Advice needed for incontinent caree

I think my wife is incontinent. She has mobility problems, and although the commode is by her bed, she needs help getting to it and back into bed when she needs to use it, This can happen several times a night. She insists on sitting on the commode for up to 15 minutes to make sure she has finished. Then, increasingly often, back into bed wearing the pants which contain a pad, she tells me she has had another wee. Sometimes there is nothing in the commode anyway - she has had the urge with no immediate result.

The local Bladder and Bowel Clinic are now involved and Ditropan has been prescribed, to slow down the action of the bladder. My wife has been taking it for a week, with no discernible improvement. I have been told by the clinic it can take a couple of weeks for the effect to become evident. A nurse will visit within a few days to do a bladder scan to ensure not too much urine is being retained (no evidence of that so far!).

So I need some advice, please. Does anybody else have experience of Ditropan and its effectiveness? Are pants which incorporate a pad better than separate pads? Is it safe to allow the pants/pads to stay on for an hour or two during the night if used (I am concerned about some kind of rash)? As soon as I am aware, I change them, but this maybe a while after use, especially during the night. Are those disposable bed protectors effective? I seem to be constantly washing the bottom sheets.

Incidentally, because I am so tired by the continually disturbed nights (this particular problem has been going on for months), I sought help from Social Services, who reckoned I needed a break for a week or two and tried to find somewhere for my wife for that time. I was told a few days ago that despite trying all the places within a reasonably big area they have not succeeded. When my wife’s needs are outlined, none of the homes wants to take her in. I thought that they were there for this kind of problem, so that reaction puzzles me. It appears that a 75-year-old amateur is expected to cope with a problem rejected by trained professionals.

I shall appreciate advice from anybody with experience of dealing with incontinence of this type. Thank you.

I can only answer about bed pads; I have no experience of medication.

If using the disposable ones, don’t get the smallest ones as they get rucked up and shift across the bed and then the sheets need changing anyway. If you can afford the bigger ones, they worked well for us. However in the end I found it better to get washable ones with wings to tuck under the mattress and then wash those. Of course that adds to the washing, but I found it much easier to strip off one of those and put on a new one rather than changing the sheets.

I can’t comment on the best pads/pants combination as I was looking after my husband and women’s needs are bound to be different. However, concerning skin care I can say that he used pull-up pant shaped disposables and did keep one on overnight and he had no skin problems - the carers were good about washing in the morning and we had the gentlest sort of wipes we could find the rest of the time.

Is the Bladder Clinic providing pads for your wife? If not, you should ask your GP surgery how to get them so you don’t have to buy them.

I am sorry to read your dreadful tale about the lack of respite care. I hope there will be someone around who has ideas about how to follow that up.

Thank you, Dusty for your advice.

I have seen the washable bed pads with wings advertised and from what you say they seem ideal, so I will get some.

My wife feels more comfortable with the panties which include the pad, so we shall probably continue with those. The Sister at the Bladder and Bowel Clinic offered some pads, but they were enormous and didn’t seem suitable for my wife. She certainly didn’t want them! We’ll see if the panties continue to serve my wife well before we enquire about the pads. She receives the Attendance Allowance, so that pays for any items such as these.

Thanks again for your help.

Hi Alan,
My advice, based on my experience with my Mum who had mobility problems and could no longer get to the bedside commode in the night, is go for the maximum capacity pads.
Yes, they are bulky, no. they are not feminine or appealing but do they do the job? Yes they do.
The continence nurse ( a very helpful person) visited my Mum for some months, starting with recommendations for daytime light pads, ‘in case’, onto ‘panties’ with greater capacity for the ‘accidents’, then onto the full capacity pads which look like nappies, velcroed round the waist for the ‘can’t control’ and night time needs.
It didn’t take my mum more than a night or two to get used to being able to ‘wee’ while in bed at night, without worrying about struggling to the commode or ‘wetting’ any sheets. Nor did she feel wet or uncomfortable. Washed and creamed in the morning by her care team, she suffered no soreness or rashes. These products are designed to keep urine away from the skin.
In the scales of your wife not liking it, or feeling awkward about ‘letting go’ in the night versus you both having disrupted nights, lack of sleep and all that washing and bed changing I would think that your wife should at least give the easier option a try, for both your sakes.
I get up a number of times in the night myself. If I live long enough or when the need arises I will go for the high capacity pads as the best option. My pride or my regret for the need will. I do hope, be disregarded.

Proshield on prescription (expensive over the counter) was what mum had to protect her behind but had had pressure sore as well. The carers used Sudocreme.

If she feels like she needs to go but doesn’t, and then wants to shortly after, you might want to ask the nurse or doctor if your wife may have a bladder infection. They could test her urine for that.


