My First Alzheimers patient and incontinence

[ladybug888today]

Hello,

I was hoping I can get some advise or ideas on my situation..

I am new to home health and am a home health aide.. My situation is that my patient has Alzheimers and he is incontinent some of the time..

What is happening is that he is wearing pads and as sits in his chair, when he feels he

has to go to the bathroom, instead of going on the pad he will pull his member out and just go in the chair.

His wife yells at him when he does this, and I know with alzheimers patient it doesn't do any good.

She was looking at me for advice, but I am new, and I just suggested for him to try diapers.. but.. if he still pulls out his member to go pee, whats the use?

Anyone ever been confronted with this problem? All advise is greatly appreciated.

[duskyjewel]

With Alzheimer's and other dementias, the oldest neural pathways are the last to go. He's acting out behaviors that are familiar and make sense to him, even if their execution doesn't make sense with his current situation.

First thing I want you to do is speak to the nurse managing this case and suggest that the wife might need more support and definitely needs education. Yelling at him is unproductive, but it's also cruel. He doesn't understand what he's doing wrong. Does your agency employ dementia educators? If not, hopefully someone knows of resources to whom they can reach out. Left unattended, her behavior could escalate to elder/spousal abuse.

Second, does he have a urinal? Maybe he could be taught to use it, if it's kept very close by and handy. But if he can't be, at least when someone sees him they might be able to get it in place before he goes on the chair.

[rosey200735]

Try taking the resident to the bathroom at least every 2 hours. If you notice him looking like he has to go then direct him to the bathroom if possible. Also get some Geri pads for the chair so if he goes it will not make a mess. It sounds to me like he still knows when he has to go, but he might need help to find the right area.

[ladybug888today]

I work for a nurse registry and they don't have nurses that give advice. they told me when I was hired that I am basically on my own, like self employed.. Anyone familiar with this? I am per diem, only a few hours a week for now.

I will suggest the urinal, great idea. What is a Geri pad? And where can I get one?

Thank so much for the advice.

[daimere]

Also, have you noticed cues that he is giving off before eliminating? I have on resident that will start tugging at his pants and you can usually guide him to a toilet. There was another one that would start fidgeting when he was about to go. A urinal is a great way to go to catch it in time. There are many times I've had to throw a urinal under a dementia resident to prevent a mess.

[Ramcharger310, ASN, CNA, RN, EMT-B]

First,

Be patient, understanding and never get mad like the wife.

He does not understand what he is doing. What he is doing is what's called muscle memory. Like other's said, the basic needs are the last things to go. He needs to go pee, he pulls his thing out from the underwear type clothing and goes. In his mind, he may think he is in front of a toilet.

Another thing, it won't get better. As his disease progresses, he will eventually become completely incontinent.

I work in a locked Alzheimer's and Dementia facility. Get his wife informed. He will never be like he used to be.

Also, like Rosey said, get some Geripads or Chuxs