stitching up the vagina.! ? ! ?

Chickenfeet, I browsed the web just briefly and was not coming up with any info regarding changes in Medicare coverage for pessaries. But I don't know anything about this and would have to do more research. The Athena seems to be "prescribed" for incontinence, so how that's supposed to take the place of a pessary to hold the organs in place is beyond me. It just further illustrates how little these doctors understand about prolapse. But keep checking around.

I cannot imagine trying to get my own very elderly mom to understand and follow the posture techniques......so I do feel for you. If you can just get her to keep some lumbar curvature on the toilet, but stay firmly on the seat, maybe it will help her somewhat to void without straining and you won't have the mess to deal with.

Stitching up the vagina.....does there become a point where an elderly woman without all her mental faculties will just do better with this kind of radical "solution"? I honestly don't know. But it is a disturbing thought. Might be worth a consult with Christine herself.

Chickenfeet, i hope you are practicing the posture. You haven't said if you have a prolapse or not. Most of us end up with some degree or another. Even if you aren't feeling it now, please make it a goal not to end up in your mother's situation with few options to deal with it. Make this change, for the sake of overall health and especially as it relates to the hip joints. - Surviving

The thing with dementia is that most of the time the short term memory is affected. When I worked in the nursing homes, I was in a very practiced routine of repeating my self over and over every day with my dementia residents, but they just went along with me as long as I explained what I was doing. They did not do the routine with me because they remembered anything from the last time they did it. Don't be frustrated with your mom; this is all part of dementia. You will just have to develop a routine with her that you are both comfortable with.
I have seen anuses sewn shut because of colostomy bags, but have only seen one vagina sewn closed, and that was when I was in hospice, not the nursing home, and the women was younger. I don't think doctors routinely sew a woman's vagina closed because of prolapse. At least, I hope not!
You may want to consider a V2 supporter or fembrace for your mother to keep things from slouching out.
I wish you and your mother well, and hope you can find a gentle solution for all this.

Unfortunately AG, I think that this procedure is indeed often recommended, especially for the frail elderly who are not sexually active. I have heard of it on many occasions, and Christine mentions it. Check out the links provided by Chickenfeet. - Surviving

I do remember Christine mentioning it. I just didn't realize it was gaining in popularity out there.
Having worked with the elderly I find it atrocious that we do any kind of invasive procedures on them, especially if they have dementia and aren't given a choice. Gentleness and routines is what they need more than anything.
Sorry, but this is a sensitive subject for me.

As you say AG, these would be a nice gentle alternative. But I have no experience with them. Would they be difficult for a frail elderly dementia patient to remove in time to avoid an accident? - Surviving

Guess I was thinking would be better than sticking a pessary in an elderly woman. I suppose they would be tighter than regular underwear. I wish someone more experienced with them would post.
The best bet that I would see doing, would be to put depends on her and have a regular toileting routine to help prevent accidents.

I guess I would like to know what are the possible side effects to having your vaginal walls sewn together. What studies have been done on this procedure: success rates versus failures, chances of infection, etc.
I am hearing your frustration about your mother's prolapse, but am wondering if it is bothering her as much as it is you. Not trying to be sassy here, but she is the one who would be going through this.
I just have to wonder if it would better to leave well enough alone, get her a good caregiver, and give her the best comfort you can.

I would ditto Aging gracefully. My 93 year old grandmother fell and broke her hip. While in the hospital we were told she had a prolapsed uterus and would we like them to remove it. She lived with my mother and her reply was, "absolutely not." She recovered from the broken hip and was able to walk. She came home enjoyed her life for the next few years. My mother hired a caretaker during the day when she was working. My Nana did just fine and died with all her feminine parts. My point is sometimes it is better to leave things alone.

Dealing with dementia is tough enough. I'm learning patience with it myself in my dearly beloved. If your Mom needs to pee in a squatting position this way in order to really empty her bladder, maybe she could do it better with a receptacle other than the toilet. It's hard to squat and hit the toilet with weak knees and bad aim! When I shower, I get on my hands and knees to completely empty my bladder. She may not be able to do this and get back up safely. So otherwise, if I'm having trouble with the need to empty, I use a wide-mouthed bowl (like a margarine cup or whipped topping cup) to catch the urine and then rinse it out and leave it behind the toilet (or in my case in another private room) to use again. I started doing this because we only have one bathroom in the house and sometimes I can't wait, but I've found it really helps because of the semi-squat I have to use to do it and it isn't messy if the bowl is wide enough and held close enough. It's such a relief that I void this way at night when I'm having trouble settling down to sleep with a constant urge to pee. This might be useful for completely emptying her bladder, but I don't know what you might do about her bowel movements. Sorry.

