Ask Miriam – April 2024
Dear Miriam,
My husband was diagnosed with Alzheimer’s disease some years ago. It has been progressing slowly but steadily, and it is getting harder for me to physically manage the care that he needs. The worst part is that now he is not always making it to the bathroom on time, mostly I think, because he doesn’t realize he has to go until the last minute, he is just generally confused, and he walks so slowly. I am exhausted from doing all the housework, cooking, and everything else. Cleaning up after him is awful, and I know it’s not his fault, but he is not able to help much when I try to wash him off, and the amount of laundry is impossible to keep up with. I honestly don’t know if I can do this anymore. I’ve thought of placing him in a facility where they can manage his care better, but I really love him and want him to stay with me. What should I do?
—What to Do?
Dear What to Do,
I’m so glad that you reached out, and I know that caregiving for someone with dementia can be an overwhelming task. It is important to recognize that no one is going to do it all perfectly, and that there is room for simply being a person doing your best. Since you are hoping to continue to care for him at home, there may be some changes you can make so it’s easier for you to keep caring for him.
Incontinence – a person’s inability to hold their bladder and bowels – is often a turning point for families. But there are some things you can do to cut down on accidents. The whole situation can be upsetting for both the person with dementia and for you, and the solutions may not make people feel better right away. To start, have him wear adult diapers, which are made of absorbent material and look like briefs. These are available online and at medical supply stores. If he still selects his clothing for the day himself, try placing them in his drawer and remove any other types of underwear.
In addition, institute a bathroom schedule. Every 2-3 hours, take him to the toilet, whether or not he feels that he needs to go. Stay in the bathroom with him in order to coach him through sitting down and using proper hygiene. When washing hands, it can be helpful to start washing your own hands to demonstrate what he needs to do.
Try making sure that he stops drinking liquids approximately 2 hours before bedtime. You may also want to consult with a dietitian since the foods that he eats can affect the amount and frequency of his output. Consider having a commode next to the bed so that he doesn’t have to go far if he wakes in the night. Pads, which are also online and at stores, can be placed on the bed and in the event of an accident, they will make cleanup easier.
Take time for yourself, too. Think about whether bringing in a professional caregiver, even just for a few hours during the day, could relieve some stress. Perhaps they could take over doing the laundry. There are also support groups for caregivers where you would be able to talk to others and exchange ideas.
For more information about coping with incontinence, read our tip sheet or call the Alzheimer’s Los Angeles Helpline at 844-435-7259.
Best,
Miriam
Questions for Miriam can be sent to askmiriam@alzla.org.