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Has disability, lives in AL, under hospice care, frequent urination, both day & night - takes a lot of time transferring from WC to toilet, requires aide assistance each time. Any ideas?

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Jkmerriman: Edited to omit the double "a."
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I'm surprised hospice is allowing this transfer - it could be a safety hazard to do this. Also, hospice has supplies for this - pads, commode, diapers.
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My 89 YO wife is in hospital. She is supplied with a PureWick urine collection system. Available on-line. Passive for her. Expensive for Medicare. It's marvelous.
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jkmerriman: This 91 year old could have a a U.T.I.
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Make hospice aware; hospice should have options including a variety of incontinent supplies.
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Since she’s on hospice she won’t be able to see a urologist. I too have my 91 year old aunt and she urinates frequently, so you just have to change her frequently and keep her dry and clean like you would an infant and speak words of love. I know it can be very difficult, but it’s ok because I won’t have any regrets and know I helped her in every way I could.

catheter would be uncomfortable for her although convenient for others and the point of hospice is to make your loved one as comfortable as possible
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lealonnie1 Oct 2023
How do you know the LO is a "she" and there is "discomfort" involved with a catheter? Neither parent expressed such a thing while catheterized in hospice
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Deal with it. Change diapers bed pads keep them clean and dry. Pure wick is great but way too expensive. I almost had my low cost prototype finished when my wife died
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Catheter is probably best but also consider UTI and what to do about BMs. The catheter will get in the way. This also sounds like the NH isn’t doing a good job looking after your LO.
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lealonnie1 Oct 2023
Why is the ALF not doing a good job? Bc an aid is helping the LO to the toilet each time they have to go?
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Yes make life easier for all involved and have hospice put a catheter in. That way this person doesn't have to keep being transferred to the toilet and all the aides will have to do is empty the catheter bag a couple times a day.
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This person is under Hospice care. So no going to see doctors on hospitals. So, a catheter maybe the only alternative.
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jkmerriman Oct 2023
Thank you - that is what I thought. Will discuss further with Hospice.
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Often in age this frequency has no root in UTI at all. Though that is the first and the easiest step to check out. So a U/A, C&S is step number one. Once you have clearance on that, know that this is primarily a brain thing. The constant urge has little to do with the amount of urine in the bladder, and there are exercises for the mentally competent to do to train the brain against this constant triggering of the "urge to go". But it takes a lot of determination. There are also devices that work on specific nerves. Again, problematic, don't often work, and not really adaptable to aging.

I would see a good urologsit for a good workup and for options and I wish you good luck. The urinary system is exceptionally complex ruled by both the sympathetic nervous system and the parasympathtic nervous system. Think to yourself of those time when you have been out for the day, have a full bladder, and are now on the doorstep of your own home and you almost CANNOT BEAR the urge to go, it's so strong. Yet get in the house and get diverted and once again there's no urgency. Your brain is at work here, directing urges to your bladder, or not.

Hope you'll update us, and wish you luck.
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jkmerriman Oct 2023
Thank you. She is in Hospice, so that eliminates workups, etc. Will discuss with them tomorrow.
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Frequency/urgency could be a sign of a UTI. Are there any other symptoms, like sudden change in behavior, confusion, delusions, temperature, etc? If so, this is a trip to Urgent Care.

You don't say if your LO is a man or woman... could be a prostate issue for a man (70+% of elderly men have prostate problems) and there may be meds that will help (like Flomax or others), for a woman there are meds for overactive bladder issues.

I agree with the others' advice about wearing protective disposable briefs (and taking away all cloth undies) -- this is hopefully already in place.

Nightime trips to the bathroom are the most likely time when an elder falls and is injured, so this is a problem that needs to be solved soon.
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DeniseV Oct 2023
We had my mom on meds for overactive bladder, but when dementia progressed, we stopped. Interesting that her cognition and confusion improved as a result. We use a brief with an extra pad inside the brief so many times just change out the pad. I feel so blessed to still have my 94-year old mama. She’s failing, but still knows her immediate family. 🙏
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The first question hospice asked me is whether I wanted dad catheterized or not? I said yes, dad agreed. Life for all involved gets much easier once the frequent trips to the bathroom stop.
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You do have them in Depends? It may not be so much frequent urination, may just be incontinence, can't hold it anymore. Maybe its time for a catheter. Its really not fair to the aides.
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