I'm also sorry you have to leave your mother and hope you can find a good caregiver for her. Let's hope there's someone who would appreciate a live-in situation, has some compassion, and is trustworthy.

I don.t think your mother would find the Fem Brace helpful to her as it is quite a fiddle to deal with on and off, that's what I found anyway.
If you look for Jade and Pearl web site you will find that they have some plastic funnels that are meant for helping woman to go pee in a standing position. Perhaps something like that would be helpful to your Mother.
Daphne.

Sounds to me like the easiest thing at this point is just to have her sit normally on the toilet. Was the squatting actually helping her have a bowel movement more easily? I'm guessing the whole thing was just too awkward and complicated for her. Try just having her lean forward with as much lumbar curvature as she is capable of. - Surviving

I for one would like to stay with this thread for a bit longer....you never answered my question from my first post up above. How's your posture? Did Paula check it? I love how your Mom made this mind-body connection, and if she can do it, anyone can. I hope for the sake of your own future health, that you have given this WW work some very serious thought for yourself. Let us know. - Surviving

Just make sure you do your research on the nursing homes. I have worked in some real hell holes, and then also some really fancy ones. Balancing cost and care is a big issue when taking this option with a loved one. The problem with most of them is their own profit, and being short staffed. The patient to Aid ratio is an important question to ask, because the smaller that ratio, the better care the person will receive. I could easily care for and pamper 6 to 7 people during my shift, but if it got to 10, 15, or even 20 at times, they just got the basics, and that always made me feel horrible.
Well, anyway, could go on and on. I have been thinking about you and your Mom, and really wish you the very best.

In my (humble) opinion, Chickenfeet, an elderly woman (who has dementia and therefore isn't capable of "learning" the posture) and whose uterus is in a good position and who has only a cystocele, does not need any kind of treatment at all. If you want, you can remind her to try and maintain lumbar curvature and not to strain on the toilet. Of course, if you are not the caretaker you won't be able to do this, but you will simply do what you can, when you can.

If she complains that she feels things are falling out, Aging Gracefully has written a great post on her recent experience with a V2 supporter. Unlike your mom, she has uterine prolapse, and faithfully practices the posture. She uses the support only occasionally, finds it to be easy on and off, not constrictive to the belly at all.......this might be a great solution for your mom.

This whole discussion has been so valuable as a reminder of why our future pelvic/hip health depends upon us retraining our bodies while we still have the maximum capacity to do so. - Surviving

Yes, the V2, is an easy on and off unabtrusive device to use if your mom says she is feeling saggy down there.
If she has trouble completely emptying her bladder, she will end up with UTis. I saw that quite a bit in the nursing homes. They would get quite a few rounds of antibiotics for that. And, if they were retaining too much urine, catheters were used very frequently to keep the bladder empty.
I guess my concern is her dementia. She may be at the beginning stages right now, but as it progresses, she will forget more. My own grandmother had dementia, and my dad lived with her, but he also had mental illness, so it really wasn't an ideal situation. It was a good thing they lived in a small community, because they would always find her wondering around. So, a good caretaker either way would be the best thing for her right now. We had people coming into the nursing home all the time where family didn't think they were bad enough yet, and they ended up burning themselves on the stove, or falling down breaking bones, and overall generally bad health, etc.
I am glad you are being very attentive to your mom. You seem like someone who wants the very best for her. As always wishing you both the best.

Thank you ladies for this valuable tip regarding the V2 supporter. I will put this in my spiral notebook where I make note of things I may need in the future, maybe someday when I won't remember the name or even how to use this iPad any more. My latest idea is to order Christine's book for my 2 daughters for CHRISTMAS. Something they can read on their own and gain the knowledge before they may have to take on the challenge themselves. I'm sure they think it won't happen to them just like I thought it wouldn't happen to me.They both do a lot of dangerous core training and my telling them not to suck and tuck just isn't sinking in.

That would be a wonderful gift for your daughters, whether they realize it right now or not. I was nervous when I told my daughter, because I wasn't lifting my grandchildren anymore. Making excuses about my bad back, but when I finally did, I was relieved, and she was actually very understanding about it all. I loaned her my book and she did read it.
I do hope that some day your daughters realize the importance of the work you are doing, and how it could affect them also.
I wish you and your daughters well, my friend!

