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Old 07-25-2011, 03:25 PM   #1
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Not caring and incontinence

My mom has not been formally diagnosed with Alzheimers or dementia, but that will probably come out of the next dr. visit. There have been some strange symptoms, though: she has been having ongoing incontinence (bladder, but worse - diarrhea) issues, coupled with a very apathetic response toward it ("oh, I could go (to the bathroom on time) if I wanted to, but I'm just lazy"). The assisted living place has put her on a bathroom schedule, which seems to be helping.

This is coupled with her mobility and memory getting worse. Fortunately, perhaps, she moved into assisted living by her choice about 5 years ago (she has some mobility issues due to a brain tumor about 40 years ago), so we avoided driving, cooking, and other crises. However, I think that her being taken care of has hidden the onset of real memory issues over the past few years. Now, things are seeming rather bad rather quickly (forgetting important dates, repeating questions, apathy, and such, along with the lack of interest and care in personal care).

I guess my question is -- the apathy regarding the toileting is really odd. Has anyone run across this before? Is it symptomatic of Alzheimers or another dementia? Suggestions?

 
Old 07-25-2011, 03:42 PM   #2
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Re: Not caring and incontinence

Quote:
Originally Posted by campergal View Post

I guess my question is -- the apathy regarding the toileting is really odd. Has anyone run across this before? Is it symptomatic of Alzheimers or another dementia? Suggestions?
Hi campergal,

Since I don't know her diagnosis yet and have no idea about her stage and other medical conditions in details, I cannot really say for sure what is going on with her.

However, I can tell you this toilet thing is very very common with the person with dementia. I don't know if her incontinence is due to other conditions or not, usually incontinence due to Alzheimer's happen in stage 6 (there are 7 clinical stages.)

Apathy is typical for a person with dementia.

First of all, the person will forget why she needs to wash her hands. Then she will be afraid of water temp. and she will stop using water unless the caregiver reminds her or make her wash her hands. Usually it is more about water when it comes to the toilet or shower. In your Mom's case, perhaps she has the adult diaper anyway (Does she?) so she does not need to worry about going to the toilet. And thus the apathy. She won't wash her hands if it is dementia.

My FIL has stage 7 Alzheimer's but he still wants to go to the toilet because he does not want to wet his diaper and he thinks they are underwears, not diapers. But he won't wash his hands. He is afraid of showers so he only has
a shower per week given by the caregiver. They do sponge bath on him twice everyday.

It is very obvious the person would not know how to go to the toilet or bathroom unless you guide her. Once my FIL thought the toilet in his house had something funny about water overflow (it was a bad old toilet) and thus he peed in the sink instead once!!! The caregiver had to clean the old sink with the chemical stuff.

All in all, the person with dementia needs to be reprogrammed about going to the bathroom or toilet. The reason is that they forgot what is like to go to the toilet now. Also they are afraid of water as I mentioned above.

Also some people are afraid of mirrors in the bathroom - they hate to look at themselves thinking it is someone else.

My FIL is better now because the caregivers tried to show him the right way.
He is now in a residential home.

Probably your Mom is used to incontinence and does not feel she needs to go to the toilet given the adult diapers.
Everyone reacts differently when it comes to dementia so she may have some different habits.

I am thinking maybe she feels it is too much trouble to go to the toilet. It may also be other type of dementia. I am not clear about other types.

I cannot say for sure this is dementia because she needs to be diagnosed first.

Regards,
Nina

Last edited by ninamarc; 07-25-2011 at 03:51 PM.

 
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Old 07-25-2011, 09:42 PM   #3
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Re: Not caring and incontinence

Camper, welcome to our little corner! Sorry you are having to deal with this but glad you found us.

Apathy is many times one of the first thing you actually notice. They can't do something so they create excuses. "I could do that if I wanted to".... WOW!! I have heard that from Mom so many times! "I could have baked that cake but I didn't want to!!" I remember the day Mom said that. She messed up her pound cake and I make the replacement for her. She had forgotten she messed up the first one. Over and over she used that same statement.

You do need to get a diagnosis. As the physician to do a MMSE (Mini Mental Status Exam) and see what her score is. 30 is a perfect score and anything less denotes problems. The lower the score the more cognitive decline she has. Then please ask for a referral to a geriatric neurologist or Memory Assessment Service. You can get more information and help from a specialist than a general physician.

I would also suggest you make sure the physician does a urinalysis with a culture. Many times a UTI can cause symptoms to be come worse quickly, and could be the reason for the bathroom incontinence. It is worth ruling out!

Mom is on a bathroom schedule as well. She has been incontinent for over 2 years. Yet when they take her on her regular schedule she rarely has an accident. I had to laugh at one of the new caregivers. They came to me concerned because Mom had not wet all morning. She didn't know about the schedule. So I took Mom to the bathroom and yep, she was just waiting for her scheduled trip. The only accidents she has is when she has stomach upset. So the schedule is a good idea.

Glad your Mom is in a care facility and you don't have many of the difficulties some of us have had. Hopefully you will be able to get a diagnosis and know what you are dealing with soon.

Hang with us. We have all been where you are. We truly understand. This is a great place to vent, learn from others, and just hang out with kindred souls!

Love, deb

 
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