I am concerned about my mother's toilet needs in the middle of the night. Advice?

If she has been in AL for 3 years, with 3 shifts of caregivers.. how do you think you are going to do this? Not being smart arssed here, just really want to know? I know my father took out 3 of us when he morphed into all night man,, and she will. And it will get worse.. and you WILL get no sleep.. I didn;t nor did my mom or hubs. We had to put into MC just to get our feet back under us, and it was the best move we made (don;t tell MOm I said that!)

JudyAnn, is there a reason that you need to move your mother in with you? I wondered if she is running out of money or you just want to spend more time with her. Or if her needs are so much now that assisted living can no longer accommodate her.

Moving her in with you will be a lot of work and you may find that it is harder than you can imagine. I understand if it is what you need to do. A bedside commode would help, but if your mother is prone to fall, she may fall as easily going to the commode as going to the bathroom.

We have had many people in the group take care of their loved ones at home who were more frail. I hope that some of the people who know the technicalities of what you will be facing will join this discussion. They will have some good advice, I'm sure.

There is a little voice in your head trying to warn you not to do this. No single person can replace three shifts of nurses. Get her to a nursing home or you could easily be among the 30% of caregivers who die before their patients.

JudyAnn, I am the same when it comes to be awaken at night, it is almost impossible for me to go back to sleep... thus it always ruins the next day as I am exhausted. I couldn't imagine having that happening every single night, day after day after day. It will ruin your health very quickly.

What is the reason you are attempting to bring your Mom into your home? Does your Mom dislike where she is living? In the 3 years she had been in Assisted Living, she probably has made friends with people of her own generation... would she be around anyone her own age if she lived at home?

If Mom falls on a regular basis, would you be able to correctly pick her up, so not to unintentionally harm her? Have you picked her up in the past? If not, an elder become dead weight, it's like trying to pick up a 100 lb to 200 lb barbell.

Is Assisted Living becoming too expensive? The place where my Dad lives, they have it set up where one can share an apartment with other, thus cut down on the expenses. Or have you looked into a Medicaid Waiver depending on if your State offers such for Assisted Living?

You need to get a night shift to care for mother then, you need to reconcile yourself to being sleep-deprived for the rest of your mother's life, or you need for her to be in care center when a small number of people can take care of relatively large number of people overnight, thus being more cost effective than one-on-one overnight care.

Those are the choices I see.

Why are you planning to bring her home at this time?

Thank you for honest opinions everyone. I have lived overseas for the past 6 years and so we have wanted some quality time with my Mom. I have to move her from my sister's assisted living place because I need to be the daughter doing the primary care since my sister has special needs adult children and is stretched too thin. So far no one in her bloodline has lived past the age my mother will be turning this month. We want to give it a trial to see if we can care for her and ourselves well. We have assisted living places in our town researched as a back up and to give us respite care for her. So it seems like once people have mobility problems that is the issue that makes people put relatives in homes or hire home care at night? No one has cared for frail relatives with bladder needs at home? and lived to tell about it?(smile)

Thanks for the explanation. Quality time with Mom is a great goal. Speaking from experience, one can have quality time with a parent in a care center, too. I'm glad to see you are realistic enough to look at this as a "trial."

My husband needed assistance any time he got up in the night. I was sleep deprived the entire ten years I cared for him. That was my choice. That was my soulmate. Could I have done that for my mother? Sorry, I don't think so. The nature of the relationship is just different.

To begin with, the sleep deprivation was so severe I knew it would not be safe to continue that way. He doctors came up with solutions to help him sleep through the night most nights. That made it possible. He still got up to go to the bathroom at least once, but that was manageable. I also had daytime help coming in the morning and more than once I stay in bed for a while after she came.

Good luck to you!

In my experience, the way to have 'quality time" with an elderly parent is to have the ability to visit, chat, do fun things and then leave, so that you each have your own lives. 24/7 caregiving is burdensome and does not lead to making fond memories.

