Help with incontinence

Hello, this is my first post. I am a bit overwhelmed and not sure how to proceed. I have moved in with my 80 year old mother as she had a fall and was very lonely during lockdown. So we are me, my husband and 6 year old daughter as well as my mum in a 2 bed flat. We are intending to move to a new (bigger) house with my mum once it has been refurbished, so this is temporary. However, living with her has made me realise how dependent she has become. She is very immobile and never leaves the house. She walks with a stick and clutches onto pieces of furniture on her way. She is very overweight/obese and this does not help, although I do not think that realistically her weight is likely to change in the short or long term. My main issue is with incontinence. She is OK during the day but at night she leaks in the bed and on the bath mat that I place by her bed (as the room is carpeted). She then leaks all the way to the loo (maybe 5m) and all over the bathroom floor. She also doesn’t really get much urine into the loo and most of it goes onto the floor. I think that this is largely due to her size, but she also suffers from macular degeneration and cannot see the mess. We have had a call from the Continence Team and they sent 4 huge boxes of continence pads for her to use but it was too much and rather overwhelming for her. She was genuinely shocked when this delivery arrived (as was I!). I should also point out here that she doesn’t wear underwear (I have not asked her about this, but assume it is because of her size and the discomfort). It is therefore unlikely that she would wear the pads as she is not accustomed to wearing pants in the first place. Indeed, she has not even tried the pads since their arrival a week ago.
My question to anyone who can advise is around the logistics of managing all this. I have resigned myself to the fact that she will not wear the pads, but I cannot continue dealing with all this mess on a daily basis. I am also paranoid about hiding all this from my 6 year old as I do not want her to think badly of her Granny, but I also do not want her to walk in wee on a daily basis, so I am constantly mopping and cleaning. My mum tries to clean up after her but does not do a good job due to her eyesight. I am also not sure what the best way of doing this cleaning is. My mum uses loo roll, but I worry that this will block the loo and also she has some rags that she uses and keeps by the loo. However, these become soaked pretty quickly and start to smell, so need to be exchanged. If there is a hand towel on the towel rail, my mother will use this to mop up her urine and then put it back onto the towel rail, so I have taken this away. When I mentioned this to her (kindly), she was shocked and said that she could not believe that she could have done such a thing, but then did it again an hour later. She has also used my daughter’s bath towel in the past. I mop the corridor and bathroom every morning but I need a better way of maintaining cleanliness throughout the day when she misses the loo while urinating. I have considered a different kind of loo seat? Is there such a thing for the ‘larger’ person? We were given a commode but she flatly refuses to use it and actually I think that this might be worse for me to clean up. At least the bathroom is tiled. Apologies for such a long post but it has been cathartic to get it all down. I realise that this may not seem much of a problem and I sometimes feel I am overreacting, but at other times I feel I can’t cope. Obviously lockdown, homeschooling and working from home hasn’t helped! Thank you for reading.

Hi & welcome Lisa

Do I assume medication as been investigated. And has a urine infection sample been done. Has there been any discussion of an overactive bladder.

There are a multi possible conditions …

Continence Team - I’m not sure sending over a batch of pads is the answer. I would think Mum needs to see a Dr or prescribing practice nurse. There are pull on pants which would be better than pads and keeping them in place. I know it’s difficult as Mum is not wearing pants. I would ask to have the pads changed to pull up pants.

Thanks Sunny. She has given urine samples (today latest one) and seemingly nothing untoward. I will ask about pull up pants but I am not sure they would be big enough. Also not sure about her ability to actually get pants of any kind on due to her size and immobility. However I will certainly ask and raise this. I bought her some from Boots and don’t think they are big enough, but she actually hasn’t even tried to put them on. :sleepy:

This is a very sad situation, but really I think your long term plan needs a rethink.
Your 6 year old deserves a happy loving mum, but you can’t care for her and mum as well.
Mum is fast approaching the need for residential nursing care.

I helped look after my brother, who was bedridden and obese. We wanted to put a wipable floor in to replace the carpet but it never worked. He also had a Conveen, a kind of non-implanted catheter, which wouldn’t work for women.

Anyway, I do well remember the NHS/Social Services would deliver pads of some kind or another, but not the really big ones - had to buy those privately. I agree with sunnydisposition that you really need to see a continence nurse. There was one in our borough, but we only ever found her by accident - GPs and district nurses would deny she even existed! Even then there were problems as she wanted a complex diagram filled in calculating how much he had drunk and how much he urinated - this just didn’t work with different carers coming in.

I can well imagine that your mother is not going to wear pull-up pants, and I expect they don’t even exist in the right size.

Anyway, that doesn’t help you. I agree with bb that you can’t go on like this if you have a daughter to look after. What is your mother’s prognosis? I assume things are likely to get worse, which may help you to consider residential care.

I know residential is not what you WANT but it may be what she NEEDS. My mum was so frail at the end of her life that residential became the only option left.

Thank you Bowlingbun and Greta. I think that I know this situation cannot continue and of course my daughter is my priority.
It is heartbreaking :broken_heart: every time I snap at her for going into the bathroom before I have 'sanitised ’ it and I hate myself for it. But I also want to be a good daughter to the woman who has been there for me every step of my life and is in many ways an inspiration. I realise that a compromise has to be reached and I am lucky to have a supportive husband. I think I was holding out for the continence team to be an ‘answer’ but the reality is that pads will not work. I was hoping someone might have faced something similar and have some wise words. I have thought about calling a care home and asking them for some tips??! Is that a silly idea?

If my wife didn’t have a catheter I’d be mopping up wee from just about everywhere, she has very little sensation as to what is going on down there and just doesn’t know, even when her catheter occasionally by-passes and she is soaked she doesn’t know.

A catheter would be the way forward, an indwelling (urethral) catheter can be fitted easily, usually by the DN. I feel sure that if your Mum went into residential care it would be one of the first things that they arranged.

Oh yes, of course, indwelling catheter, hadn’t thought of that as for a man you can put the Conveen over the penis and manage (up to a point) without.