In dementia would having a bladder proceedure make ones life easier in their elder years?

Submitted by chickenfeet on December 16, 2013 - 3:18pm
Body: 

Assuming that hygiene gets worse and the bowels get sluggish and incontinence becomes the norm, wouldn't it be perhaps a godsend to not have to deal with a prolapsed bladder in the elder years of someone that will probably be faced with dementia who is now 78 and absolutely gets depressed wearing any padding at all? (took out my moms pessary and the uterus is very small and flat so it appears that my Mom only has a bladder prolapse. Her retention of water for the urine test with the ultrasound was good. She eliminated mostly everything. BUt I am wondering if life will be soo much easier if she had some time of minimally non invasive procedure done to put the balder up higher only because having a prolapsed bladder puts her at greater odds for other uncomfortable fussy issues?
And are there any cutting edge proceedures that are promising and offering lots of relief for the individual with a prolapsed bladder when they get older?
My Mom bladder without the pessary looks like 1/2- 3/4 of a ping pong ball sticking out of her vagina.

Forum:

fab

December 16, 2013 - 4:57pm

I am not familiar with modern bladder prolapse operations, but would like to talk about having an operation from an elderly woman's point of view. If she is to go under a complete anesthetic, I would be worried about how it would affect her mind. My mother-in-law (who had mild dementia) was anesthetized in her early 80s and came out giggling and not really knowing who or where she was. The strange hospital surrounds also did not help. My mother was to have a minor procedure and she did not suffer dementia but her short term memory had been affected by some episodes of pulmonary edema. So really the doctor was loathe to cut from the point of view the patient may forget to hold still, or what in that moment was happening which could of course accelerate things to trauma. These are only a few experiences of my own, but perhaps worthy of some thought.
My limited experience of independent living/hostels/nursing homes etc as a visitor led me to believe that incontinence was a very wide spread condition amongst the elderly which was mostly handled by gentle reminders and when on their own or on an outing by padding. I think if people around them are relaxed about this, then it becomes the norm rather than an emotionally charged novelty. Incontinence is not only caused by prolapse of course and the prolapsed bladder has its own characteristics, but a good regular lubrication and a watch on the person's diet are effective comfort creators.

Surviving60

December 16, 2013 - 6:51pm

Chickenfeet, this is the 3rd surgical procedure that you have come onto the forum to ask about. First it was hyst and then you asked us about having her vagina sewn shut. Now it's a bladder repair and if you have been reading on this forum as much as I think you have, you know perfectly well that there are no new "cutting edge procedures" and there is no surgical solution for cystocele. I can understand that your mom isn't able to do the postural work. I haven't been able to figure out why it wouldn't be enough to provide her with nice easy comfy clothing, some protective underwear, something to apply to the bulge if it gets irritated (a touch of diaper rash cream works great for me) and simply not fuss any more than that, or stand for any fussing on her part. I recall that you don't live near her and perhaps you are still hoping for a "quick fix" for this situation. There isn't one, but a cystocele isn't the end of the world and may not justify all this hand-wringing. I'm sorry to be so blunt but we've posted lots of suggestions and I think we are fresh out of them at this point. - Surviving

Surviving60

December 17, 2013 - 12:24pm

I am feeling like I was a little too blunt in my reply above, and I'm sorry. But I do see that you are still in search of a medical solution to your mom's cystocele. I understand it is a quality of life issue and perhaps you are looking for someone to tell you that surgery at her stage of life is an OK choice. But I don't think anyone on this forum, other than Christine herself, can make an educated guess in that regard. Maybe a consult with her would give you a better idea of the issues, and perhaps she can help you decide if a repair is more feasible at her stage of life. No one on this forum would even suggest that 78 is too old to manage prolapse naturally. Many of us ARE that age or older. But your mom is your mom. Consult with Christine. - Surviving