For the elderly people I cared for, the first indication of a UTI, was extreme behavioral changes. People that were normally pleasant and quiet, would start to really act out. If you see enough of it, you recognize this right away.
I took care of women from the beginning stages of dementia all the way to Nth degree dementia, and not all of them were incontinent, and no, not all of them had catheters, but they did wear depends. We were actually taught to push down on the bladder to empty it completely. I would not suggest this for your mom. If they had too many UTIs, they would get catheters. And, if catheters were not taken care of properly, they could still end up with UTIs. Sorry, but this is the nursing home reality.
I know there are many women on the forum here that have good remedies for preventing UTIs, and getting your Mom's constipation under control will really help her a lot. She may have to continue to wear depends. A good toileting routine and cleanliness goes a long way in keeping the elderly comfortable.
As always wishing you both well.

Chickenfeet I think you need to get a few things straight. You did not cause your mother’s dementia. You did not cause her incontinence. If you want to blame anyone, blame your mother’s age.
Another thing. If your mother has dementia and incontinence, you cannot automatically assume that you will experience dementia or incontinence. It is always possible of course, you only need to look at the statistics on these things to see the possibility and there is an important contribution that genes have to make, but you must remind yourself no-one knows the future, what fate applies to one does not necessarily apply to another even if they share the same genes. If you want to take what has happened to your mother as warning for a possible scenario for your own future, please don’t rush into doing kegels and other rash decisions; instead give yourself time to think things through without panic.
Suddenly having to look after your mother is not an easy thing to take on. Many people find they cannot do it for any number of reasons. That you are seeking to do the best you can by your mother and the rest of your family means you have to make sometimes heartbreaking decisions. You are not to feel guilty or inadequate because you find you cannot live up to some high expectation that you have of yourself. Judgements are better made in the glare of reality and then maybe push yourself just a little bit more within the area of reasonableness.
You have demonstrated on this site that you are seeking out every possible angle from which to do the best you can by your mother. If I were you, I would be giving Graceful a barrage of questions. She has a wealth of experience in caring for old people and she has a wonderful empathy and love for them so that what she has to say is eminently trustworthy.

Chickenfeet, I have a very elderly mother myself, who does not have full-blown dementia but does have mobility issues. She wears Depends if we have to go out, just for a little added security. If accidents are an issue with your mom, I would suggest the same. Nothing else at this stage of her life is going to "cure" incontinence, and I'm not sure all of your running around looking for solutions is good for either you or her. Fab is right, please take Aging Gracefully's experience to heart. Watch for the UTI's but stop worrying so much over the accidents. There are good brands of diapers out there now, they're almost like underwear. - Surviving

A few ideas that might help your Mother feel relaxed and content in her own house, my mother passed a few years ago, she had dementia for a couple of years and she enjoyed holding a doll about the size of a real baby, she used to dress it, sing lullabies and make us keep quiet because the baby was sleeping, simple tasks like folding laundry, cutting cookies, organizing the cutlery while being in the kitchen when you are cooking, she loved hearing piano music, drawing, painting with her fingers, taking weeds out of the vegetable garden and she did a great job, she did not forget which were the weeds .... playing with big sponge puzzles and pictures of her own city puzzles, she did not enjoy watching TV at all, we played with her rolling a ball over the table and she did catch it and rolled back and laughed like a child if she caught it, she loved the rubber balls that light up when they bounce and will follow their lights with her eyes and show us where they were, she loved a cat that had batteries and purr if you stroke it also a dog that bark etc. she loved to be busy with her hands and enjoyed most of all when she was outside in the shade, the bright sun light did bother her eyes and sometimes the birds that were eating at the bird feeder or hummingbird feeder made her very happy and she will watch them for a long time and sometimes she did not pay attention to them. Her diet and routine were written down by the geriatric specialist and she had to drink many glasses of fresh watered fruit juice daily to keep her hydrated and with good digestion and she had to use diapers. If possible keep talking to her about her past and her interests and she will be more alert, some days she will not answer back or recognize anything or anybody. Gentle massage on their feet body or hands with a bit of butter made her relaxed and her skin soft. We took the bathtub off she was scared, she enjoyed showers sitting in a special stool, we installed safety bars in the bathroom and a ramp to go outside, if you have black tiles on the floor they make them scare, we took away all pieces of carpet because they can trip them, also telephone or appliance cords, do not forget to install a high up lock on the outside doors and alarm at night because she will open the doors and go out. I wish you and her many of those beautiful short moments of recognition when you are together that will be in your heart always. Thank you Aging Gracefully for all the love and tenderness that you have given in your life to many persons that were lucky to have you in their moments of need.....

That is just beautiful Solita! What an inspiration to those of us who have yet to enter this journey, either as carer or cared-for. Beautiful. Brought tears to my eyes.

