My 93-year-old dad has urinary frequency at night to the point that his sleep is severely disturbed. Once in a while, he sleeps fairly well, but not most nights. He is being followed by a urologist & has been prescribed all the usual meds without success. We've tried taking them in the daytime & when that doesn't work. We switch to night time. The most recent one is oxybutinin which he has been taking at night & he swears it makes things worse. I've tried explaining that these drugs take weeks to show any effect, but he is too impatient. To his credit, he has given it his best shot, but still no positive results. It's driving me crazy! He saw the urologist September & I went with him. I get a feeling the urologist is reluctant to do any procedures due to Dad's age & I agree with that. He will be seen again in March.
Anyone else dealt with this? I'm tired of hearing about his plumbing problems.
If the patient ever has pain, a jacuzzi or swimming is out.
Check out oregano oil (oregamax ?) it is supposed to help with elder men and urgency. You can also get tablets.
My dad was put on a medication for prostate cancer, doesn't have that, but it helped with his urine issues.
if his glucose levels are normal, then urologist can figure this out. Get an appointment
Husband has sleep apnea and uses a cpap machine nightly. He's been using the machine for about seven +/- years.
Husband has been on a drug called Tamolusin (sp?). I don't see any improvement or difference.
Looking forward to reading other comments / suggestions.
Thank you.
Instead of telling him that you're tired of hearing about his plumbing problems, tell him you're working on it with his physician.
A Condom Catheter sounds like what he is needing but only his physician can say for sure. We considered it for my DH but his physician felt DH should go on a pill that would allow him to have more time in-between needs. DH passed before it became a problem, but he was waking me hourly to void so it was getting a lot closer. He was 96.
When my Husband would sit it would be one thing but when he either reclined more of lay down I would end up with a flood! It seems that going to a laying down position allowed the bladder to fully empty.
You might want to try having him fully recline during the day to allow the bladder to empty so there is not a lot retained that will empty when he goes to bed.
A condom catheter works well if your dad will leave it alone. My Husband would "fiddle and reposition himself" so I could not have used that on him. I did once he declined to the point where he was no longer "readjusting" himself and it was so much easier than changing him every 1 to 2 hours.
1. Drink as little as possible liquids after 6pm.
2. Do kegel exercises throughout the day if he will.
3. If there are prostate issues, it might be helpful to see Michael F. Roizen and Michael Crupain's "What to Eat When: A Strategic Plan to Improve Your Health & Life Through Food ( National Geographic Book, 2019), Chapter 31 "What to Eat When You Need to Shrink Your Prostate," pp. 239-242.
4. Moving on to the many suggestions you have from other caregivers.
Just remember that incontinence is an inconvenience, but retention of either urine or bowels is a big deal requiring immediate medical intervention.
All the best
Prayers and Hope
It really doesn't matter for your dad to get up all hours because he can make up his sleep the next day. It is however awful for the Caregiver having to help him since they can't make up the sleep.
My 95 yr old Dad has a Catheter but it's a pain to have to drain it a few times a day and most importantly, it hurts a whole lot having it changed out once a month and I feel so bad for him to go thru this once a month.
But, your Dad and mine are way too old for surgery.
I guess you could start letting him wear Adult diapers at night.
if no infection there is a catheter that can be placed, it
does not need to be long term; there is also an overnoc
condom that can be placed hooked up to a bag and he
won't need to get up
In the meantime, I agree with others to use adult incontinence measures (diapers, pads, and allowing him to rest more during the day).
Does he have a portable plastic toilet that could be kept by his bedside for use at night?
If that's not an option there are some good quality overnight pullup underwear that could be worn to prevent him from having to get up.
They are just like the pullups that toddlers wear and there are a variety of absorbencies and sizes available. You would want a very absorbent overnight style to provide up to 8 hours of leak protection.
You can contact the various manufacturers and request samples to try until you find one that meets your Dad's needs.
Elderly people are already receiving too many prescription medications. Once you get to about 5 medications a day you greatly increase the chances of them experiencing a side effect, adverse drug interaction or enhancing/ decreasing the effects of one of their other medications.
