Incontinence, how to broach?

[Flora73]

My Mum is 76 and has Parkinson’s. She still lives independently but I’m not sure how much longer this can go on for. She lives in leggings and jumpers/T-shirts but it’s become apparent that she never wears any underwear under the leggings and she doesn’t appear to be changing them regularly. She is beginning to smell of wee and we really don’t know how to broach the topic with her.

She used to be so immaculate and concerned about how she looked, and I’m not sure if this is a result of the cognitive decline with the Parkinson’s. Such a hard thing to have to raise with her, but if we are beginning to smell it then other people will as well (not that she really goes very far now anyway or does very much, but that’s another topic!)

Any help on how to raise the issue delicately and without causing offence would be much appreciated!

I would be surprised if she can continue to live independently op.

I think this needs to be a wider chat with her about next steps in terms of her living arrangements

I think matter of fact is the way to go. I used to work in care. Sometimes it helps to make clothing rolls ( legging, top, incontinence pants and socks) put them in easy access storage and label days of the week. Another set for bedtime. Digital calendar that says the day. Laundry basket with a lid so dirty clothes out of sight

Thank you for your reply.

I think you’re right, but she steadfastly refuses to consider moving.

That’s really helpful, thank you.

it’s staining her sheets, and I don’t think she’s showering that regularly. Predominantly because she struggles with the shower I think.

@Stubtoe The incontinence was? This is so out of character for her. She always made such an effort with how she dressed and her overall appearance, so maybe you’re right.

My mother has been incontinent for a few years now it’s just gotten worse. Poo on the floors walls etc. she just says it’s a rare event (it’s not) and won’t accept the truth. She sis cleaners come 2x a week and she sends them home early so I just leaving her to it now. She knows but doesn’t want to go into care so she can live like that. I would raise it but be prepared for denial.

@Galdownunder Oh crikey, that must be so hard. Fortunately we’re not at that stage yet. I do fully expect denial however.

Sorry you’re going through that.

It’s something you can find ways to scaffold if not ready for residential care. Incontinence pants at bedtime, a seat in the shower, someone to come and wash her/ her hair a couple of times a week?

It might be a good idea to book a couple of hours with an independent experienced carer who could work with you to come up with strategies.

Not sure about where you are but here we have continence nurses that will visit the persons home (for what that’s worth).

Bluntness with care is the way forward, and statements not questions. 'It's not as easy as it used to be for you to manage getting to the toilet on time mum. I think you need to see a nurse about it. I'll give them a call'. Then tart with the community neurological nurse for Parkinsons - google them or try your hospiral Trust. She should have the contact number herself if she will cooperate.

if no joy then Google the Bladder and Bowel service in your area and have a talk with them. There will probably need to be a GP referral. Make sure you're there for the appointment.

This way there is a chance for them to protest, but it's less effort for them to let you take action.

I agree re bluntness. I wish I'd just made my mum speak to her GP and get referred to the Incontinence Service ages ago. If she's not using the loo it's a medical problem (and will probably land her in hospital with a UTI soon enough), so go that route.

I know it's easier said than done though. It's baffling watching someone let go like that.

I'm glad it's not just me! I tried to raise it with my mother (although she wasn't as bad as your mother seems to be) and she blamed the cat! I just didn't know what to do, she was a determined person who didn't like being told what to do. One day she fell and broke her hip and while she was in hospital I discovered just how much she wasn't coping, and she went into care. I always said the broken hip was a blessing in disguise. It's so hard isn't it?

I think being direct is the least embarrassing way. Be factual. Mum , are you wearing underwear? I can smell wee. Shall I get you some tena lady when I go shopping?

Agree. But do get referred by your gp. Tena lady ain’t cheap and you can get a prescription for incontinence pads

Parkinson's doesn't necessarily mean having to move home. However, it does mean that supported living at home may be required. In the situation you describe OP, I do think your mother would benefit from a range of help.

It's best to be honest with your mother but do so in a proactive way, not one that could be interpreted as ridicule. Tell your mother gently and compassionately that you've noticed she's been struggling with laundry and bladder weakness. The Age UK website is a great resource for links, information and contacts. It sounds to me as though your mother would benefit from a home carer, who would also provide company for her. The carer could help with washing, preparing food and would also have some medical training.

Your mother's home should also be made more suitable for her changing needs. Hand-rails are a must, as are adapted showers that are suitable for those with mobility needs. Adult Health & Social care may be able to assist with this. Remove trip hazards, such as rugs and also carpets, which could hold odours of urinary incontinence and can prove difficult to clean.

Offer to help with laundry, for example, you could ask if she'd like you to run her bed sheets through the wash; "whilst I'm here can I wash anything for you mum" or something along those lines would be a gentle way of offering help.

Make the effort to spend time with your mother, play a game of cards perhaps or dominoes. Do a jigsaw puzzle. Keep a keen eye on her mental health, as she could be suffering from depression from the issues you describe. A lack of self care is usually a key indicator that someone is in a poor emotional state. Silverline also offers companionship for elderly people and may help to bring your mother out of the low moods.