Our parents changed our diapers when we were babies. As we grew into toddlers we were "potty trained," and from that time on we were expected to control our bodily functions. Is it any wonder that elders who have been rendered incontinent by a medical problem or disease often deny their incontinence and refuse, even in the face of evidence, to wear protection? They equate incontinence protection with diapers and diapers with babies. They feel humiliated.
Wouldn’t they feel more humiliated smelling of urine or feces, you ask? Logically, yes. However, I hear frequently from readers that their parents will not wear protection, or will only wear it when they go out of the house. Their home, their clothing - everything around them stinks. The adult children nag, rant and push their elder to wear protection. What’s the big deal? No one will know. But the parent resists or refuses.
The first thing I mention when adult children write in about this problem is that they take a look at how they present the issue to their parents. If they use the word diaper - and yes, some people do - they need a time out in the corner. The elder often interprets the use of the word as meaning that incontinence is a big step in the downward spiral that will turn him or her into a large, helpless baby. "Brief," or some related word is easier on the elder’s ego.
Help preserve dignity
I’m not implying that by changing your words you’ll magically make your elders agree to wear incontinence protection. However, I am saying that how we present some of the issues that need addressing can make a difference.
Incontinence protection, like using a cane and then a walker to keep from falling, takes an acceptance of loss of function. It takes an acceptance that life is passing by and that, with age, there will be more losses. So, frustrating as it is for adult children to see their parents stubbornly deny the need for incontinence protection, some compassion is in order.
Parents are parents. The idea that a child of theirs is telling them to do anything angers some elders. Yet, something needs to be done, right? So, often I suggest that the adult children notify their parent’s doctor and ask the doctor to make the point that it’s more dignified to use incontinence protection than to leak urine onto clothing and smell bad. If the doctor can’t help, then maybe a good friend of the parent can. Does Dad have a friend who became incontinent after cancer surgery? This friend may be able to casually bring up the subject and mention his own issues. Dad may listen and think that if "Herb" doesn’t mind it so much, maybe he can wear protection, too. The same is true, of course, for women, who have a higher risk of incontinence if they’ve been pregnant.
Depression can lurk behind stubbornness
Depression from suffering the losses associated with aging may be behind your elder’s stubbornness about using proper protection. One sign of depression is often a lack of hygiene. A visit to the doctor is in order if you suspect depression in your loved one. Once people feel better about themselves, taking care of their bodies generally becomes a natural process.
No matter what the reason is behind an elder’s refusal to wear incontinence protection, a third party is likely your best choice for intervention. Asking a doctor or trusted friend to intervene is more likely to work than your best efforts, because that takes out the parent/child dynamic. You won’t be seen as trying to "boss" the parent. The parent has a chance to save face by making the decision to wear protection him or herself.
Everyone wins if this works. Alas, I can’t guarantee any of your attempts will end with success. If your parent has dementia, he or she may just not understand what all the fuss is about, or even understand what is happening when he voids. Even professionals in nursing homes wrestle with this issue. At least you know you aren’t alone.
Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. She is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack is also a contributor to several books on caregiving and dementia, and is passionate about preserving the dignity of elders. Her website is www.mindingourelders.com. Follow Carol on Twitter @mindingourelder and on Facebook at Minding Our Elders.