Elderly parents - how much can you realistically do?

[mears]

Hi folks - here is a subject that needs a heading of it's own IMO. At this point in my life I am finding the strain of helping look after my elderly dad much harder than the issues I have with teenagers and work issues.

Dad is 87 yrs old and has mild Alzheimers which was daignosed 3 years ago. He is on medication and isn't too bad really. Mym mum is younger (71yrs) and very active. She does however have arthritis which is getting worse, especially in her hands. She is Dad's main carer and I help out when I can. He was extremely unwell at the beginning of the week with a urine and chest infection and needed admitted to hospital. The ward wanted to keep him over the weekend and mum and I met with the doctor to argue for his discharge home. Thankfully they did agree but there is still a concern about the infection he has (mainly the chest). However he has responded well to the intravenous antibiotics and is now on tablets. My concern was that his Alzheimers would deteriorate the longer he was in hospital. There will be some help arranged by Social Work regarding some kind of care package to assist mum so that is good.

However, the main problem is that he is now incontinent of urine, mainly at night. He had started having 'accidents' at night prior to being ill but he seems to be very incontinent at night. During the day, by the time he realises he needs to go, he can't make it to the toilet. He is 3/4 of the way there and it is upsetting him.

Mum does have a bottle but it is not knowing how to manage it well that is upsetting me. Should he just use the bottle and not even try going to the toilet? Will he regain control as he feels better? Can you toilet train an elderly man? He cannot go on demand- we tried that. Anyone got any experience out there? Will have a look at websites later myself.

However, I feel I want to help as much as I can but I am limited because I have a fulltime job and 4 children who need me too. How can you fit all these demands in? Feeling a bit overwhelmed by it all at the moment.

Am going out now with DD who I abandoned this morning to 'babysit' Dad.

Help!

Thanks again - thankyou for sharing that information Issymum. For a man of 35 it must be dreadful and I am glad he has some help with it.

I think I am worried because there is the expectation that continence goes in the elderly (I think that myself) and that once it has gone it is gone.
It may be that once the course of antibiotics for the urine infection are completed then things will improve. Also being catheterised won't have helped although it was removed in less than 12 hours from insertion.

My Dad is such a proud old man and, even though he has Alzheimers, he is upset by this indignity to him. Thanks for all your advice. I have asked mum to ask the district nurse when she comes in, what best to do.

Mears, first of all, {{hugs}} to you and yours - it's very tough situation that you are in, and all credit to you for your love and hard work.

I haven't read the whole of this thread, but I wanted to tell you a bit about my grandfather, whose situation is almost identical to your dad's: pneumonia, UTI (as a result of brief catheterisation in hospital), slight dementia, incontinence, plus a daughter who is a geriatrics nurse!

Dgf was still very poorly when my aunt had him discharged from hospital, but she did it because of the catheterisiation and iv - she felt they had been done for convenience, rather than clinical need, and would only make things worse. In the month since his discharge, dgf incontinence has improved a lot. There was a marked improvement as the various courses of antibiotics finished and pneumonia improved. I don't know whether he is being given any continence mediation now, but the anti-dementia medication has helped a lot. He is not back to normal, but there is constant improvement.

Mears, Sorry to hear about your dad. It must be really hard for him, incontinence is terribly embarrassing for any adult. If he has a UTI this can in itself be a cause of incontinence so it is important to get this treated and make sure it is cleared up. In many cases incontinence in the elderly is treatable even if it cant be cured. Depending on the cause there are drug treatments which may improve incontinence symptoms and bladder control and might help him so it is worth getting advice from his GP or a continence specialist. Try the continence foundation www.continence-foundation.org.uk for a useful place to start for information.

hi mears

i see you have got a lot of great advice here. but i am wondering if we have got to the nub of the gist.

the title of the thread is "how much can you realistically do?"

i am wondering if you were looking for guidance on that specifically, i.e. how many hours should you be spending over there? how should the burden be shared among the family members?

the reason i mention it is because my mother was ill late last year (it was an acute illness which thank goodness she has recovered from now) and the "share of care" was not spread evenly in the family. this led to a great deal of family discord, the ramifications of which are still being dealt with.

my advice would be to agree with other members of your family asap how you will split things between you.

imho, it is very difficult to find the time for elderly, sick parents when you have a family of your own - and of course then the guilt kicks in.

hope i haven't completely gone off on a tangent and good luck.