chickenfeet

December 17, 2013 - 11:23am

I don't mean to fuss. I have not been reading on the forums. I'm setting up other stuff trying to make like an ALF in my parents house and create a schedule so my moms needs are met by the male caregivers because my Mom got upset when I had her meet the woman caregiver. (go figure) Juggling my disabled uncles care. It is just that I am far away now and my bro does not see the urgency the way I do in getting a female caregiver. This is all new. Getting things right or the creature comforts in place.
There are just small parts of this management of bladder in the future that I hope to clarify for my own understanding to know what to expect. I got a lot of great information from all the women that replied to me on what the future is going to be like. But forgive me for this but one area of my understanding isn't clear yet and that is the part about if the prolapse bladder can come further down and have a worse situation and have her experience more discomfort. HOw worse can the bulge get in the next 20 years and can she get UTI's from not being able to eliminate completely or more so from getting dehydrated? So that can be life threatening anyway. My fear is compounded by my aunts telling me that I should have done something for my mother when she could have survived a procedure of some kind. I meant surgeries that won't be as invasive...(if there is such a thing) I appreciate your bluntness. My aunt had a hysterectomy and totally fine and so did my mother in law so i look like a daughter that wasn't looking out for my mom and directing her to get a hyst 20 years ago when she was vivacious. (yes i know that hysterectomies have bad outcomes and my Moms cystocele prolapse came in her 50's.

chickenfeet

December 17, 2013 - 11:31am

THank you for the emotional mental input for helping me see this angle. She is so proud and hates herself for wasting even the pads. The frugality is so that spending the money on pads makes her feel ill. So i have washcloths i tell her to wear and throw into a bucket. Then she blurts out if there is an operation she can have where before she was not interested in one in 2008 if she could avoid it although was letting me decide for her. My concern was if the prolapse drops even further so i am going to contact Cristine.

Aging gracefully

December 17, 2013 - 11:38am

Peer pressure from relatives is not a good reason to have a procedure done on your loved one. Of course you are going to have differing opinions, but it always comes back to the same place for me: good care. I did care for a woman in the nursing home that had a bulging cystocele. We made sure she was toileted, kept clean, and we lubricated the bulge. She did have dementia also, and she was very happy in her environment.
I can't say enough about what gentle care without rushing in on them means. The outcome is so very rewarding, because they are comfortable and content. I believe more than anything she needs that kind of environment no matter where it is. Have you considered that maybe her current environment might not be the best for her?

Aging gracefully

December 17, 2013 - 11:40am

Agree with surviving. Christine may have the answers.

Christine

December 17, 2013 - 7:30pm

The best answers have already been provided by Surviving, Fab and AG. If ever there were a population to fight for in preventing painful, damaging and unnecessary surgery, it is the elderly. There is no surgical cure for prolapse that does not come without great risk. The aunt and mother-in-law may be fine, or they may be choosing to suffer in silence, it is impossible to know. What is known is that many post-hysterectomy, post-incontinence procedures women become extremely debilitated and bedridden because they no longer have any semblance of the natural dynamics of pelvic organ support or continence.

It was all said so beautifully. Help her bathe and dress in comfortable cotton clothing, humor her and love her and let her be OK just the way she is. The bulge is not going to get much worse.

Christine

chickenfeet

March 13, 2014 - 2:14pm

Ok, I get that....but as far as maintenance.....let's say incontinence can be managed better with a pessary right now....since she has procidencia and making sure she is lubricated daily is not in my control at the moment......and the caregiver thing is not right yet..(I am flying up tomorrow)...my mom is luckily still behaving with some independent ideas,,,,,that is good for somethings, but as far as reminding her to moisten her vagina that turned out......I can phone call her each night long distance......But sometimes she doesn't answer. She is too awkward to have someone there right up until she goes to sleep...
I am wondering if the pulling down of the vagina and bladder will aslo pull down the rectum? IN that case perhaps the pessary might prevent that? Is my imagery accurate or remotely so?...PS my moms mood is good.. I do not allow my need for details and clarity to interfere with her peacefulness...Just so that you know. BUt her vagina was bleeding so she wasn't saying anything and washing her panties without telling anyone she was spotting...so the caregivers were always giving me a good report..