Incontinence and UTIs. Suggestions?

Dehydration is usually a culprit for UTI's. So I push the hydration with my mother by handing her a water bottle regularly. I no longer withhold water from her at night and encourage her to drink as much as possible.

My mother also takes D-Mannose with Cranberry - a readily available supplement for bladder health.

I change my mother's Depends regularly and don't give her any choice in the matter. If it's for her health and safety, her attitude about it is not relevant.

The UTI’s are concerning and over time can cause changes to her mental status. They can also land her in the hospital. It is VERY important that she changes out of wet pants and keeps up with hygiene to avoid both UTIs and skin breakdown.
in addition, she can try cranberry juice and/or cranberry supplements that seem to have some beneficial qualities in preventing UTIs. But again, there is no substitute for proactive hygiene.
There are some products on the market that might help if they are in your budget. One is called a Purewick device. It is basically a soft collection tube that lays outside against her privates which suctions the pee into a tube and into a collection container. If used correctly, it keeps her dry while sleeping so she doesn’t have to get up and doesn’t wake up to a sopping wet diaper.
During the day she would still have to wear and change pants. The other product is called Uquora. It is a collection of oral supplements that purport to help prevent UTIs. You would have to evaluate and decide if these items could help. In the meantime. She will hopefully cooperate in changing out of wet pants and cleaning herself so that she doesn’t get into real trouble. Good luck!

Edit: She'll have to switch to an incontinence brief.

PapaBill: Your wife must now switch to an more dependable incontinence brief as padded underwear are no longer effective and that was not an intentional play on words. Actually my late mother, who was a frequent U.T.I. sufferer wore padded underwear and there you have it - causation. As your wife suffers from dementia, incontinence and reoccurring U.T.I.s, she is no doubt requiring regular toileting. To be left on the body, the "padded underwear" may actually be inviting a U.T.I. Also, once an individual develops cystitis (U.T.I.), they are going to require a course of antibiotics to clear the infection. Caution should be used to ensure that hematuria, the presence of blood in the urine is not present. At her physician's office, a clinical urinalysis should be performed and not a simple dip stick test. Once the infection is CLEAR and to prevent re-occurrence, a good suggestion would be a regimen of pure cranberry juice (not cranberry juice cocktail) as well as cranberry tablets. I recommend AZO brand since I am currently in the process of clearing a urinary tract infection. As far as bathing, harsh soaps are to be avoided.
U.T.I.s are quite serious and need to be handled as such. She will need to follow her physician's orders to ensure that it does not infect the kidneys or turn septic.

Yes. You cannot be 'reminding' your wife to change her 'padded underwear'.......she needs to be wearing the appropriate incontinence pull ups or tabbed briefs and they need to be changed regularly and not left on her soaked. You're in over your head thinking she's capable of changing herself with dementia at play! She needs a caregiver, or you, to be taking her to the toilet every two hours and to then check her briefs for wetness. When they're wet, they need changing right away, that is the solution. She should not be sleeping in wet briefs either.

Chronic UTIs are dangerous. What is your plan for managing your wife's care in the future? Memory Care Assisted Living is an option, and so is bringing in a caregiver to help her every day. Learning all you can about dementia is a necessity if you plan to be her caregiver, and then getting comfy with doing all the caregiving yourself, too, whether she gets angry about it or not, will be required. She cannot be left to her own devices to keep clean, showered, changed, etc. It would not be surprising if she reaches the point where she doesn't want to shower anymore at ALL; that is a common occurrence with dementia. What then? Get a caregiver in place (at least) right now so if/when that time comes, your wife will be familiar with her and willing to get in the shower or be cleaned up by the caregiver.

D-Mannose is a suggestion as a supplement for your wife to take to ward off UTIs in the future. But nothing will be effective w/o good hygiene in place.

How much D mannose should you take for a UTI?
For preventing frequent UTIs: 2 grams once daily, or 1 gram twice daily. For treating an active UTI: 1.5 grams twice daily for 3 days, and then once daily for 10 days; or 1 gram three times daily for 14 days.

I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”

https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4

Best of luck to you.

Women who have diabetes are susceptible to UTIs.

Please make an appointment with an Elder Law Attorney to get your wife placed appropriately and assist you in dealing with the reality of Dementia. I'm guessing placement will be in Memory Care, so you can place yourself in an Independent Living situation at the same facility, but you cannot live in Memory Care with her.

