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Developing incontinence close to hospital discharge - Carers UK Forum

Developing incontinence close to hospital discharge

For issues related to specific conditions and disabilities.
My mother is starting to develop incontinence in hospital. She is on strong IV antibiotics (for her pneumonia) and diarrhoea is a side effect of this. I assume she will still be on antibiotics should she be discharged, i.e. tablets (this has been indicated). I would like to know how others deal with incontinence, i.e is it manageable, how, equipment etc.

I understand that the incontinence pads are free via NHS but that there is a wait... Will I be reimbursed if I have to buy the pads myself in the meantime? Are there special sheets? I know about the bed pads. Extra help care with this would seem not to be practical, i.e. who can predict when she will soil her pads?

I am not sure I will be able to cope with this on her hospital discharge so I need to better understand what I am up against from others here. She is experiencing difficulty getting out of bed (due to pain from pneumonia). Is it a one person job to change the pad? She seems quite heavy to me, i.e. I can't lift her off the floor easily (when I had to - have since discovered paramedics will help with that). Perhaps this is for the hospital to assess so apologies if it doesn't lend itself to an answer here.

This is very worrying to me since, prior to her fall (whereby she contracted pneumonia), her excruciating gout was misdiagnosed and prescribed antibiotics for it (had to take the whole damn course). This led to uncontrollable, sudden bouts of diarrhoea which caused me so much stress to clear up, i.e. the carpet and her continuously soiled nighties. She now has a commode in her bedroom.

Any knowledge on this matter would be beneficial to me. She is not due to be discharged for about a week or so (if at all...she is very poorly). I know my rights re. hospital discharge so now I need to assess if I can manage the incontinence condition.
You may not have to manage her incontinence at all. I would first check with her medical team and clarify the cause of the incontinence and whether it can be treated ie Imodium.

Secondly, your mum should be assessed for social care needs prior to discharge, the first six weeks of home care is free if I recall correctly. Obviously incontinence cannot be 'planned for', but you will have a rough idea of the number of times incontinence happens over 24 hours and I would be pushing for the maximum amount of support. This is particularly important if mum has poor mobility from hospitalisation and fighting off infection and she will need help with personal care anyway. If incontinence is an issue, you will be busy enough with extra washing etc so I would be pushing for cleaning calls, meal preparation etc basically any support to manage normal household chores if you will be tied up managing incontinence.

If incontinence persists, contact your mum's GP to arrange a continence clinic referral.
Hope this is of some help.
Having considered this further I would be concerned about the effects diarrhoea would be having in terms of hydration, particularly if it's occurring frequently. Perhaps your mum would be better off remaining in hospital until the diarrhoea has resolved?
People are supposed to be "fit for discharge". If mum didn't have these problems when she went in, then my gut feeling is that they shouldn't send her home until she is properly well again, i.e. continent. It's not fair on you, or mum to discharge her like this. Ask to see the doctor in charge of her care and talk it through.
Thanks frito for your helpful posts and bowling bun on your concern re. mum being discharged. The 'should' and the 'what does' happen seem to not be aligned when it comes to hospital discharge. I recall how much drama I had to rouse up to stop mum being prematurely discharged, after her 2nd stroke, when the care procedure was not yet in place.

Frito - what are cleaning calls?

As mentioned, it's the antibiotics (used to treat the infection caused by pneumonia) that causes incontinence and will be having to continue this (albeit in tablet form, i.e. not IV) on her release it seems. I will do all I can to ensure they adhere to hospital discharge procedure...not looking forward to that battle again.
Amy ,
You make sure everything is in place , before mom is discharged ,my Dad was discharged recently & everything was sorted i was told , so not true , he is now incontinent & was at the time of discharge , i was misled , please dont fall for it like i did ,Since he has been home i have been told our incontinence nurse is on long term sick & the waiting list is a very long one .Hope you handle it better than i did , Juneo
Oh dear Juneo that sounds dire. I will certainly heed what you say and verify any thing the staff tell me. Thanks for your post.
Hi Amy,
My sister has cleaning calls where staff clean the bathroom and her bedroom. I also had the agency update her care plan to include laundry (can't get many extras added as she's at maximum of care budget already). These extras help, as I would be doing it otherwise and I have enough to do already!
As your mum's incontinence is a side-effect of the antibiotic, I would consider whether:-
I) given her age and frailty, is discharge home (with incontinence) safe given the need to maintain adequate hydration?
II) can the incontinence be resolved with medication?
III) if incontinence cannot be safely treated, what care package will be made available to your mum to manage her personal care and what will be made available to you to manage general household tasks plus increased workload from incontinence?
Yes Frito...we will be asking these questions when discussing the care plan. The dehydration issue is the least of this incontinence problem...i.e. just a question of more fluid uptake?
Hopefully your mum drinks well, dehydration is a big issue for the elderly and should be avoided.