My wife uses a bedside toilet every night. She is a fall risk but is able to handle the bedside toilet. I clean it out next morning

4 years ago my Mom came to live in our house. She also has mobility issues. My Mom's case sounds like your case. Both my husband and I work full time. We hired a caretaker to come in during the weekdays. At night my Mom wears depends and calls me when she needs to use the restroom. Some nights its one call and some nights it can be 2 or 3. My sister who lives back East comes for "Mom relief" about 3 x year. This break helps us to rest. You need time away from Mom duty to recharge. I would recommend having someone come in on a daily basis. It doesn't have to be for 8 hours. This way you can get out of the house for errands and such and not worry about leaving your Mom for an extended amount of time.

JudyAnn - so you & your husband have been living abroad the past 6 years during which you mother has been in AL with 3 shifts a day of care. You all are moving back to States & mom is going to move in with you as you want to now have quantity time with mom.

That's in a nutshell it, right?

Is it going to work? Well maybe but may have the same probability as me getting back into a size 4 rather than a size 14. As one who has lives abroad for periods of time, the adjustment of being back in the states is in & of itself a hurdle. Your body clock will be off for weeks. You mind will constantly be filtering change of language & culture (& perhaps some regret). Even if you've been living where US English is spoken everwhere. If you travel back & forth regular & have a homebase in each & fluently multilingual & multicultural, it's not quite the issue but will require adjustment nevertheless.

Then add onto this, taking on caregiving for a elder who is 6 years older & more frail than when you last were around her & that you know needs 3 shifts of caregivers presently. That you know has worn out your sister even with mom being in AL with 3 shifts of care. That somehow you being her 24/7 caregiver in your home is going to provide & make up for quality time you've missed with mom those last 6 years. Really is this at all realistic?

Please, please, please speak clearly with your husband on all this. If you all are moving back because he's retiring from a job abroad.....he is not going to be at all happy about coming back to the US to essentially become a unpaid caregiver & emptying a porta potty & having a needy elder 24/7 in the home. If you all lived in a country where all the expats have help, maids, drivers.....& he was used to having staff at work......well he is not going to be happy now having to do scut work no matter how much he likes his MIL. Please think about this.....Being sleep deprived coukd be the least of your problems.

Quality time and caregiving IMO are 2 different things. Spending time visiting, talking, sharing and reminiscing are far different than helping her to the toilet in the middle of the night, changing depends, giving meds, waiting on her needs etc If you want quality time, then find a good place that can tend to her 24 hr needs and then visit often, knowing in your heart you did the right thing for your health, her well being, and that of your family. Good luck

Picture this- my 92 year old father was 230# of frailty- could use a walker but where he landed in bed was it- couldn't roll over, get up, or move an inch in any direction. My 88 year old mother (with back problems) had to help him get in/out of bed and reposition him for comfort day and night- who was going to get hurt first? I investigated solutions and developed an expertise in mobility issues- would be glad to offer suggestions if I have more details. My father was able to safely "help himself" in the bed area eliminating the need for my mother's help- keeping him home years longer. Can't say whether your plan is good or bad- but proper assistive products and home helpers may be critical to making things work. In the toilet situation you mentioned- products allowing your mother to safely get herself out of bed to use a bedside commode could be key to your sanity. In many cases this eliminates the need for a paid night shift. Good luck and please let me know if I can help with suggestions.

