First, she's in Depends but doesn't really need them except for the night. I was told to try to put her on a schedule. During the day, she goes to the toilet when she wakes, at noon, five and before bed. She's now taken to not drinking like she should after dinner and then the fun begins because she can't go to the bathroom at bedtime (10:00 ish). All she must do is take two medium sized glasses of water between 5:30 and 9:30. She takes a diuretic at dinner time, so there should be no problem. She doesn't do it and lies and says she does. When she does do it, we don't HAVE a problem. She mostly doesn't unless I walk by every 15 minutes and tell her to drink some water (and it always seems to be on the worst days) then we're up until midnight (and I work full-time and have to get up at 5) before she can go to the bathroom. Otherwise she goes 2-3 times during the night, and everything is soaked including her and that's even more work that's NEEDLESS. I tell her every single day; I ask her to write it down in a book and keep track of what she drinks because she must drink a lot because she has a colostomy (whole other problem). I'm starting to think it's a mental block and not physical. Maybe it's my fault for getting upset about it and now she can't go because she's worried about it?
Anyway, I'm really losing my patience with this. I took five days off to try to finally unpack my deceased husband's things that are in storage. I never get time off and need to do this. Now I will be too tired tomorrow because it's already after 12:30 a.m., I'm still up and wound up. I need to get her up by 7 for her pills and then get out of the house and go over there and be back at noon for her. I feel REALLY bad for losing my patience at a 90-year-old woman. I'm not abusive or anything but she knows I'm mad. I try to tell myself maybe she's losing it and I just don't realize it but It's such a freaking easy thing I'm asking her to do. I know she can do it. I guess I'm just really getting burned out. I mean, I shouldn't get upset about this, but at night I'd like to go to sleep at a reasonable hour. I guess that's not going to happen if I'm the caregiver and I'd better just get used to it.
She does get some fluids from food, but not much. She eats only 2 meals a day and burns off about zero calories. Her skin is overly warm and she has 'cotton mouth' all the time, so she sucks on hard candies.
Somehow, even with this barely drinking thing, she can flood her Depends like nothing I've ever seen. She HATES that, b.c if that happens, she has to change from the skin out and wash herself down, and frankly, she has no strength for that.
I KNOW she feels better when she's hydrated well, but she prefers to not. She doesn't go anywhere but to BINGO for one hour on Tuesdays. The rest of the time she is stuck in her tiny apartment and just watches TV or does a puzzle.
And her Apt is kept at a mind blowing 80 degrees---or hotter. Makes me ill to be there longer than 1/2 hr.
Se's 92. This has been the dynamic for the last 10 years. None of us have the energy to deal with her, and we don't. Occasionally, YB will being in an IV of simple glucose solution and run that into her (he's a paramedic and can get this kind of thing). She always feels so much better.
At 92? We just leave her be. I don't want to spend my infrequent visits haranguing her to drink more. She simply won't.
Sometimes we have to pick our battles.
You will find the right rhythm that works for you and mom. I have worked with two very different elders to encourage drinking water. So my advice is limited to their personalities. One with dementia.
My mom, who could get around with her walker, had the days water all lined up on the kitchen counter. Her finger tips were numb and a full glass was too heavy for her so instead of picking up the glass she had a large straw. She would move the straw from one glass to the next. Each time she walked pass the counter on her way to the bathroom, she would whittle away on the water. Seldom were all (any) of the glasses completely empty but she would have anyone who came in the house to refill them to the top.
She took diuretics also, but took hers earlier than your mom. She had a bedside commode she used at night. She was up four times a night from her hospital bed. I don’t know how she did it. I would be a zombie the next day if I got up four times a night. She wore depends as well. We had to insist as when she stood up, her bladder would release the urine. She had a surgery to help with the bladder and it did help for several years. My mom knew she had to weigh each morning, had to walk, had to have water and had to get up the next day and do it all over again. Oh and in later years she also took something to release the bladder so it would completely empty when she went to the bathroom. She took a portion of the tablet. Her urologist said it wasn’t enough to be therapeutic but she believed in it and they let her have it.
