Incontinence Management Change Up Could Make Dad’s Fishing Trip Possible
Dear Carol: My father is 72 and is in the moderate stages of dementia. Before his dementia diagnosis, he was an active hunter and fisherman. He also has incontinence issues due to prostate cancer, surgery, and treatment. This requires an external urinary attachment system to maintain an active daily life. My mother, as his primary caregiver, works diligently to keep the system and attachments clean and in working order. However, he is at the stage in his dementia journey where he is not able to maintain this attachment on his own. Yet he is defiant when we try to explain that he cannot go on trips with friends because his friends cannot be expected to clean and maintain the system. Due to COVID-19, they have all been isolating, so now a car trip is planned that will take them to a cottage they like so that they can fish. How do we help him to understand it is no longer possible, not due to the virus, but because he could become infected without help with cleaning the device? – MH
Dear MH: Dementia of any kind makes nearly every aspect of self-care and caregiving by others much harder to manage. Your mother's fortunate to have you in her corner.
Some of these devices that collect urine can be helpful, as seems to be the case with your dad, but yes, there is the upkeep that is necessary for health and safety. Since your dad wants to be independent enough to travel with friends but he can’t do this self-care while away, it seems that it’s time for him to transition to using pullup pads so that he can maintain his independence even when there isn’t a caregiver to help him.
You’ve probably thought of this, too, and of course, you are likely thinking, sure, but how do we get him to make this transition?
One thing in your favor is that since he’s been using this collection device for a time you know he’s not in denial about needing some type of urine control. That’s a bigger plus than it might seem since breaking through the denial of incontinence problems is what most caregivers face with older adults.
You might want to begin by taking your dad to see the urologist who prescribed this device. This physician might have some suggestions that could help him continue to use the device during a short trip, or he may be able to suggest alternatives that are less caregiver dependent.
However, with his dementia, it’s pretty much inevitable that your dad will have an increasingly limited ability to complete the tasks that make mechanical devices a safe, hygienic option. As you already know, UTIs and other infections are to be avoided since they can cause significant problems.
He will likely fight the alternative, but he’ll need to understand that he has two choices: Stay home where others can help him use his attachment in a safe way or accept that there are excellent pull-ups on the market today that can odorlessly collect urine and still allow for independence when he stays overnight with his friends.
Pullups can allow adults to live normally with only minor inconveniences such as disposal. The problem, of course, is that adults often equate any type of pad or pullup with infancy and diaper-wearing, so convincing them to make this adjustment can be hard. Most often, this takes many conversations, so starting now is a good idea. Again, enlisting the doctor for not only an opinion but for backup is a good idea.
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