JudyAnn - In your reply you asked "No one has cared for frail relatives with bladder needs at home?" Up to the point I began typing this, you had but one answer that directly gave you the advice you are seeking - other answers got to the specific topic amongst their other advice. And all the other advice was basically the same theme - why is that? Obvious. Most of these people have first hand experience at doing what you are about to do - and if not trying to dissuade you, at a minimum they advise that you really reconsider. Those like me, who never cared for our elderly loved ones in our homes, by our selves, are advising you the same. I guess its presumptious to assume you don't have any experience with this level of care - I mean, you know it took three people to do the job your are going to undertake. Three people who in an AL situation probably didn't have to do the cooking, the laundry, the showering, organizing and dispersing, medication all while taking care of their own home, husband and self. Usually another employee performs these additional jobs and when the direct caregivers eight hours are over they go home - but you are home. What I'm having a problem understanding - even though you explained your motives - is why you would take your mom from a successful AL situation. Just getting our loved ones into AL would be a minor miricle for a lot of people here. Your mom has been there for a few years - knows the routines, the staff, her living space and probably has friends that she socializes with. And you want to take your mom from there to live with you for "quality time"? Read enough posts here from people caring for frail, elderly loved ones in their homes and you'll know getting up at night for a potty break is only one of the problems they face. I never, ever considered moving my mom in with my family. I've had three back surgeries, my adult son with severe autism lives at home and I have a small two bedroom house that is not wheelchair friendly. But even if those factors didn't exist, I still wouldn't do it. As best I can, I want my time with my mother to be "quality" - not spent thinking of ways I could kill her in her sleep and make it look like an accident! You mention plan B if things don't work out - why put your mother in the position of having to move back, new space, new routines to learn, no friends to start, when she is taken care of where she is - and you can still spend quality time with her. In my experience every time we had to move my mom, it took a toll on her - and not one that was recouped. Maybe it would be different for your mom, maybe not. Just for informational purposes - try that old method of helping to come to a decision. Piece of paper, two columns, pros and cons of having your mom move in with you. Before you start, spend a few hours here looking at posts from the people who are doing, or have done what your about to take on. Be honest. Be sure to consider the likelihood that mom will change in personality and in needs. It's not too late nor unreasonable to take a little more time to really consider the facts and likelihoods of what you now already are expressing concerns over.

Put a diaper doubler in her diaper with a bed pad and tell her that she must use it during the night. Whether it is you or a 24 hour caregiver, you must get at least 8 hours sleep. I went through this with my mom and it was the only way because I was going crazy from sleep deprivation.

JudyAnn - Mscoulter's idea is certainly a solution to consider - it wasn't planned but this is pretty much how they deal with my moms nighttime issue at her NH. Mom doesn't wake up needing to go - she wets in her sleep. Mom is also a major mobility risk anytime of day but especially when half asleep in the middle of the night. Anyhow - if your mom begins using a nighttime diaper with liner etc and wets at night, know that you'll need to be showering/ throughly cleaning her almost daily - something most elderly come to strongly resist. While adult diapers are a necessary evil in the lives of a lot of elderly folks - urinary track infection risks become much greater with their use. Something to consider on your pros and cons list.

Someday, there will be technology that detects a wet depends, records the time, and the caregiver can track giving fluids at hour of sleep, x the hour of wet depends, create a rigid schedule, and change the depends to last the rest of the night, or, if possible, ambulate to toilet on that most likely to go schedule.

The benefit: For the caregiver, knowing you will be up, when, for how long-having some control over that will be less frustrating and allow for better rest when you do get it. For the 'patient', benefit is having no wet depends for hardly anytime at all.
Of course, this won't solve all the issues with you getting your REM sleep.
Sorry you are, and so many are having to go through this.

JudyAnn, thanks for the update on the reason why you want your Mom to live with you. Even though I never lived with my parents nor they with me, I have read over the past couple of years the trials and tribulations of caring for an elder in one's home. It isn't pretty. Quality time and care time are as different as night and day.

And you will need to elder-proof your home. Those lovely items you bought while living overseas will need to be put away due to Mom's mobility problems, as you don't want them broken nor Mom. Same with those nice accent rugs bought in far away lands. Mom will need a main floor bedroom/full bath. The bathroom will need grab bars.

Your quality time will slowly morph into resentment time. And your Mom will start to feel the same way, missing her best friends forever at her old Assisted Living. Meals will need to be the same time as Assisted Living because that is what Mom was use to, and she may prefer their meals over yours.

Have you thought about what if something happens to you? Last year I fell and broke my shoulder. Any type of caregiving to an elder is out the window for months on end. I couldn't drive for 6 months, thus I had to cancel all my parents doctor appointments as they refused to use a taxi. It would take me a half hour just to get dress myself.... couldn't imagine meeting the needs of an elderly parent, too.

