Why Would Mom Choose to Smell Rather Than Use Incontinence Products?
Dear Carol: My mom is only 79 but she has a lot of health problems including lung disease requiring oxygen. She receives good health care through her Medicare policies, and she doesn't need help around the house other than what I can provide by going to see her two or three times a week. Since we live near each other, that's not a problem. The problem is she leaks urine. She doesn't leak constantly, but she does smell most of the time even though she showers. I've told her that she should try some pads, but she refuses, saying that she doesn't need them. Why will she agree to use oxygen but then feel insulted about wearing an incontinence product? – Stinky's daughter
Dear Stinky's Daughter: How frustrating for you! Does it surprise you to know that this isn't an unusual situation? It’s sad that we tend to equate even intermittent issues of incontinence with being a baby when the reality is that many health changes can lead to various degrees of incontinence for adults.
As with so many things regarding our aging parents, you could consider how you are approaching your mom. You might think that you are doing so with compassion and gentleness, but it’s possible that your frustration is showing. If you want to double-check yourself, reading How To Communicate With Your Older Parents So They Hear You could prove helpful.
The “sharing your problem” approach
Many middle-aged women have some leakage problems with coughing and sneezing so this could be your way of connecting with your mom (whether or not you really have this problem).
Here’s how: When you’re talking about other things and having a relatively good time you could mention that you’ve been having some trouble with urine leakage so you’ve started wearing a light pad so you don’t have to change clothes when it happens. You’ll come across as more authentic if you are actually wearing a pad when you bring this up.
Don’t push her at this point, though. If (when) she resists, wait a week or so and then mention it again, perhaps after you’ve “had to” run to the bathroom. Say something like, “Well, this is frustrating, but I know that it’s common. I’m learning that it’s not that big a deal.”
Now, your mom may be mentally sharp and/or acting isn’t your thing. My point isn’t to write a script for you. The idea is that sharing a secretly embarrassing thing like incontinence can lead toward more closeness and more opportunities for you to let your mom know that needing incontinence protection isn’t unique. What you’re doing is normalizing the experience.
Over time, your mom may ask what product you use and then you are on a roll with helping her. Admittedly, this approach might work better if you didn’t have a history of arguments over her urine leakage issue, but it’s still worth a try.
When dementia is present
The above approach to getting someone with dementia to wear, say pull-ups, can help a great deal. You could model your pullups for your mom and she might get the idea that this is all okay.
You can’t pull off “sharing” Mom’s incontinence problem
If you just can’t get into this approach or you know that your mom will see through you, you might have to be more direct. That still doesn’t mean that you need to be cruel.
First, try positive reinforcement. When you catch a time when you don’t smell urine, just say, “Um, you smell good! Is that new soap?”
If you never have a chance for this positive reinforcement and nothing else works, you may have to go back to being blunt. “Mom, I can smell urine leakage which means that others can, too.” Let me order some pads that will prevent this. No one needs to know.
The bottom line is that urine leakage is a tough issue to address because of the mindset that protective products are for babies. The caregiver’s job is to break through this denial and present a viable option that helps people live better with a natural if embarrassing, bodily function that’s gone somewhat awry.
This is another situation where putting yourself in your mom’s place will be helpful, so ask yourself how you’d like to have this issue addressed if the situation were reversed and take it from there.
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