Mum wears depends but typically they are dry until she actually goes to use the toilet.
She knows how to go to toilet,.. the problem is that as soon as she stands up,.. that’s when her bladder releases most of the pee! Every time that she attempts to stand up, pee starts falling again. So her depends actually get wet after toileting if that makes sense and a lot of the time from the exterior too while she’s pulling them up. It’s got to the stage where I just tell her to pull the depends back up even though pee is still coming out. Then half hour later I say let’s change the depends to dry ones. This is making her extremely upset. She’s often in tears going to the toilet and I wish I could make this better for her. She sick and tired of this happening and as she calls it “making a mess”.
I am cleaning the bathroom floor nearly after every toilet visit and admittedly It’s really starting to get to me as well. We’ve tried different things like I’ve said to her to try lean forward , back etc or stay seated for a while but the bladder keeps releasing as she stands up.
She’s also prone to UTI’s and as soon as she’s off the antibiotics, her pee starts to really smell and within a couple weeks she will start complaining of burning.
How do we get her bladder to empty seated?
Mom was getting one UTI after the other over the last 3 years. I honestly thought she was going to died from a UTI.
I cut her C Memantine dose by 50%. Amazingly she no longer "holds" her urine. She also has not had a UTI in over 3 months which is a record.
Look into cranberry pills and D Manoose.
Let her use the incontinence underwear just as they are supposed to be used.
Change her position in the chair she is sitting on and leave her there for a bit. Tell her it is OK to pee. Then when you get her change her position again it may release more urine. When you get her up again to go to the bathroom she may release more. By the time you get her to the bathroom her bladder should be empty. She should still "try" clean her properly and thoroughly and then another incontinent underwear. Might want to hold some toilet paper just incase she "dribbles" a bit more.
There are home urine tests for UTI. I would get them.
I would also schedule with a Urologist to get to the bottom of the problem.
Also, never pull up wet Depends. That’s a recipe for uti.
My mom’s utis have been so constant that she has been on a lo-dose preventative. Seems to be working! We are a 3 weeks without one.
I suggested she hold a pad next to her as she is standing that will catch the last 'dribbles' without it running down her leg before she can put all her incontinence wear on.
We keep trying stuff. The catheter, while annoying and smelly to boot, made he 'lazy' and she complains she has to urinate every 4 hours. Well, so do I and probably 90% of the women I know do too!
I like the running water trick but be warned that if she is cued to pee with water running her brain may pick this up anytime she hears water running (at the mall, in the kitchen etc) and that could begin a whole new set of problems.
As mentioned earlier make sure her rectum is emptying well and that could be known by the the stool form, (large, hard or small balls, or having to strain is a big clue) and if she is having a BM regularly. As much as you are able try to avoid straining by keeping the stool soft with whatever method works ( OTC fiber, diet, hydration, exercise, stool softeners) and use a squatty potty. If her medications are making her constipated then talk with the doc that prescribed to find ways to soften stool.
Instead of raising on tippy toes try using a squatty potty with elbows on knees, leaning forward and have her breathe in a very relaxed, slow, diaphragmatic pattern. It is fine to try and press on the bladder at this time by placing a balled up hand towel at the top of her pubic bone or using a hand if it will fit. Also tapping or tickling the sacrum (right above her tailbone) either during her peeing or after to see if more can be released while still seated.
Sometimes just rebooting the system by making the attempt to stand up (maybe just lift the buttocks off the seat as high as you can before she begins to dribble) and then sit right back down again if that is possible.
She should not be tightening her buttocks during the peeing process. I am assuming she is well hydrated so her urine is not dark normally. If her bladder is prolapsed (high probability) then the use of a "well fitted" pessary can be very helpful and this can be fitted by a urogyn, gyn or ARNP that knows how to do fit well. Avoid someone that off the bat tells you it does not work well. I would choose one that does them often and likes them. A corrective surgery at this stage of your moms life may not be in her best interest but a well fitted pessary can mimic what a surgery would do. She may need vaginal estrogen at first to prepare the tissue for this but again a good clinician would be able to tell this as well as if she even has a prolapse. They are easy to put it, clean and place back and if you can't be shown then simply have that clinician or a visiting nurse take out every 3-8 weeks (depends on the fitting clinican) to clean and replace.
Another quick solution to keep the floors from getting wet is to purchase these standing female urinal bags that are used for hikers or travelers. You can place the opening right over the vulva before she stands and then hold it there while she stands solving at least that problem.
There are probably more tricks but I can't think of them now. Good luck.
Constipation can interfere with fully emptying the bladder.
Certain medications interfere with bladder emptying.
She may be having pain when seated on the toilet and not be able to communicate that, so that when she stands up again, she can release urine. Can you coax her to release urine into Depends while in a standing position in front of the toilet? Or run the water in the sink while she is sitting on the toilet, to promote voiding?
The idea of disposable waterproof pads to stand on is a great idea.
A geriatrician (board certified in care of the elderly)would be a good person to perform an assessment of her situation. A geriatrician can probably identify enough of the problem so that a referral to a urologist or gynecologist can be made. Even if there is a waiting list for a geriatrician, it is a good idea to get on the list.
So frustrating for both of you.
Mom sits on toilet. Feet go to tippytoes. Mom leans forward and places elbows on knees. This posturee helps the urethra fully open so you can pee easier. The other part of this is take mom to toilet every hour and a half. She sits in this posture whether or not she has to go. It ultimately retrains the bladder.
I don't know if this will be as successful in AlZ/DT patients because of damage to different areas of the brain, but it's worth a try.
Before I learned this trick, I went to a specialist physio, who checked that I was doing the Kegal exercise properly by putting a gloved finger into my vagina and waiting for the squeeze. You may be willing to try that. I find that squeezing the buttocks together first, then alternating with the pelvic floor muscles, helps to register which of the ‘invisible’ muscles are being worked.
What I do to avoid having to clean the floor each time is I put down a small disposable underpad at her feet and help her up, then she can pee down her legs onto the pad. I use a wet wipe/towel to clean her legs. This saves me from having to mop the floor each time she has an accident.
I am curious. Why does your mom not pee standing up while wearing her depend, then go sit on the toilet for cleaning?
Consider taking your mom to a urologist or genito-urologist. My mom's gynecologist prescribed a hormone cream (rePhresh) which helped with the dryness my mom was experiencing in her vulval area which was causing frequent UTIs. But it sounds like what your mom has might be structural, and hopefully, easily addressed.
Can your mom do Kegel exercises? Sometimes pelvic floor physical therapy addresses this issue; learning to release the Kegel contraction is a way of making sure you've voided everything.