Lot of food for thought.

JudyAnn, I gave been caring for my mother for almost 10 years. I would not make any other choice. She is totally incontinent, is no longer mobile, and cannot really make her needs known. She has advanced Alzheimers Disease. At this point, she sleeps with 2 pair of pull-ups and a bladder pad between. She does not wake during the night any more. She did for a while. I managed by taking naps when I could. Even now that she sleeps through the night, I wake up.

She is at hospice for a 5 day respite and I plan on sleeping late. Yes, I am having her do at home hospice so there is still a lot on my plate. For the next few days, however, those responsibilities are lifted. And I will be ready and happy to have her come home on Monday.

Telling a continent adult to go ahead and pee in her disposable underwear is a problematic concept. If the person is at all lucid, even a little, that is not an acceptable idea. They tried it on me once when I was in ICU and they finally had to bring in a bedside commode and get me up. Even when Mother had a catheter it was very very difficult to explain to her that she didn't need to get up when she felt the urge to pee. Now she wears disposables at all times but telling someone who was potty trained 93 years ago that she should pee in her pants just doesn't cut it. If the aides don't come right away to toilet her I say, "don't worry if you leak a little, Ma, you have a pad on to catch it." and that calms her down.

Maybe you can convince someone to just go ahead and pee in her diaper at night and not to get out of bed -- maybe. But I'd bet against it.

Just to be clear, it is risky in that she may try to get out of bed by herself. I used a bed rail for a while and took the commode out of the room and also moved the walker out of the room. I also left an intercom phone with her so she could press one button to call me if she really needed me. She needed it once when she got nauseous in the middle of the night and had to vomit, but otherwise she has let me sleep. Her aide comes in in the morning and helps her sponge bathe and dress. As Rainmom said, she must be kept very clean, and may also need A&D or diaper ointment applied once per day.

Bed rails can be risky in that people who really want to get out of bed can do more harm trying to get over or around the rail than they would without it.

There isn't such a thing as a risk-free life, especially in old age or with dementia. But it is usually good to be aware of the risks and to recognize which ones we can minimize.

I have personally been 'three shifts' for six years now. Mom got up between three and EIGHT TO NINE times a night to go to the bathroom for over 120 days until she went on Vesicare thru the new urologist. And yes, I do all the cooking, cleaning, driving, bathing, dressing etc. She's almost 93, frail, and not ambulatory. If you have access to help at night USE THEM.

JudyAnn are you visiting your mother a lot where she is, now? You see how many activities the facility offers. How are you going to provide stimulation and peer contact and interesting activities in your house? There are certainly ways it can be done. They all involve effort from you and cooperation on her part.

Being involved with her in some of the activities where she is now could be quality time. My mom lived with my newly-retired sister for about a year before her mobility problems and dementia became too much for at-home care. It is very important for Mom to have her hair looking nice. Toward to end of her stay my sister could not even talk her into going to the hair dresser. Now the hair dresser at the nh comes for her weekly, wheels her to the shop, and then wheels her to lunch or where ever she needs to be next. There is live entertainment at least once a week, and she doesn't even have to struggle into a jacket! I try to go when they have certain crafts scheduled that I know are helper-intensive. One sister always meets the nh van at Walmart when they go and takes Mom around. Another sister went with the nh group to the local 4th of July parade. Another sister (there are 4 of us!) and I took Mom and her friend to an outdoor apple festive the nh put on. (Volunteers are available for those who have no family member to help.) In other words, Mom has gone from watching television all day and dreading any trips at all to participating in lots of activities. Instead of sitting alone a lot, we come in to find her having coffee and talking to other residents.

Are you sure that taking away your mother's current social life, moving away from people she has been used to for three years, and reducing the number of activities available to her will be an improvement to her quality of life?