Thanks to Elaine, Rosemary and Honey Badger for your advice.

I have taken note of your comments regarding the larger protection and will discuss this with the nurse from the Bladder and Bowel team when she calls next week. The nurse is doing a scan to check for urine retention. The panties we are using at present seem reasonably secure and my wife is gradually getting used to the idea of just “letting go” while she is wearing them in bed.

She has Proshield Plus on her repeat prescription and we use it daily.

She has had her urine tested for infection regularly, most recently about three weeks ago and there appears to be none.

Thanks for your input and advice - much appreciated.

Hi Alan,

My aunt is using the panties that incorporate pads, and they seem to work quite well. She prefers them to the other kinds she’s used.

She is normally incontinent overnight. We tend to go in to her a couple of times during the night to see whether she’s peed, and if she has we change her (and the bed if necessary). Wet pad against skin isn’t ideal, but (on our experience) it’s okay for a few hours, if necessary, as long as cleaned and dried as soon as possible.

Edit to add: my aunt was diagnosed with nocturnal polyurea last year i.e. condition where she produces most of her urine overnight. A medication was prescribed but in the end she didn’t take it because she has compromised kidney function after many years of choosing not to drink enough. She’s now (like many other elderly incontinent people) in a situation where she Is reluctant to drink during the day because it will result in peeing at night. Of course, though, that commonly leads to confusion and possibly to UTIs, as well as adversely affecting kidneys. It’s the proverbial vicious circle - total nightmare, and you have my sympathies.

Hi I can only offer the advice as to what we do for my 83 year old aunt who has limited mobility,after a nightmare time in a care home came to live with us,we make sure she has plenty to drink during day but use caffine free tea bags on advice from bladder nurse also after 4pm we start to taper off the amount she drinks,during the day she wears no pads as we take her to the toilet on her wheeled commode so she can feel relaxed going a toilet over a normal toilet.She usually is in bed by 7pm and at about 9-10pm before I go a bed she is put on commode and again wheeled to the toilet for a last “try”,we then put her to bed with a tena maxi flex pad on,the largest incontence size,these are more than just a pad as they have a “waistband” which can be adjusted,these are used with a pair of special pants which hold eveything in place.A large bed pad is also used under her for added protection but with the tena flex we have never had a leak unlike other pads.
At first she wasn’t happy with wearing a pad but I was at the point of collapse after nights of getting up nearly every hour because she wanted me to put her on the commode,and as she was tired she was a danger to herself, after seeking advice I knew I couldnt continue without a good night sleep.At first we agreed to one night wearing a pad then one without,gradually increasing the nights so now she using them every night.When I wake in the night I will check and change her if I feel she needs to be changed.We have never had any problem with her skin or pads rubbing.Again we are always checking her skin and and use proshield and make sure she has a good wash over in the morning.The cost of the tena flex are dear but I think its about trying to reach some middle ground and even if she will agree to a couple of nights wearing some form of incontince protection the good nights sleep you will gain will help you care even better for her.After a year on caring full time caring now I dread to think what state i would be in if I had carried on with lack of sleep!!
sorry if I’ve waffled on and good luck!!!

Thanks, Maria, for the tip about the Tena Maxi Flex pads. My aunt has some good Tena pads but they always leak at night. I’m going to see about giving these other ones a try.

You said they’re expensive. Has your aunt not got them prescribed? After my aunt broke her first shoulder earlier in the year we insisted on her seeing the Incontinence Nurse. Eventually that happened and she now has her pads prescribed. Perhaps this could happen for your aunt too?

Discussing with my sister this morning, she’s pointed out my aunt has her pads prescribed specifically because earlier in the year she was given a diagnosis of nocturnal polyurea (I.e. she makes and expels most of her pee overnight). It wasn’t easy to get the diagnosis but we persisted. Hopefully this might help somebody else with a similar issue.

Hi sorry for delay replying but i’ve been knocked sideways with a chest infection!we do get some large comfort tena pads on perscription but we were told the tena flex were not available.But perhaps we will try and chase this up again.Luckly since she has left the care home and been with us she only really needs the tena flex at night which helps keep costs down.We are lucky and the cost isnt to bad for us to cover but I know for some people it could be an issue,But I think if somethings going to make your life a bit easier its worth trying to use,even if for just a couple of nights a week.They have made such a difference with not leaking its been amazing!We only discovered them after watching a video by Tena on Youtube giving advice on the different pads and how to wear them!

Hi Maria, sorry you have been poorly, you aren’t the only one. Carers and carees alike.

Glad you have found something that works. Worth pushing to see if she can have them on prescription, explain why the ones given are no good at night and see what happens. If no joy, remember your aunt should be paying for them not yourselves.