How to broach the subject of incontinence with my MIL

[WoofWoofBeachLife]

Hello, my MIL is 76 this year and ferociously independent. She worked up to October 2021 when she was 74, she was a cleaner at the local school. Since then we have seen her slowly deteriorate, especially in the last 6 months. She has osteoporosis and suffers back pain at times, she takes osteoporosis medication, anti inflammatory medication and painkillers. Mid February her back was painful as she had done too much in the house cleaning, she was housebound for 3 weeks before venturing out. During this time she mentioned peeing a lot but a dribble at a time, I got her an appointment straight away and took her to the GP who prescribed her antibiotics. He didn't take a sample from her. She hates going to the GP. Since then I've noticed there is a very strong urine smell from her dressing gown and the chair where she sits, but not when she is dressed on day clothes, only pyjamas and her dressing gowns, she has 3. She is able bodied and shops, cooks and visits friends and has visitors everyday, she is quite forgetful but not irritable with it. She is sharp brained with quizes, anything financial and plays suduko and solitaire too. She often forgets to switch a cooker ring off or that she has something in the oven though. It's the urine I am worried about first to tackle as she could have another infection but not noticing, she said she didn't have symptoms last time. I'm wondering if she is incontinent at night but she is very particular about washing clothes and showering daily so I don't know why she can't smell this. The problem lies with how to approach this and deal with it. She is headstrong and we do get on amazing but I would hate to upset or offend her with a clumsy approach. She has 3 sisters and my husband will give her elder sister a call tomorrow to start the ball rolling how to bring it up. Had anyone successfully conquered this subject, how did you do it?
Thanks for reading it's a bit long winded.

I'm wondering if she is incontinent at night but she is very particular about washing clothes and showering daily so I don't know why she can't smell this. You can’t always smell your own urine.

I work in the care sector.
I'd suggest to her about incontinence pads - literally 85% of the clients wear them!!
She could have another uti but also sounds like she just can't hold it in at night. Perfectly normal at that age but def ask dr to dip a stick just to be on the safe side.

Also the forgetting side of things is a worry. I'd ask the doctor about that. Her leaving on a job ring is really dangerous and she could cause a fire or harm to herself.

She may even be forgetting to go to the toilet when needed.

You would most likely be referred to the memory clinic.

Im afraid it does sound as if she has cognitive decline. My mother turned out to have small vessel disease, which is closely associated with incontinence.

I would go very gently. Say that you're a bit worried about her as some things seem to be harder for her now. See if she responds at all.

You could then say that you're wondering if she perhaps has an irritable or weak bladder (my mother used this term) and again see what she says.

Say that you've found Tena handy on occasion and has she considered trying them?

Tbh something she could try that often helps is to go for decaf, if she drinks coffee or tea. I have some continence issues and it works WONDERS for me. Also suggest that she sees a women's physio - it's a way into the system.

If you can bear to lie and say that you've found these things helpful, it might be a good idea.

We need to get Mum to allow us to speak to the GP for her or with her too, that's another subject. Thank you for thw suggestions. I don't mind at all saying I've found these things helpful. I have asked her how she feels after her antibiotics and said promise you will tell me/us if something doesn't feel right and she said yes. I don't think our practice offers the best for her needs, it's 2 make GP's, one she hates and the other she won't discuss what she calls lady things. There is a another practice across the corridor with several doctors available and female doctors. One of her sisters has brought up the subject of her memory but we have still to be brave enough to speak to Mum, she's also very stubborn. I know we need to address this now and not put it off. Thank you for the decaff suggestion as she does have a coffee in the evening later on so that will not help. I should change myself to decaff. I will bring thw subject up about Tena in regards to myself see what she says. X

My wife is 76 and was given pads by the NHS. They were terrible. They looked awful and she hated them. We then discovered Tena pads. We now buy packs of 108 pads for £64. Not cheap but she does not mind wearing them and feels happy in them,

Thank you Paul for replying, I'm hoping we will take a wee step forward today when my husband speaks to his aunt later.

while you are thinking about health issues, have you got power of attorney for her? for both finance and health? if she will consider that topic, you want to get it set up asap, before any cognitive decline sets in.

you can remind her that this is a backup option, so that if she were to have a hospital stay then you can pay her bills and talk with her doctors etc.

My DM has osteoporosis and recently fractured a vertebra. It's very painful and she has been given quite strong pain relief. I only mention this because since the fracture and taking the pain relief she has also become mildly incontinent, basically can't feel it in time. So I got her some always incontinence pads and she's much more confident about going out. She is of a similar age to your DM. Is it possible that her medication is dulling the sensation for her?
You could always say you've been reading up on osteoporosis and the side effects might give incontinence issues so here are (get a variety including the very thin liners) some products in case it happens to you

I'd suggest to her about incontinence pads - literally 85% of the clients wear them!! But whose preference is that? My experience is that the carers much prefer oads because they can be changed without taking trousers off.

@parietal that's the next thing we need to tackle as soon as we can. That needs to be the Husbands job to have a chat in private. He's finding it hard seeing his wee Mum like this.
@ninjafoodienovice I didn't think of that thank you, I will bring it up with her and reference my own medication and say its happening a little to me and see what transpires. We are popping over when she is out at the weekend to check the bed etc. It's hard she's an amazing woman I just hate all this we love her so much ♥️

I’ve found with my mum that taking the direct approach is the only thing that works. “This dressing gown is getting a bit whiffy mum, I’ll shove it in the machine - do you want anything else doing?” “Are you struggling a bit getting to the toilet in time mum, would you like me to get you some Tena pads when I’m at the shops?”

appreciate that you may not have the same relationship with a mother in law compared to your own mum. I try and emulate the detached, kind but direct manner that doctors use, have the conversation and then change the topic to something else. Seems to work ok and I wait until I get home before I cringe!

@funnelfan I could actually do that, I think that's the best approach thank you. We have a good relationship and she says it how she sees it 🤣
It's better than pussy footing about and making a hash of it. X