What if after a good night's rest you visited her after breakfast and did activities with her, if there is something scheduled she particularly likes, or sat and chatted with her and other residents she likes, or wheeled her around the ground (or helped her if she uses a walker) and commented on the changing seasons or the odd picture in the hallway? Admired the decorations on the residents' doors? Took her out to pick out a new decoration for her door? (If she is able to ride in a car OK). The next day go for a few hours after lunch and play cards with her. One evening bring in photo albums of your time abroad and tell her about your life there.

I really can understand that you want to have quality time with your mother. I am not at all sure that requires you to do the hands-on caregiving.

Why not give visiting her where she is a chance for a couple of months, before you decide you have to move her to achieve your goal?

Wow, I have to ask if you're sure you're ready for this MAJOR responsibility? Caregiving is mind-blowing difficult!

I care for my grandma who wears depends. Sometimes she calls out to me in the middle of the night but sometimes she forgets and tries to get up so I have to listen for her. I'm a light sleeper and I was exhausted at first. I would have trouble like you are, going back to sleep and would be living off 2 hours a night if I was lucky. My body adjusted and now I can fall back to sleep almost immediately after getting up with her and I also take advantage of her nap time in the afternoon. Where she takes a two hour nap, I sneak in 45 minutes or so just so that I have time to my things and rest a bit. I have found that it helps a ton even if it's a no sleep kind of night to be able to rest an hour. I have a caregiver as well who helps me during the day so I am able to work a few hours two days a week. I could technically work all 5 days but honestly I needed the time for me to go do errands and I"m in the process of moving and wanted the time to pack up a huge house now that my mother has passed away and its now my responsibility. My grandma is up 2 or 3 times a night going to the bathroom (basically she goes to bed around 9:30, is up around 12, 3 and 6 which is for the day) on her good nights. Other nights it can get bad and if she has a UTI watch out as it means no sleep for me for a few nights until the medicine kicks in. It's not easy but I manage alone. As I said my body adjusted and I'm sure yours will too just don't be afraid to rest for a bit while she is resting so that you keep your strength up.

I also should have mentioned I sleep next door to her and use baby monitors. With the baby monitor in her room I am able to hear her chair if she uses it to stand up to try to go to the bathroom (It's a lift chair so quite noisy thank goodness) and I can hear her grunting when she tries to get out of the chair forgetting to use her remote. I can hear her call for help at times she remembers through the baby monitor and then I can just open my eyes for a second if I hear noise and look to see she's still sleeping or is instead moving around needing a bathroom break. Baby monitors are the best invention in the world in my opinion. I have them on her in every place she sits so I can move around a bit while she's resting and still have eyes on her.

I tried taking my loved one back home. I tried. It was not good for us. I felt like I was hurting her when I tried to suction her. She required too much nursing and I am not a nurse. Hell, I couldn't even keep the room sterilized enough for her suctioning and feeding tube and bedsores. It was just impossible. I tried. Within weeks of placing her back in a nicer nursing home she died. Probably due to their neglect. No one will ever watch over your loved one like you will. Both choices were impossible.

Nature: Sorry for your loss and you spoke the touching truth!

JudyAnn, I can tell you about our experience with my mom. She lived with me for 9 yrs during which time she could do most everything for herself. She then moved in with my sister. After a couple of falls and rehab she could no longer be unattended. We set up care for daytime, myself and niece but the nights fell on my sister. My mom would get up every two hours to go potty. It took only a short time before my sister could no longer handle this. She is 60 and works full time. The night time breaks in sleep took a hugh toll on her, even thought her husband would help out. Just knowing that at any moment you are going to be called for is enough to provoke anxiety and making it even harder to get to sleep. The constant wake sleep cycle finally made us decide it was best for mom to move into an Adult Family Home. Its a home with 6 residents and a wonderful family who give remarkable care. She is 10 minutes away for both of us and she loves it. She herself knew it was to much for my sister and is glad we made the move. Caring for someone in your home is very very hard. 24/7 is just that 24/7 so I suggest you give it a lot of thought and read what others are saying on this forum. I know you love your mom, but caring for her yourself may not be the best for all involved. Whatever choice you make I do wish you all the best. You have a kind heart. Hugs. 😃