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Posted April 23, 2009

Ask An Expert

Elderly Care: How to Handle Mom's Urinary Incontinence

Q.

 I am not a caregiver, but I am living temporarily with my 79-year-old mother because I lost my job. I have known she has incontinence issues, although she doesn't like to speak of them. Two weeks ago, I noticed a foul smell coming from her bedroom which led me to her bathroom. There, in a pile thrown on the floor of her bathroom, were a collection of used rags soaked with urine. The pile must've been a weeks worth. I tried to be sensitive and supplied a bucket with Clorox and water for her to use. 
 
On my way to work, I left her a note so she wouldn't just stumble upon what I'd done. Again, I tried to be sensitive in my wording, only mentioning the placement of the bucket. She acted as though nothing had happened, which surprised me. I did, however, notice she was washing the rags in the washer when I got home. I thought maybe she'd continue using the bucket, etc. She has not. This morning I found another growing pile of wet and smelly rags thrown into a pile in her bathroom. 
 
This is SO unlike her. I don't know where to turn or whether to do anything at all. Thank you for your time. 
Danalee L., Sacramento, California.

A.

 I can feel your dismay. Bathroom issues are something we're trained from toddler-hood to be very private about, and you don't want to embarrass your mother or yourself. Yet, this is something you should investigate further, much as it will be uncomfortable for both of you.
 
Find a time soon when you are both fairly well-rested and relaxed. Be frank with your mother about what you saw and smelled in the bathroom. Explain in as calm a manner as you can that allowing urine-soaked cloths to accumulate creates a breeding ground for insects and bacteria. Offer to buy her a package of disposable undergarments to experiment with. They will be much more comfortable and more absorbent than her rags. 
 
Be as gentle as you can, but insist that she visit her doctor as soon as possible. She may have a urinary tract infection or other physical problem that is contributing to the incontinence. The doctor can also do a cognitive screen to determine whether she might be developing some memory issues that make managing her hygiene difficult for her. 
 
If she will allow it, go with her to the doctor so you can hear what is said. If she won't allow you to go along, call the office and let the doctor know about your concern. This way, if she doesn't bring it up, there is a good chance that the doctor will. 
 
If she won't cooperate about going to the doctor or changing to a disposable product, purchase a closed diaper container and deodorizer from the baby section of your most convenient store. You will have to insist that she use this and not the floor. She will also have to do her laundry at least every other day in order to keep odors away. 
 
Borax is a good addition to laundry soap for eliminating the odor of urine, which is probably also in her clothing. 
 
I'm sure you will have a hard time agreeing right now, but the fact that you are available to observe these things is a blessing for your mother. If you weren't there to insist on getting to the bottom of a potential medical issue, there would be no one to push your mother toward getting help.

This answer is provided by Molly Shomer, a family caregiving specialist and licensed geriatric care manager. She is a nationally recognized expert on eldercare issues and the author of The Insider's Guide to Assisted Living. Her website is www.eldercareteam.com, and she can be reached at molly@eldercareteam.com

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