You are right serenequeen - I was worried about how much time I could realistically spend helping to look after Dad and was feeling torn between helping my parents and looking after my own family. My mum has commitments outside the home (she is an active local councillor) and I think she also needs time for herself. This week I have actually found I have got myself more organised and taken work round with me. Kids have been at school and i have been on days off. DH will help too but he has concerns about the continence issue.
He is getting much better during the day but not at night. I am going to GP tomorrow with mum and dad so I will ask about input from the continence nurse. The district nurse input has been to drop off a supply of Tena pads!

prettycandles - your story is almost identical - sorry I didn't read it till now. He certainly is improving and has not yet completed his course of antibiotics.

2boysmum - thankyou for that link - I will have a look now.

Check out The 36 Hour Day I don't know if there's a UK edition, but it's a great, practical book that deals with all the nitty-gritty issues of caring for Alzheimer's patients including balancing responsibilties among the family, preserving dignity, and tips and tricks for dealing with incontinence (and other reasons for peeing on the carpet!)

Thought I would update this to let you know that DF is now continent again day and night. He developed another UTI and once it was treated he started being dry at night again. He is doing pretty well at the moment. Having searched the web it looks as thought he may have prostatitis, so we will need to keep an eye on him passing urine. My mum picked up the second UTI just by noticing the change in colour of his urine before he got symptoms. Just hope we can keep on top of it.

oh thats good news. hopeeverything else is going well. good on your mum for spotting thinsg werent right.

It's weird that you updated this thread tonight,Mears. I've just been searching old threads and came across this one for the first time - as I read it I was dithering about whether to post to check how you and your Dad were getting on, so I was delighted to read your update. I don't have anything to add but having elderly parents myself, the issues are very close to my heart. I am so glad about your dad regaining continency - fingers crossed you can keep it up. BTW I'm so glad you posted about this - I think many of us will/do find ourselves in a situation where we are torn between caring for our families and our elderly parents. It's as much a part of parenting as anything else.

Mears, I missed this first time around because of my elderly parents! I can totally empathise with you! Glad to hear things are on the up re the incontinence but I thought I'd share with you something I discovered recently.

My dad is 83 and my mum 72 (she was 40 when I was born.) In mid-September my dad had a mild stroke which put him in hospital for two weeks. Because I am an only child the onus was on me to help so every day I had to drop DH off at work (16 miles away), go home, quickly give ds twins lunch, drive to my mum's (20 miles in the other direction), take her up to the hospital for visiting (another 10 miles) then drop her off, pick up DH and home (all with ds twins aged 33 months in tow) to do everything I couldn't do that day. It was hell and in the end DH had a word with the hospital (dad was waiting for the doctor to discharge him, no other reason) to hurry them along.

The worse thing was no one asked me to do that. It was expected of me. The good thing was, and this is why I am telling you this Mears. I realised how everyone takes me for granted, that I will automatically do everything for them. I had even been trying to talk them into selling their house and us all moving into a bigger house together, that would have just sentenced me to be a scullery maid to the lot of them.

Every now and again you have to sit back and take care of yourself. I am a SAHM, my main priority is caring for ds twins. If I had continued doing that I would have ended up with exhaustion, was already showing the signs. I am still having a hard time making them realise (and I include DH in this) that I have changed and am not on beck-and-call anymore.

if this happens again (incontinence), you can get condom-like sheaths that fit over the penis and attach to a catheter bag. If it is a urinery tract infection causing the incontinence, the urine will be very strong, so it can be better at night to keep the urine away from the skin, as it can leave burns and cause pressure sores. I hope I em not being too forward in mentioning this, I thought it might be useful. The brand name for the sheaths is "conveen"