My DH aunt has dementia. So when I would try to encourage her to drink water, we made a game of it. I would tell her that I had to drink eight of the small bottles of water each day and I needed her help. I would give her one and I would take one and we would drink them down. I would leave her another by her chair and replace it often. I also used her pill time as a way to get more water down. I would give her the pills in batches, each requiring a small glass of water. Three batches of pills, three glasses of water. Aunt was a coffee drinker as well. She drank two or three cups of very weak decaf each morning. She loved to peel the little cuties and eat those which was mostly sucking the juice out. Loves watermelon. I would give her anything that had a high content of water. Aunt doesn’t connect the soggy depends as having anything to do with her but she is good natured and will go along. We used a large poise pad inside her depends and used the large pink medline pads from Amazon on her bed with the disposable pads beneath and between the sheets. This cut down on the laundry when she had a leak.
The Gatorade you mentioned has a high salt content. My mom couldn’t have salt, so I never gave her anything like that. I was lucky as both my LOs liked water. My mom would eat soups but aunt would not. Moms care was managed by a heart transplant/CHF center. They advised me that anything that contained water had to be counted as water my mom had. This when her water was being restricted. From this I knew that anything mom was forbidden as it related to water, would be good for aunt.
Working in a storage can be very very taxing. I have a friend who uses them for her business. She gives herself a limit of four hours per day. Otherwise she gets overwhelmed. I helped her once and was glad to escape. When there is an emotional element such as your brothers things might bring, the job would be all the harder. Give yourself a big hug from brother and from me. What you are doing is very hard.
Accept that your mom is doing the best she can. Give up trying to control, or in “making” her do anything. Think more of managing and encouraging and notice that the word “should” carries a judgment. Her situation needs a calm, relaxing atmosphere to release her bladder.
You don't just have to drink water for hydration.
Any of the following would count.
Soup
Salad
Stew
fruits
veggies
jello
ice cream
milkshakes
Ensure or any of the protein drinks
coffee, tea, iced tea
fruit juices, lemonade
And the fluid does not have to be consumed right before bed. It should be an all day goal.
There are absorbent pads that are intended to be placed in a pull up brief that will absorb excess fluid. That might be enough at night to keep her dry. The pads are not like the bladder or period pads as those have a lining to prevent them from leaking though. The absorbent pads will wick through to the pull up that is under it. Also try using a washable or disposable under pad under her at night as well. That should keep the bedding dry if she does leak though.
You are dealing with:
bereavement
burnout
guilt
frustration
urinary incontinence/diuretics/hydration (in summer)
scheduling
all in one go. You are *allowed* to feel screamy and tearful. Better?
But you're right, the tension is catching, and your mother has caught it, and that probably is the reason it's grown into such a monster issue. So for that reason and that reason only, you both need a reset.
I hope you've already gone to bed. When you've had some sleep and you have ten minutes, do her a pretty chart showing her medication, toileting and hydration schedule and pin it where she can see it (but chance visitors can't, so that she isn't embarrassed). Get her a Hydr8mate bottle or similar to drink from. Give her something to drink in it that she enjoys, as well as the water.
Next, lay on reassurance with a trowel. Tell her that the diuretics and not her personal failings are responsible for any wetting accidents, and it is absolutely vital for her urinary tract health as well as her general comfort that she has an ample fluid intake.
Make liberal use of continence aids such as disposable bed and chair pads as well as Depends.
To cut down how time-consuming night-time accidents are, I'd suggest plastic laundry bags with soluble strips - you bundle everything into one of these, tie it loosely, and then you needn't do a thing about it until you're good and ready because you just shove the whole bag into the washer and it comes undone by itself.
She won't write down what she drinks, and being asked to will add to her anxiety. Instead, measure what you're giving her and record the difference - you need a rough idea, not precision to the last ml.
Above all, just start again tomorrow :) A big hug to you and her from me, you will get this sorted x