Hi I’ve looked at other questions similar but been unable to find answer. My mother's in middle/advanced dementia. I can tell when she needs toilet now as she says she feels ill (for peeing or pooping). l have tried everything, changed toilet seat, tried her on commode but she refuses to go? She says she doesn’t do that kind of thing? I get she’s not recognising going to toilet as a normal bodily function but I dunno what to do about it? She is on lactulose to help her go and drinks plenty but she will go days without even peeing? Can anyone help at all please? She's 84.
How mobile is she? How closely is she monitored? How long do you leave her on the toilet, and do you stay with her or leave her alone? Is she wearing a pullup?
You need to contact her doctor right away to discuss the fact that she's not urinating or having BMs. That is a very dangerous situation going on and not something a forum of caregivers on the internet is equipped to help you with.
Advanced dementia and a situation such as this may be something out of the realm of your capabilities to handle (or any ordinary layman for that matter). It sounds like she may need to be seen in the ER.
Good luck.
He never had any problems with the lactulose.
I agree with CWillie. She must be peeing when you aren’t around. An X-ray would show if she were impacted of the bowels.
In her mind, someone is putting water in her pants! I always know when she talks about rain/flood that she’s actually referring to pee!
Ie she’ll get out of bed and say “water is getting in my room again”. I’ll sigh and say,.. Mum you have a roof and it’s not raining outside and then take her to toilet for a change.
If I ask her if she needs to pee, she will often not understand the concept and say no she doesn’t have those things. So I just take her routinely and sure enough she goes.
On the actual toilet she will also sometimes announce “what is this” and she will sometimes sit and get straight back up and I’ll say “you haven’t done anything yet, give it a little time”. She also almost always gets pee on the bathroom floor either by not sitting fast enough or when getting up too early.
Shes gotta be going somewhere if she’s drinking enough fluids! Does she wear incontinence wear? Otherwise something seriously wrong if no pee. I would be careful about giving something that was prescribed for someone else for the stools. Surely there are more natural mild alternatives. As some suggested laxatives do absorb moisture. Feeling ill could actually be feeling ill because the bladder isn’t working,.. I’d get it checked out. My late brother once couldn’t really pee and had to have a catheter put in as somehow his badder was holding on to the urine. His bladder had swelled extremely and he was also feeling ill. He was in hospital for that. So if no pee,.. I’d take that seriously!
And the diaper can show you her actual output.
Try weighing an unused diaper, then weighing a urine soaked one on a kitchen type scale to gauge her output. The color of the urine can be an indicator if her urine is concentrated, too. You don't want to make a big deal about it to her if there isn't really a problem.
(You can do the same with a Poise pad or similar.)
But you can't rely on her report alone.
Adult diapers probably hold more. I know mom will wear hers until they are ready to explode and I have warned her that they actually WILL, if she doesn't change them. She's incredibly tight with a dollar and won't change them but once a day. Her ability to use the toilet is pretty nil. She just stuffs a couple of incontinence pads in with the diaper and calls it good.
You do not want an elder to go days without passing waste. It backs up into the kidneys and bowels.
My SIL is a GI doc and he says that he has patients who come in and their breath smells like poop. That is a dire situation, but it's not unusual.
When it's time to pee have your mom sit on the toilet and put her hand in a small bucket of warm water and tell her to close her eyes and relax.
Or try turning on the sink faucet, not at full force, just pleasantly so she hears the sound. You might tell her to close her eyes and think about a beautiful gentle water fall. Kiss her on the head and say, isn't it a lovely water fall.
I hope it works.
So sad.
I would never allow a loved one to go an entire day without going to the bathroom, let alone several days.
For my mother with Lewy Body Dementia, I utilize a calendar-style dry erase board for documenting hydration and hygiene. We developed a legend that we use along with the time of day. For example, '2-832' means that mom had a bowel movement at 8:32am.
Mom wears diapers as a safeguard but we call them "underwear" because the word 'diaper' is not helpful at all with making her feel better about her declining health. If we had to change her underwear (diaper) we would write 'UC' on the board for underwear change.
All of the part-time helpers, myself, and anyone who helps has to look at the board and assess when was the last #1 & #2. We also assess how much fluid she is drinking and what time the last fluid was given.
Every 3 hours we tell mom "it's time to go in the bathroom to see if anything will come out." Then we escort mom into the bathroom even though most times she will say "I don't have to go to the bathroom yet." We simply respond by saying "it's been 3 hours so let's just try because something might come out when you sit on the toilet." After mom is on the toilet, we turn the lights out (she likes the light out when on the toilet because she believes someone tries to watch her through the pipes) but we leave the fan on for noise. Every time it never fails, she urinates or does #2, but she just doesn't know she needs to, so it became pointless to ask her if she need to go to the bathroom. You can ask all you want and she'll say no.
In a nutshell, the signals from the brain to/from body parts is not working properly so you have to help your loved one along.
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This is only a suggestion. Perhaps you can try it and if it doesn't help, maybe her doctor - or a nurse at a nursing home - might have more suggestions.
She might have a kidney or bladder blockage - and that could certainly contribute to her feeling 'ill.' Call MD asap.
Most people poop daily and some have a routine of pooping every 3 days. If she doesn't poop in 3 days, she needs "help" regularly: fiber-rich foods at every meal, 2 liters of fluids (no caffeine) daily, more physical movement, stool softener and fiber medications... The most extreme forms of help are lactulose, enemas, and disimpaction (using a plastic glove and lubricant to remove poop from her rectum). If she does not have "results" with extreme forms of help. take her to the ER. She may have intestinal obstruction - an area of her bowels can not move.