My wife has dementia. She is also incontinent and wears pads/padded underwear. She suffers from frequent UTI's. Could this be a result of her wearing urine-soaked pads/underpants, especially at night? If so, is there a recommended solution as it is often difficult at this stage continually reminding her to change them frequently? Reminding her only makes her angry. Thank you.
Work with her Dr to get the infection under control and then try giving her cranberry tablets daily to help make the urine less susceptible to infection. A pharmacist can help you with what's best for prevention.
She should not be left in wet underthings for too long. If she's going all night in sopping wet underwear.
Yep, she might get mad, but that could definitely be a part of the dementia. You kind of have to roll with that.
The last UTI my Mom had she went to the hospital. They catherized her and got all the urine. Then she was put on IV antibiotics for 2 days. The cranberry tablets and probiotic was introduced at that time. Alva, an RN, recommends D-Mannose to prevent them. It may even clear it up. Make sure a culture is always done to determine what antibiotic is needed. They can get resistant to antibiotics if used too much. This last UTI was in Oct, Mom passed the next Sep. In that time, she never had another UTI.
As we women age, especially if we have had children, our bladders drop. This causes the bladder not to fully empty. This is one way the infection starts. Moms doctor wanted to use a "sling" on her saying it would help with the UTIs but at 80 she refused. So, if possible, take ur wife to the toilet every 2 hrs. Have her sit, even if she had a good stream and seems done, a little longer sometimes you get the urge again. Leaning forward helps to empty the bladder. Water is important in flushing out the kidneys but I would stop any liquids a couple of hours before bed. I would make sure she voids completely before bed.
If you toilet her, you need to make sure she is clean. I used Huggie Wipes to clean Mom up well. They are big and thick. If you bathe her, do not use soap near her urethra. No powders. I used to use a hand held shower head to clean that area. Not once in the 22 months I cared, in my home, for Mom did she have a UTI. Of course, she was able to use the toilet.
Push the liquids, use cranberry supplements and probiotics. When we think a UTI is beginning a specimen is sent to the lab for cultures. The correct antibiotic needs to be subscribed.
A CNA taught me to put 2 on my parent (one over the other). That way it can be easier to remove one.
Consider having a CNA come for her showering.
Try to make all these clean-ups feel more like a spa time. Hold your breath and try not to wrinkle your nose when the odor wafts your way. Use warmed wash cloths and pleasantly scented products. (Avoid lotions or powders in private areas as those can cause UTIs as well).
This loss of independence is confusing and humiliating.
When it comes to incontinence, being a visitor is a great option!
Chronic UTIs are dangerous. What is your plan for managing your wife's care in the future? Memory Care Assisted Living is an option, and so is bringing in a caregiver to help her every day. Learning all you can about dementia is a necessity if you plan to be her caregiver, and then getting comfy with doing all the caregiving yourself, too, whether she gets angry about it or not, will be required. She cannot be left to her own devices to keep clean, showered, changed, etc. It would not be surprising if she reaches the point where she doesn't want to shower anymore at ALL; that is a common occurrence with dementia. What then? Get a caregiver in place (at least) right now so if/when that time comes, your wife will be familiar with her and willing to get in the shower or be cleaned up by the caregiver.
D-Mannose is a suggestion as a supplement for your wife to take to ward off UTIs in the future. But nothing will be effective w/o good hygiene in place.
How much D mannose should you take for a UTI?
For preventing frequent UTIs: 2 grams once daily, or 1 gram twice daily. For treating an active UTI: 1.5 grams twice daily for 3 days, and then once daily for 10 days; or 1 gram three times daily for 14 days.
I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.
The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2
She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”
https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4
Best of luck to you.
U.T.I.s are quite serious and need to be handled as such. She will need to follow her physician's orders to ensure that it does not infect the kidneys or turn septic.
in addition, she can try cranberry juice and/or cranberry supplements that seem to have some beneficial qualities in preventing UTIs. But again, there is no substitute for proactive hygiene.
There are some products on the market that might help if they are in your budget. One is called a Purewick device. It is basically a soft collection tube that lays outside against her privates which suctions the pee into a tube and into a collection container. If used correctly, it keeps her dry while sleeping so she doesn’t have to get up and doesn’t wake up to a sopping wet diaper.
During the day she would still have to wear and change pants. The other product is called Uquora. It is a collection of oral supplements that purport to help prevent UTIs. You would have to evaluate and decide if these items could help. In the meantime. She will hopefully cooperate in changing out of wet pants and cleaning herself so that she doesn’t get into real trouble. Good luck!
My mother also takes D-Mannose with Cranberry - a readily available supplement for bladder health.
I change my mother's Depends regularly and don't give her any choice in the matter. If it's for her health and safety, her attitude about it is not relevant.