I'm concerned mum's stay in hospital will leave her double incontinent

[Bluespecs]

My 82 year old mum was diagnosed with Alzheimer's back in 2018. She also has a pacemaker, is bent over with osteoporosis and last year received a breast cancer diagnosis, so not in the best health sadly.

She lives at home with my 84 year old dad and between my dsis and I we go in and see them most days. We help with modt things and mum has a carer in every morning to help shower and dress her.

As is with this awful disease mum is getting worse but has been doing quite well considering. She has had the odd toilet accident over the last few months so she now wears pull ups just in case but is able to get to the loo with help from dad or one of us. She goes to a day centre two afternoons a week and they never need to help her with the loo.

All was ok until 10 days ago. Mum fell in the garden. She fractured her hand, dislocated her knee and unfortunately has also fractured her neck (odontoid fracture).

She has been in hospital since. Everything is very slow. The massive gash to her forehead, the dislocated knee and the hand are all healing well. She has to wear a neck brace. They are telling us the neck fracture should heal within 6 weeks (contrary to A&E where they basically told us she would never recover).
They took another x-ray on Friday but we still have no answers yet on the results or when mum is likely to be discharged.

Mum is in an elderly orthopaedic ward where most have broken their hips. Due to their injuries they allow the patients to soil the bed and they clean them up. Mum is the same. I have tried explaining to the nurses that I am very concerned mum will not understand the difference between soiling herself in hospital and at home. I feel this practice is going to accelerate her incontinence (which I know is eventually inevitable with dementia).

She doesn't need to be bed bound as the physio/OT,'s have got her moving but due to staff shortages especially over weekends it's obviously easier for them just to clear up the mess than to take ages getting a dementia patient to the toilet.

Has anyone had any experience of this? Did their LO go downhill after? I fear this could be the beginning of the end.

Btw, mum is happy, she's always happy and hasn't made any fuss since being in there (not like many of the others).

I think this is a very reasonable worry. It might be time to be ‘that relative’. Ask to speak to the Sister or nurse in charge. I’d have another talk with the physio first to get their views on what is needed, but expect them not to back you up once you start causing a fuss.

Mil (died aged 76) was deemed to be a falls risk, so they adopted a similar frustrating approach. I'm sure it was based on ease of support rather than her dignity. We tried to remind them of the person rather than the patient. Sadly her final months were spent in a care home during covid where it was impossible to see how her personal care was handled.

Thank you. We asked today, apparently the second x-ray is still not acceptable so we will have to wait yet another day for answers.

So much hanging around waiting for questions which never get answered. Tomorrow we will need to ask for the nurse in charge.

BTW your mum sounds absolutely lovely

I am so sorry you are going through this. Before my dad 85 went in hospital he could walk fine and walk upstairs. After a fall and time in hospital as they didn't try and get him out of bed he couldn't walk when he came out and had to go straight into a care home. My mum tried to get him up and about but they wouldn't let her.

I'm sorry that happened to your dad, I fear this may be the case for my mum too. Although they are saying the OT team have got mum standing, she hasn't walked at all. She used to walk all around her bungalow and the garden and would walk to the day centre, I fear this will change after she had laid in a hospital bed for two weeks or more.

So sorry you and your mum.are going through this. I hope things are getting better. If/when she's back home, the carer section on the demcon.org.uk website gives some tips for managing continence at home for people with dementia. Beat of luck to you both - not an easy time.

We had similar with FIL and then MIL. The hospital just didn’t have the staff and time to do certain things and were overstretched massively. We asked and asked and it was made clear they were doing as much as they could just by treating and feeding them and anything ‘extra’ for quality of life / mobility / or that would increase fall risk just wasn’t going to happen in an nhs hospital ☹️

My mum has been in hospital for nearly 10 weeks, she went in with a bladder infection which has caused delirium, she was fully continental when she went in but was discharged a fortnight ago wearing incontinence pads. Unfortunately she had to be readmitted less than 36 hours later as even with 4 carers visits a day we just couldn't manage her, I couldn't get her on the commode on my own which meant I either had to get my brother out of work or my son away from university to come to help, the carers had already doubled up as it needed 2 of them to get her out of bed or from her chair to the commode, she has open pressure sores on the bottom of her back & her bum. The carers told me to not attempt to get her on the commode on my own as I'm disabled & the likelihood would be that we would both end up on the floor together. I asked what I should do & was told that she had a pad on & would have to do it on the pad. She has chronic diarrhoea because of being on Metformin for her diabetes & I was worried about her pressure sores getting infected. We ended up having to ring for an ambulance as our GP basically said that there was nothing she could do & if she came out all she would do was ring for an ambulance herself. 24 hours after she went back in, the hospital said there was nothing medically wrong with her except the delirium, 20 minutes later they rang back & apologised after she started screaming blue murder & had thrown a full jug of water at a doctor & hit the bullseye, they then said they would look at respite care, 48 hours later she was diagnosed with another bladder infection & was put on a 14 day course of antibiotics. My mum is now refusing medication & is not eating, when she went in 10 weeks ago she weighed 14 stone, she is now under 9 stone. A fortnight before she started being poorly she was up a stepladder cleaning windows, cooking, looking after herself , you would have thought she was only in her late 60's, now she looks like a skeleton & much older than 87. I feel like I have already lost her, she doesn't recognise or remember me, I know she wouldn't want to end up like this, I keep hoping & praying for something like a swift dose of pneumonia to take her peacefully & give her back her dignity, lots of people will think I'm awful for this, but to see such a change in 10 weeks is heartbreaking.

I get they’re overstretched but it’s truly disgusting to let adults poo themselves because it’s easier than taking them to the toilet. Things need to change. The nhs is a disgrace.

It's absolute disgrace, isn't it. My disabled ds (life limiting) was in similar situation recently in hospital and only b/c I was allowed to stay he got cleaned and showered after any such incident, dread to think had I left him as he couldn't communicate much.

I expect they know what they are doing to hasten a deterioration: dirty bed surely is a risk for UTI and that leads to delirium in older people - even without other UTI symptoms. We discovered it a hard way - his UTI in hospital was never even picked up until we did a test at home when we got him back.

We now have home strips to test for UTI - please keep an eye on that b/c UTI in elderly can manifest as dementia, delirium, loss of balance and more and the temperature can only be marginally raised so usually ignored.