Incontinence –please help

[pufflingsencroute]

My mum is currently staying with us and will be for a good few months. We are struggling with her incontinence as she refuses to discuss it at all. I don't even know whether she gets pads on prescription or buys her own.

The smell at times throughout the whole house is just horrendous, and while I am very sorry for her and appreciate that it must be awful, she is also a hoarder and very reluctant to get rid of the binbags she is piling up in her room. I suppose most of these must contain used pads. I can get her to put them outside her room for me to dispose of maybe once a week, but it needs to be more often than that.

She just closes up when I try to talk about it and shuts down the conversation. I think I am trying to be kind and considerate in my wording and not make her feel embarrassed - have been saying things like "I want to help you with the incontinence."

Please, can anyone suggest anything else I could be doing? We really are starting to go spare –windows open and chemical-nasty candles are burning most of the time to try and eradicate the smell, and we will have to bin our sofa and the mattress when she does go home.

Alas, this is one of those times when you have to be very direct about things - 'mum, you need to put your pads in the outside bin everyday, it is making the house smell and I don't like it'.

An alternative is that my mum was drying out incontinence pads and the solution was to get the washable pants which have actually worked really well. But you can't avoid a very direct conversation I'm afraid

Thank you, CMOT. I will try –she just does get really hostile and puts the barriers up when it's anything she doesn't want to talk about. It's really difficult.

"Drying out" incontinence pads? What, and reusing them? Surely not!

Washable pants are better, then? Do they not make the washing machine smell - or do you put them on at a really hot temperature, maybe?

Thanks so much for your reply, it's all a bit grim atm... :-(

The thing that I have discovered through my journey with my parents is that learning to parent them is the hardest. But making them talk about stuff they don't want to is the only way to look after them sometimes. Dad and I have had some cracking arguments - when they needed a cleaner, a carer, when he had to accept that mum had dementia and so on.

Oh yes, drying them out on the radiator and using them repeatedly...
Bio washing powder works fine, though I'd add Napisan personally (dad can only just cope with bio washing pods). You have to wash at 40 as they are all in one and too hot will hurt the waterproofing layer. I get mums on Amazon and she accepted them very easily which was miraculous.

It is grim. And no one in RL wants to hear about your parents incontinence so its v hard to get support

Would it be possible to get her an appointment with a medical professional perhaps she might listen to their advice?

Go through your GP and ask for the number for your local bladder and bowl service for advice, if your mum agrees they ll do a continence assessment

Thank you all. It actually helps a bit just offloading here.
Rhino, she has a doc's appt shortly–I will ask her to mention the issue and I have also given information to the doctor about her, but because she has capacity I can't be sure it will be spoken about at the appointment, and of course she won't allow me to attend with her.

I think she probably has pads on prescription but they're maybe not absorbent enough now. It looks as though maybe the washable pants can't cope with really heavy leakage, either, I'm not sure.

The other thing is that she won't wash, either. She is slow and not very mobile, but I have installed secure handles in the shower and a proper disability sit-down seat, but she still won't have a shower or wash her hair. That's nearly a month now :-(

I found a firm called Clearwell mobility that has all sorts of specialised kit for elderly and disabled. Dad has a waterproof cover on his mattress, but they also had a sheet that could absorb up to a litre that saved the carpet a number of times. Likewise a choice of disposable pads, pants and washable kit.
As for disposal, if she won’t co-operate with instant disposal of waste, have you considered one of those nappy bins that seals each one in its own bag as you put it in? Her unwillingness to discuss solutions is a major issue, as it was with my dad. I had to get very explicit and professional on him before he started co operating grudgingly.
She may also need barrier cream as skin can get very sore. Getting professionals involved can be helpful.

OP - you can’t cook pufflings

I can only say re the personal washing, one contact had to tell her mum bluntly “You smell, I cant be around you”.

Interestingly, her mother wasn’t upset...later we got to thinking perhaps tippy toeing round it had been unnecessary, as the mother was lacking in sensitivity a bit in not realising how she was upsetting others?

I feel for you.

I really think the only thing is to be really blunt and direct, as you might be with a toddler. I would think the smell is her, as much as used pads, if she isn’t washing. Maybe she is wearing pants that aren’t clean, or clothes ?
Can you swiftly nip in and clear any pads out of her room when she is downstairs, or napping ?
I also wonder if a District Nurse might have a chat with her ?
Does she have a stack of pads in her room, and is she definitely using them ?

"Drying out" incontinence pads? What, and reusing them? Surely not! Yeah. Prescription pads aren't issued in large enough quantities (I've heard two a day but that's just hearsay), buying your own is expensive and physically difficult, carrying home perhaps 3 big bags a week. So there's a strong incentive to re-use, especially if the one you've taken off appears to be hardly wet.

Also, my dad used to dry out pants on the radiator rather than give me wet pants for washing.

Washable pants are better, then? Do they not make the washing machine smell not in my experience, but you can always use biological powder.

