Welcome to our Dr. Karen Column. Here, Dr. Karen offers expert advice and answers your questions about caring for a loved one with dementia. If you have a question, feel free to submit it here for personalized guidance and support.
QUESTION:|
“Dear Dr. Karen, My husband has memory loss and is incontinent. But he loves to go to the store and run errands with me. But he refuses to wear a diaper.”
“What can I do? It is very embarrassing to me when he wets in his pants. And I am always having to think about where the closest bathroom is.”
Sincerely, At My Wits End!
Dear Wits End, Whew!
I hear you! And I can feel your frustration over the situation! Believe me! It’s not the first time I have heard this story! I know you want to do the right thing for both you and your husband so thank you for this question – I’m quite certain I can help.
One thing to keep in mind is that memory loss fluctuates from day to day, hour to hour, and sometimes even minute to minute. You may have already noticed this with your husband. Sometimes he may seem clearer in his thinking than other times. The trouble is – we never know when our loved one is going to be more clear or more confused. So never give up. Keep trying.
The second thing to keep in mind is that we always want to think ahead and set up a plan that is going to make our loved one feel successful. Accidents in his pants can cause him to feel badly, especially when he senses you are at your wits end! So, it’s very important to take care of YOU. And, it’s time to create a plan that will result in both your husband succeeding and you getting the relief that you need.
Taking trips to the store is very good for him if this is something he enjoys. It will help his memory and his physical functioning. Consider yourself lucky that he wants to go with you. This too may change one day, so enjoy it while you have it.
So here is what I suggest doing right now. It has worked for every patient whose loved one has shared this similar situation.
First, think carefully about using words that do not have a potential negative connotation to them.
For instance, the word “diaper” may put an image in his mind of something a baby wears. “Incontinence” may also be a word that he doesn’t quite understand. In this situation, it is better to describe words that he can imagine as helpful, comfortable, and easily understandable. For instance, instead of using the word “diaper” – use the phrase “your new underwear”.
Instead of saying incontinence, use the term “little accidents”. And instead of telling him in detail about his “new underwear”, simply remove all his current underwear from his drawers and replace it with pull-ups. Stack the pull-ups in his underwear drawer exactly like his old underwear is normally stacked, and he likely will just pick up a pair and pull them up like he does his regular underwear. If he says anything, you can simply say “Oh yes, don’t you love your new underwear? It’s perfect for all day because it can catch any little accidents that you might have and neither of us need to worry about little accidents anymore. I love them, don’t you?!”
Pullups for adults are wonderful transitions for men and women who have incontinence. The trick is getting your loved one to use them. That’s where the little creative communication and actions are needed. A simple substitution with pull-ups and a permanent storage of his old underwear will work like a charm! This has worked for every single patient I have tried it with. And my guess is that is likely over 200 patients! Give it a try! It will work!
Love from your helpful geriatric specialist,
Dr. Karen