My mother has dementia. I asked her why she peed in a cup, and she responded that she didn't want to bother going to the bathroom. She's very capable of going to the bathroom and wears depends with liners. She stops for a while after I talk sternly with her about it, but she starts up a month or two later. What is weird is that she looks for cups to pee in; she actually makes that effort. So frustrating. Any advice?
Realize there are some behaviors that we (professionals or not) do not understand.
Yes, there is lots of 'weird' behavior (which is why I love working with this population ... I find it fascinating).
Although it isn't so fascinating to you if your mom in in your home (or even if she isn't ... no one wants to clean up 'pee' in a cup or whatever misses the cup).
It could be as simple as she feels tired or in pain and doesn't want to walk ... or she feels it is 'easier' for her so why not? She might be cold and not want to walk to the bathroom. There could be so many 'reasons' for how her brain processes information now - you (likely) may never know (her) the reasons why.
I would encourage you to stop talking STERNLY to her as it likely won't make any positive difference - and cause more emotional upset for both of you. However, it is interesting that after you talk to her, she seems to stop for a period of time - indicating that she has some / the cognitive ability to understand 'right' from 'wrong' and what is appropriate behavior.
Yes, I get it. As she said, she didn't want to 'bother' going to the bathroom. From her perspective ... why walk that far when a cup is closer?
If I were you and if she is in your home, consider:
1. Checking in on her more often and encourage / take her to the bathroom.
2. Consider it is time to consider a facility. You do not want to 'wait' until she might start defecating around the room. She might decide that this is okay, too.
3. Is she on medication?
4. How is her health in terms of mobility? pain?
5. Are there any other issues / behaviors that alarm you? what are they.
I always refer people to TEEPA SNOW's website. She is one of the country's leading experts on dementia. She may have an answer for you.
Yes, I empathize - it is frustrating and thank you for bringing this matter to our forum. I would like to hear from you again and what you decide(d) to do.
Gena / Touch Matters
After helping my dad to the toilet, I stepped out briefly to check my email. A minute or two later, I noticed him going from room to room, naked from the waist down and bewildered, his hands cupped together full of feces. As I scrambled to contain the situation, my sister descended upon us, screaming and cursing. Here I was in the middle, trying to help Dad to the bathroom as he was trying to hand his payload over to me, and my sister screaming into my ear at the top of her lungs, all the way to the bathroom and beyond.
Sometimes behaviors associated with bathroom and incontinence may seem bizarre at first. The patient may put their hands in their pants and then wipe their soiled hands on the wall to clean them. Or, they may manage to remove their pants and underwear, but then forgetting what to do next, may defecate in their own hands. They might mistake another room for the toilet, lift the corner of the rug like a toilet seat cover, do their business on the floor, and then put the rug back down over it.
As with everything else in dementia, you have to deal with such behaviors in a calm and collected way. The patient is already confused. Any frustration, agitation, or cursing on your part will only make things worse. Instead, try to reassure the patient with kindness so they feel comfortable allowing you to help them. You must be prepared to give up whatever you are doing, calmly take the patient’s hand and, without a lot of talking, walk them to the bathroom.
In general, the caregiver should accompany the patient into the bathroom. If the patient does not allow you to remain in the bathroom, stay close and vigilant so you can intervene if they forget what to do or start to make a mess. Above all, intervene in a calm and friendly manner. Although the patient may not be comfortable with your presence initially, if your help comes tactfully and with due respect for their privacy, they will slowly begin to trust you to help them.
It is very helpful to read it. While you refer to a patient, this is the writer's mother. You are very kind and obviously have a lot of experience being compassionate and patient with this population (dementia).
I appreciate you and how you are. It isn't easy and it is very sad that so many family members are tossed into 'this' arena with NO understanding, no education, nothing. They do not know what to do.
I am SO very sad that you and your dad had to go through this 'episode' with your sister screaming. I hope that she was able to reset - quickly - to be supportive to you / your father and the family unit. These are not easy situations. They are very difficult. Your dad is a blessing to know what he was wanting / trying to do ... God bless him. How is he doing now?
Gena.
You get her into the bathroom and you monitor her.
Use the trip to the bathroom like a break, get a cup of tea or juice and a cup of yogurt or take a walk or have her help you start to fix lunch or dinner.
The every 2 hours may seem like a lot but it also keeps her moving and that can help prevent pressure sores in the future.
get a Katie’s one so rim is wider. Old people can get VERY lazy and careless - mixture of effort it takes and laziness
She is not lazy and careless. This woman has dementia.
Clearly you either :
1. Do not know what dementia is; or
2. Didn't read the writer's concern.
Please educate yourself (and before responding here).
Older people with cognitive challenges (i.e., losing brain cells) are frightened, confused, disoriented.
If you read and educate yourself, you will gain understanding and with time and desire: empathy and compassion ... Although these states of consciousness / awareness take inner work, they aren't a given although it is exactly what we all need - caring, compassion, support).
OK, so I can see this happening. Once. Looks like now it's a habit, and that's unfortunately our brain on dementia. I am quite amazed that she can do this without spilling; I didn't find it easy!
You tell us you have spoken to her about this? And that hasn't worked. So this is something set in her mind. Might a bedside commode in her room be the answer? It's the only one I have.
If this is end stage dementia there may be other and worse habits coming, and more dangerous ones, and at some point at end stage, when there is no reasoning and things become habitual, there is no other answer than several shifts of several people each watching over things. I am talking thinking of placement in future?
If talking and reminding and commodes don't work, and if there are other things (I would suspect?) this may be a quality of life issue for YOU.
I wish I had a better answer. I sure wish you the best of luck.
What I have learned here is to provide a much larger 'cup' for her mother.
And equally important, take her to the bathroom every couple of hours.
The mother needs more ongoing supervision.
It's certainly worth a shot.
How I can write volumes ... and not even think of this.
Thank you.
Sounds like redirecting her to the bathroom would be a start. If she is one who is stubborn, it may become a battle of the wills.
Remove the cups and tell her cups are for drinking and not peeing.
Does she have a home health aide? Getting her on a toilet schedule of every two hours may work. It's called bowel and bladder training.
You 'do not' interact / treat a person with dementia as if they DO NOT have dementia.
What will happen ... with your way of thinking?
She'll pee on the floor or carpet.
And, yes. She needs a caregiver / more supervision - trips to the bathroom. But removing the cups - no. If she's left by herself, she'll either find something to pee in (a drawer ? a closet? out the window ?)
BUT--your mom's brain is broken. She no longer always equates peeing with a toilet. You can dang your head on the wall for 10 hrs and you won't be able to change this behavior b/c that skill, for mom, is gone.
You can only adapt to her. Place a stack of those big red SOLO cups in the bathroom only, along with moist wipes. If that is the only place she can 'find' cups, hopefully you can re-direct her focus to use those, instead of any random cup she finds lying around.
In time, you may find that she gives up the cups and uses the Depends. Dementia is a new battle every day, isn't it?!
With dementia, trying anything to see what works is the mantra.