See if she'll use nappy disposal bags or dog poo bags - our smells got less once Dad started using those. And look at floor coverings - minor drips accumulate and add to the smell. You could try Simple Solution which is designed for cat wee, but may well work on human wee.

No direct experience of your situation but an incontinent adult definitely shouldn't need to smell or cause the house to smell. My work includes caring for adults with disabilities who use incontinence pads and adult nappies and none of them smell, not does the house or furniture. She absolutely needs to be changing her pads every 2-3 hours except when sleeping, putting them in the outside bin, showering daily and washing all her clothes and pyjamas daily. There's no need for the smell.

How to talk to her about it is a very difficult question. Friendly and with a smile, sometimes a bit of humour but firm and direct is best in my experience, but that's not experience with a family member, rather with clients with learning disabilities.

Thank you all for your replies –sorry I haven't got back for a couple of days. Some really good tips there

Things have gone from bad to worse, unfortunately. She wouldn't discuss the incontinence at all, along with some other issues that we really need to sort out, and yelled at me "Not TODAY!!!!" which is her answer to everything, always. Everything is put off discussing until tomorrow... when it's again put off until tomorrow.

So I had to write it all down in a note, in which I was again as kind as I possibly could be. But now she's not speaking to me. She just came into the room, put another note down saying she's taking a taxi out to the shops this morning, and walked away, even after I was calling "Morning, Mum!" Jeez.

Is there someone from outside the household who could talk to her? I'd guess it'd have to wait until after the Christmas season unfortunately, but a community nurse or even a specialist incontinence nurse might be contactable via your/ her GP.

Very often personal, embarrassing advice/ talks are received far better coming from someone perceived as a neutral professional than from someone with whom you have a long, personal, complex emotional relationship and especially from your own offspring to whom you used to be the strong, reliable, all knowing parent!

So whilst she's a guest in your home she is being abusive towards you and marking her territory with urine

Aww it’s a difficult one OP, I don’t envy you, your mum is probably embarrassed and in denial. She needs help as you say but she can’t expect you to put up with the smell in your home, it’s just not fair. Do you think your mum could be depressed or has the beginning of dementia? She really needs to see her GP who will signpost the fastest service to help her. Good luck I hope things improve very soon.

She may not be able to smell her own wee (I can't usually smell mine), in which case she may be wondering why you're attacking her by telling her she smells. I'd agree, get a professional in. Meanwhile, take advantage of any absences to clear out wet pads from her room. And smelly clothes into the wash, if you think you could get away with it without WWIII.

Thanks, all. She does have a doc's appointment next Monday so I really hope she'll bring it up then –I have also written to her doctor to ask her to. But I don't think there's much I can do, if she refuses to discuss it with the GP. She did have a district nurse coming in for a while and I asked her to speak to my mum, but nothing changed, and the nurse couldn't tell me anything due to data protection. Couldn't even tell me if they'd discussed it.

What works for our disabled 10yo:
Nappy sacks (Tesco variety are far superior to Asda), then into a scented bin liner (Asda) in a lidded plastic bin, then that goes outside every 3 or 4 days.

I noticed last weekend that MIL was now using pads, she had placed the nappy sacks on top of the pack of pads to remind her to 'bag' her used pad. Her house still smelt of cat pee but not of human pee, so it must be working for her!

Go into her room while she's out and get rid of the old pads, then seize all her clothes and stick them in the washing machine on 60. Change the sheets and keep the window open.

This is not a rare problem when it comes to eldercare OP. Addressing it with them only gets you so far - again, not a rare problem.

The upside is that they usually don't mind you restoring sanity and cleaning stuff up. Taking the initiative is your friend here.

When it comes to her not washing herself, not much you can do except wait till it's time for carers.

Keeping the clothes, the bedlinen and the rubbish under control without asking her should keep her not smelling too awful.

My mother in law was the same when she came to live with me. The smell from her room was horrific. In the end I had to be firm with her. She either let me help her or she find somewhere else to live.
I ordered her pads online monthly (the nhs supplied ones were no good and she needed far more than the 2 per day allocated) and I helped her shower at least twice per week. It was non negotiable. She went on to live with us until her death 10 years later

If you do chuck anything in the wash, pop some zoflora in the prewash part of the drawer and make sure it's set to do a prewash. It's working wonders for our problematic smelly items here.

I'm sorry you're dealing with this. My eldest is still on and off incontinent and it's been a rollercoaster of emotions over the years

I know the overall toileting is an issue and I hope she will listen to you regarding that.

I've recently had an operation and I've been using the Drench shower wipes. They've been a total lifesaver. Could they help with the bits in between baths and showers.

Hope you manage to get something sorted OP x

You could try emailing her GP about the problem. Yes, you can only DISCUSS her problems with her permission however you can let the GP know your concerns about your mother, she has an appointment with them on XX date.
Call her surgery & talk to the reception, let them know that you have information you wish to pass on to her GP, no you do not have permission to discuss but you want your worries logged on her notes for the GPs to see.
This is what I did with my mother until she gave me permission to talk to her GP on her behalf.