptoms when she doesn’t drink enough water. We buy her those little bottles of water. Easier for her drink and we can keep an eye on how much she’s drinking.

Also you can get a commode that looks like a normal chair. We thought two for my DM. Lloyd Loom style, so fit in nicely with her Victorian house decor.

I disagree. I'm pretty well fully incontinent and find these work 95% of the time: https://www.ageukincontinence.co.uk/vivactive-pants-maxi-medium-2200ml-10-pack.html

I get a delivery of 20 packs every six weeks.

At night I put one of these in my bed, as the pants can leak from the sides of the legs while I'm sleeping. Also good for sitting on if needed:

It sounds like she's may have a dip in her dementia however a UTI can also mimic a decline in Alzheimer's.
Her living situation seems unsuitable as the bathroom is upstairs.
I would definitely recommend a commode. She may have a hard time adjusting to having it downstairs and forgetting it is there ect.
Get a plastic box/ draw set with pads, wipes ect.

I’ve had another thought! I spent five years supporting my fiercely independent Mum with dementia so have tried lots of tricks to keep her at home. She did end up in a care home during the first lockdown as she ended up in hospital after a fall and the hospital doctors said she was unsafe at home - I knew this but had tried to delay things!

I used doggy pee pads on the floor near the toilet pedestal to catch most of the urine accidents when Mum was in a rush and struggled to get her clothes off in time. On a carpet like in a living room they do not slip as much as they do on a hard floor so after we sectioned off a corner of the hall for a commode and screen ( a beautiful 1920s art deco free standing folding one) we were able to protect the carpet quite well. She was able to use the stairs so overnight used the bathroom and one of my first jobs each morning was to check the floor! We were able to block the front door and direct people round to the side door so we created a private area in the hall.

Not ideal but it kept Mum at home for her final year or so.

Pads are easier to change than knickers, which need you to take off tights/trousers and shoes and then put them on again.

It seems like a horrible step, but pads are the way to go. Trying to keep clean and cut down UTIs gets harder and harder as continence becomes more of a problem. However, it's also good to keep using a commode as long as possible (because it encourages movement and some independence, which is good for both Parkinsons and dementia) so it would be great if you could find a workaround to the privacy issue... Maybe a clothes rail with a sheet or curtain hung over it? And perhaps a pile of old towels next to it to throw on the floor in case of accidents. It sounds so undignified I know but it's a case of just 'making do' quite often.
It's so hard I know when you're dealing with ever-changing/growing care needs.

IMO, everyone over 18 should donate power of attorney to someone that they know and trust. We never know when we might be rendered unable to make decisions for our self - when we’re younger that might be temporary but unforeseen things happen and having it in place gives protection. DH and I are mid 40s and have it for each other (health and finance) and we’ll be talking to dc about it as he turns 18.

Legally, NOK doesn’t mean a lot at all. This explains it fairly well.

https://continuing-healthcare.co.uk/continuing-healthcare-guidance/why-should-a-lpa-be-in-place/#:~:text=It's%20important%20to%20note%20from,Power%20of%20Attorney%20in%20place.

Regarding the incontinence issues, even in a care home, it’s likely that your Mother will wear full incontinence pads or pants as the staff will not have time to take her constantly to the bathroom. I don’t know the make of the ones my Mother wore when she was in a care home but they seemed to be very effective at stopping leaks.

Yes, having joint POA with your father would be very useful for the future. However, your Mother might no longer have the capacity to agree to the POA, someone other than one of the attorneys needs to witness your Mothers signature and confirm that she has sufficient capacity to understand.

You might be too late to get POA for your Mother but if you don’t have it for your Father, get it done as soon as possible, otherwise you could end up not being able to make financial or medical decisions for either parent

I don’t think your Father can deal with your Mothers financial matters ( other than those in joint names) with our POA either, being next of kin won’t be enough for banks to let him access her accounts.

Even medical issues can be a problem without POA, when my Mother was on end of life care, I was only able to insist on no further treatment or hospital admissions because I had POA, being next of kin was not sufficient for her doctor or the hospital. I had to show copies of the POA.

www.wayfair.co.uk/Etta-Avenue--Alasdair-Enchanted-in-Marble-Room-Divider-BSHW1234-L250-K~ARGV0123.html?refid=GX666875634657-ARGV0123_28107792&device=m&ptid=293946777986&targetid=aud-1648725145179:pla-293946777986&network=g&ireid=50968660&PiID%5B%5D=28107792&gad_source=1&gclid=Cj0KCQiAwvKtBhDrARIsAJj-kTircdwSGJ-asaxL87CyH2t6BUR0MCx2-qQ-d4JDwJn21laQQTe49rUaAhNFEALw_wcB

This is the screen I mean. You can get bigger ones too.

You can get a screen that s teens off a corner of a room. Could you get one of those and keep a commode behind the screen? One of my Aunties had to have this as nowhere a toilet could be put downstairs. It worked quite well. Also instead of those dreadful incontinence pads get the disposable knickers. They fit better. Then it's just a change of the knickers and wet wipes. Clean knickers on. Shower in evening.

Incontinence pants are only suitable for light cases as they don't absorb enough for medium to severe cases. So maybe that's a cause for distress? You'll need to supplement with pads/adult nappies/disposable pants if she'll tolerate any of the above.

My dad (also with Parkinson's) was in a similar situation although they had a downstairs bathroom. He was going to the toilet every 15 minutes during the daytime and wearing incontinence pants though these leaked every single night.

Is there any space for a commode downstairs at your parents house? My dad had one supplied for his LA for his downstairs bedroom for the night-time toilet trips.

Other than that maybe a continence service referral? Dad had one but after 6 months of waiting he was hospitalised with sepsis, then discharged to a care home as he & mum simply couldn't cope at home any more even with carers coming in.

In the care home he's wearing heavy duty pads so on the occasions when the staff don't get to him in time, there's no leakage. I have to say he goes to the bathroom less now he's there which I think is down to being less anxious about creating washing.

It really is just a case of incontinence pads and a commode. If there's no private place for the commode then it's a curtain or a divider as someone else suggested.

We had similar issues with my stepdad.
Make sure that there's no infection causing the need to go.

My stepdad now uses Sana incontinence pants from Aldi.

Well it seems quite obvious that they need to move house so they can have access to the facilities they need all on one floor, however I appreciate this isn't an easy and simple solution.

I work with an old lady who had exactly the same problem so we put her in incontinence pants and the effect was very positive - knowing she was wearing the pads took away her anxiety about accidents, which it seemed had become a large part of the problem. Once she no longer had to worrry about it, the urgency decreased and it seems even her bladder sort of relaxed so when she wants to go, she can. She wears the pants but rarely has an accident in them. The anxiety had caused a sort of self-fulfilling vicious circle, which was broken when she didn't have to worry about accidents anymore.