Adding additional medications rarely does more good than harm.
- finasteride 5 mg one/day
- tamsulosin 0.4 mg one/day
but was beginning to have more troubles with urgency & incontinence. When he was in the hospital recently for an unrelated issue he had trouble using those plastic urinal bottles. They started using the condom catheters instead and they worked pretty well. Have not tried these at home. After he got out of the hospital he saw a urologist who gave him Myrbetriq. At first this didn't seem to help but eventually "kicked in", but still having problems. My husband has other issues such that the urologist doesn't want to do surgery. The doctor DID up the tamsulosin to 2 capsules a day and that helped tremendously. My husband is doing SO much better now. Here's the current mix of meds for his bladder control problems:
- Finasteride 5 mg, 1/day (morning)
- Tamsulosin 0.4 mg twice/day, 12 hours apart. Take capsules 1/2 hour after eating. Tamsulosin is generic for Flomax.
- Myrbetriq 50 mg 1/day at bedtime
I think when the doctor upped the Tamsulosin from 1 capsule a day to 2/day, that's when he really started to see improvement. He DOES wear "incontinence briefs" all day and all night, but now no longer wakes up with 12-18 oz of urine in the briefs and on the bed pad. Good luck!
We tried the meds mentioned by others and still the sheets and husband were soaked in the am even with bathroom use during the night. The Texas catheter (external) has worked well. It comes in sizes and works very well keeping him and the bed dry and eliminates trips to the bathroom during the night.
Using the catheter allowed meds to be
reduced with better results.
- Use bedside commode.
- Use protective pads/diapers.
- Assess for U.T.I.
- He is at a huge fall risk since rising out of bed to go to the bathroom when one is not fully awake is not advisable.
- Vesicare rx.
Anyway give the catheters a try, we've been using the Spirit hydrocolloid sheath, plus a 2000mL urine bag that has a hook for hanging (crucial, otherwise it tugs, which can lead to a wet parent and bed). Depending on your dad, compliance might be the most difficult problem.
When I first joined this forum, I wasn't buying the UTI comments. Then mom, who used to get UTIs all the time and knew it, got her first one after moving to MC (maybe a year or more after the move) and it resulted in late afternoon/early evening sun-downing, big time. Quiet mom who would just sit and read became a raving beast who demanded to get out, insisted she had to go home and had guests arriving and she would set off all the door alarms! Figures it was on a Friday, after office hours, so we could do nothing until Monday. She would be fine in the morning, it only reared it's ugly head later in the day! This was someone who never really exhibited sun-downing (she lived alone and had a nightly odd OCD behavior that went on for an hour or more at bedtime, before moving to MC, which we observed via cameras in her condo.)
More recently, UTIs have resulted in night-time bed wetting - we're talking soaking through disposable undies with inserts and a bed pad! When she first started this, they tried to get her up at night, but that wasn't happening. Then they would find her sitting on the floor, apparently trying to get up to go, but she stopped standing/walking on her own a while ago, so she couldn't get out of bed properly. Once tested and treated for the UTI, the bed wetting stopped. When she started again and was found on the floor again, sure enough, she had another. After treatment, no more wetting. So, now they are aware of the issue, and if she starts again, they know to get the testing done!
Note that during the day she is FINE! She knows she has to go and either "walks" her wheelchair or asks for help from staff.
Have you thought about putting a commode next to his bed so that he does not have to trek off to the bathroom - used one for my uncle and he was able to go back to sleep much faster.
I went through a terrible time with this and tried a lot of the meds. The only thing that has given me relief is botox into the bladder. My urologist is wonderful and when she suggested botox I was not the happiest of campers to put poison into my body. However, she took the time to explain it, and it has been a Godsend. Every 4-6 months she does the procedure and I get immediate relief. I still wear pull ups because nights are very difficult and the urge to go doesn't always give me time to get to the bathroom, but I am so much happier and feel such relief!!
Your dad is 93, and I certainly understand a urologist may feel reluctant to do this, but it is worth suggesting to the urologist. Many do not do this procedure, so you may need to find a different urologist.
Hope this helps.