Such a wonderful post, Solita. You are bringing back memories of very specific people that did some or all of these activities. I agree that people with dementia really need this more than anything else, and that it is presented in a patient and gentle manner.
While some were afraid or just didn't have the patience to care for them, they were my favorites to care for, because I know they didn't mean it if they acted out. And, it was so very rewarding to get them to smile and enjoy themselves.
It makes me so happy that there are people like you out there that took such an effort to make sure your mother was happy and well cared for, and that you shared all these wonderful very useful tips with everyone else.

Solita, your post is absolutely beautiful. I can just feel the total, gentle love between you and your mom. So lovely. Thanks for sharing.

Although the V2 can be taken on and off very quickly along with underwear, it would be an extra article of clothing to fuss with.
I really only find it helpful when I am increasing my activity on those really bulgy feeling low days. It just creates a feeling of security while out and about. Has your Mom complained of feeling really bulgy down there? And, is she really active?
I would only use it for that reason, not to wear it all the time.
I do hope your mother finds the comfort she needs and deserves. We were pretty practiced at whipping the elderly ladies with incontinence issues pants down very quickly in the nursing home, but that's just it: we did it, and even then sometimes it got messy. With her doing it by herself and doing it more slowly, I can see why she would get frustrated and discouraged.
I am getting a little confused about your statements about the dementia, I have seen people develop confused states from taking certain medications, and once those medications were changed or discontinued, they would go back to their original selves. So are you thinking she doesn't have dementia, after all? Was she diagnosed?
Either way, it is hard on the elderly when it comes to toileting and the embarrassment of accidents, so her getting the help and support she needs will make her more comfortable in the long run. Regular toileting routine and cleanliness.

It will be easier for your Mother to use washable warm or light material pants with elastic waist (and no panties) to pull down fast and sit on the toilet assisted by the safety bars and not hover over it until she can strengthen her legs with long daily walks.
I heard that a daily fruit juice prepared with a medium size raw beet will benefit the blood pressure but I do not have the science knowledge at this moment to back that statement for you, I think it is important to study it and help her naturally.
When the time comes to give her pills, ask the Geriatric Dr. if they can be ground in a mortar and pestle and mixed with a little juice, (some pills have to be given whole only) because they choke very easily and can become a very serious and scary situation.
I forgot to tell you that if you buy her a doll make baby clothes to dress and undress easy ( velcro) and buy one washable and with sleeping painted eyes not the mobile ones, their normal curiosity compels them to poke them.
Enjoy every minute that you are lucky to have with her!
She is your baby to love and protect as you were hers.
Solita

I agree that a support bar does help in assisting the elderly to steady themselves in the bathroom, but not all can hold on and pull their pants down fast enough without still causing an accident. Everyone has varying degrees of mobility, stiffness of joints, and the cognitive ability to accomplish these seemingly simple tasks. I can't really tell from what chickenfeet's written word exactly where her mother is in any of these categories.
That is why possibly an assessment and caregivers may be a viable choice for her, since chickenfeet lives in a completely different state.

Thank you for checking in, chickenfeet. It sounds like you have this all under control now and going in the right direction for your mom. Wishing you both the best as always.

Chickenfeet, I think that term generally refers to a very severe uterine prolapse. Sorry about all your recent problems. As it seems you are the one always going to the rescue, is it possible at this point to consider relocating your mom so she is closer to you? - Surviving

But Chickenfeet, doesn't it seem that perhaps that time has come? Elderly, frail and confused parents don't always get to have their preference of where they live or who cares for them. The time comes when we have to take matters into our own hands and do what is best for all concerned, including you. I've read your other post and I don't think it is going to be easy to find caregivers who can provide the kind of help your mom needs, and you are running yourself ragged in the meantime. - Surviving

Chickenfeet,
Your mom does need a regular routine wether that is with caregivers or not. Of course, if you are sending in a barrage of differerent caregivers, she isn't going to be too happy about it. Stick to a couple of really good ones, or it may be time for her to go to a home if her safety is a concern.
Most of the elderly people that first come into the nursing homes aren't happy about it. In fact, many are downright mad at their relatives for putting them there, but they acclimate and get used to the routines there.
You need to decide where that routine is going to be. She will continue to get more agitated with her dementia no matter where she is. That is why a calm environment is needed.
Wish you the best.

That is wonderful, chickenfeet! That certainly sounds like positive progress for your mom. Change is hard for all of us, especially when we are set in routines, but it can happen, and we can get used to new things. Good for your mom.

Hi chickenfeet,
I think we were all in agreement that trying to teach posture to a person with dementia wasn't working out so well, and you had said that the pessary worked for her previously. Continue monitoring her to make sure she doesn't get sore spots or infections, as this can happen with pessary use, would be a good idea.
Wish you and your mom the best!