When it comes to incontinence, being a visitor is a great option!

Cranberry juice (the real kind). Take her to the toilet at least every 2 hours to give her a chance to empty her bladder

UTIs can be caused by not drinking enough water.

UTIs are definitely can be caused by soaked diapers and wet pants.

A CNA taught me to put 2 on my parent (one over the other). That way it can be easier to remove one.

Consider having a CNA come for her showering.

Try to make all these clean-ups feel more like a spa time. Hold your breath and try not to wrinkle your nose when the odor wafts your way. Use warmed wash cloths and pleasantly scented products. (Avoid lotions or powders in private areas as those can cause UTIs as well).

This loss of independence is confusing and humiliating.

Omg I thought my household was the only one dealing with. My mom did so well for so long and in the last 7 months she has been hospitalized at least 5 times with UTI and ugh!!! We give her azo pro and prebiotics and she takes something that’s supposed to help as a preventative I think it’s called methenamine . Waiting to see her urologist to reevaluate her dosage. We also give her cranberry juice and yogurt. Hope some of these help you

My mom (86) has frequent UTI's and she lives in her wheelchair. Hygiene is poor but she has caregivers along with family to encourage cleaning. She uses adult wipes after toileting. Sitting all day and the incontinence does not help this situation. Getting her to walk with the walker is difficult but she has exercises to do each day.

Push the liquids, use cranberry supplements and probiotics. When we think a UTI is beginning a specimen is sent to the lab for cultures. The correct antibiotic needs to be subscribed.

For people who have interstitial cystitis, which is a chronic condition that can’t be cured, cranberry and lemon juice would be painful. In this condition , lesions form in the surface inside the bladder. Coffee, tea, soda, alcohol and acids like citrus and tomato irritate the lesions and cause pain. It is under diagnosed and sometimes thought to be a bladder infection. So you need to be sure it is a bacterial infection, not some other condition such as IC. Because if it is IC, you can’t be treating it as if it’s a bladder infection; it won’t go away.

Besides cranberry tablets my Mom was placed on a probiotic.

The last UTI my Mom had she went to the hospital. They catherized her and got all the urine. Then she was put on IV antibiotics for 2 days. The cranberry tablets and probiotic was introduced at that time. Alva, an RN, recommends  D-Mannose to prevent them. It may even clear it up. Make sure a culture is always done to determine what antibiotic is needed. They can get resistant to antibiotics if used too much. This last UTI was in Oct, Mom passed the next Sep. In that time, she never had another UTI.

As we women age, especially if we have had children, our bladders drop. This causes the bladder not to fully empty. This is one way the infection starts. Moms doctor wanted to use a "sling" on her saying it would help with the UTIs but at 80 she refused. So, if possible, take ur wife to the toilet every 2 hrs. Have her sit, even if she had a good stream and seems done, a little longer sometimes you get the urge again. Leaning forward helps to empty the bladder. Water is important in flushing out the kidneys but I would stop any liquids a couple of hours before bed. I would make sure she voids completely before bed.

If you toilet her, you need to make sure she is clean. I used Huggie Wipes to clean Mom up well. They are big and thick. If you bathe her, do not use soap near her urethra. No powders. I used to use a hand held shower head to clean that area. Not once in the 22 months I cared, in my home, for Mom did she have a UTI. Of course, she was able to use the toilet.

In my experience with mom 86 the new normal has become about four or five pullup changes a day to keep dry, frequent baking soda sitz baths to keep area clean, and reminder to wipe front to back to keep from accidentally spreading germs from fecal matter. Keeping hydrated is critical. A little lemon juice in water works for mom. Definitely get doctor opinion on treatment of the existing UTI and dietary recommendations. As for the anger, I've found that it is part of coming to terms with incontinence, as it doesn't go away nor get better. It is frustrating and sad for both mom and me. That said, we still must do the daily/hourly things to keep her healthy for the rest of her life.

Absolutely, yes.

Work with her Dr to get the infection under control and then try giving her cranberry tablets daily to help make the urine less susceptible to infection. A pharmacist can help you with what's best for prevention.

She should not be left in wet underthings for too long. If she's going all night in sopping wet underwear.

Yep, she might get mad, but that could definitely be a part of the dementia. You kind of have to roll with that.