Is incontinence a feature with PSP. After her recent fall my Lady is constantly passing urine

[BlairWit]

PSP incontinence

[Tibe]

Yes, unfortunately me too.

[Martina_MP]

Incontinence is associated, and very common as the disease develops, but the sudden onset and frequency is worth seeing a doctor for. Was she examined after the fall to make sure she didn't have a back injury? Is she having incontinence because she's injured/in pain or can't move as well and can't make it to the toilet in time? Or is it just uncontrolled all the time? Another thought is maybe she has a urinary infection that caused the fall and incontinence.

[BlairWit in reply to Martina_MP]

Thanks for your response and opportunity to share. She has had occasional minor incontinence issues for some years but since the fall, (30 days ago) which resulted in cracked pelvis, fractured wrist and hospital this has become a bigger issue. Attempts to use a catheter have not worked. I just didn't know whether or how big the PSP was a factor.

[Martina_MP]

Oh that was a serious fall! Once she recovers and is more mobile, there is a decent chance she will be better with the continence. One can hope! There are various products to make life easier. ‘Booster pads’ add extra absorbancy to diapers or pull-ups and you probably know about the disposable or washable bed pads to put on top of sheets and seats. I have found continence for my mom seems to go in phases. Sometimes better, sometimes worse. Now in fact retention is becoming more frequent.

[BlairWit in reply to Martina_MP]

Thanks for your response. You may be right. The physio thinks along the same lines.

[ConcernedEx]

Passing urine for females of a certain age is common but you say “constant” - I would see a doctor, could be one of many reasons (besides PSP for “constant”). To save your lady some embarrassment, you might wish to suggest bladder leakage pads or underwear specifically designed for leakage. You can tell her many ladies have this issue.

Hugs navigating this delicate topic.

[BlairWit in reply to ConcernedEx]

Thanks for your response. Attempts to insert a catheter resulted in pain and tears. Not too sure what to do or where to go. I understand there is a small surgical procedure to insert a tube which may offer relief??

[ConcernedEx in reply to BlairWit]

Oh I know what it feels like to watch a loved one suffer from insertion of a catheter issues.Maybe good old fashioned adult pull ups might be the answer???

Sending hugs always

[LuisRodicioRodicio]

Hi BlairWit!These are our experiences.

Hug and luck.

Luis

• UTI. Urinary Tract Infections

To identify a UTI, keep an eyeout for the following symptoms: A burning feeling when you urinate. A frequent or intense urge to urinate, even though little comes out when you do. Pain or pressure in your back or lower abdomen. Cloudy, dark, bloody, or strange-smelling urine. Feeling tired or shaky. Fever or chills (a sign the infection may have reached your kidneys). Consult a physician as soon as possible. Meanwhile this information can be useful:

1. UTIs are infections caused by bacteria in the bladder.

2. The cerebral cortex interprets messages as full or empty bladder. This becomes a nerve function and as the neurodegenerative disease gets worse so does the signaling and therefore bladder control. And aging is an issue as well.

3. For fast control of a possible UTI I use the "test strips" Combur-10-Test.

In a sterilized container the first morning urine is collected, neglecting the beginning and the end. One or two strips are inserted and compared with the references.

Notes.- Sometimes, in ages over 65 years, the case of a UTI can NOT have fever as a symptom but the patient manifests discomfort, restlessness and even disorientation. Therefore it is advisable to regularly monitor the smell and color of the urine, applying a Combur-10-test strip control at the slightest suspicion. It is critical that the infection does not reach the kidneys. In case of suspicion go to the physician as soon as possible. Testing for an “antiobiogram” is important to get the right antibiotic.

In this disease, episodes of restlessness have been described. The consequences can be slips and falls that can have serious consequences. Discarded UTI problems the symptoms of restlees may be due to a natural resistance of the patient to avoid being immobilized, losing his freedom and being dependent on other people to satisfy his needs. It may be time to consult with the physician and see if it is appropriate to prescribe a tranquilizer.

With a resistant or recurrent UTI infection:

1) An "antibiogram" is essential.

2) Apply the most appropriate antibiotic according with the antibiogram in sufficient doses and time to kill the bacteria effectively and safely.

3) If "double incontinent" (losses on urine and bowles) the problem is particularly difficult on women because without a quick and effective cleaning the contamination of the urinary tract is very easy.

4) In a case of rebellious UTIs it is advisable to consult a phisicyan who specializes in UTIs.

In our case we did not have Incontinence situations until the disease was well advanced.

"mb2roger" has had to manage incontinence in the early stages of the disease and communicates the following experience that I think is interesting:

"While wearing comfortable pull ups as a back up we obtained an improvement but these supports were helpful for a short time, and then my mom agreed to trial an in-dwelling catheter so she could sleep better through the night, with no limit to hydration after dinner which was beneficial. My mom continued with in-dwelling catheters for her remaining years. There are pros and cons with any treatment or strategy, and an in-dwelling silicone catheter was what afforded my mom a better rest. An in-dwelling catheter does require regular replacements (my mom's Homecare nurse, in Canada, changed her catheter monthly) and careful hygiene practices to avoid / minimize infections. My mom's GP sent a standing urinalysis order to a neighborhood lab so we could check for infection whenever we suspected this (symptoms can be atypical, like confusion and excessive fatigue versus pain and fever). "

I add that the use of "test strips" Combur-10-Test” can be interesting.

[BlairWit in reply to LuisRodicioRodicio]

Goodness, what an awesome response. Thank you. I am so much more aware of the problem(s) and some of the options. Kind regards,

[LuisRodicioRodicio]

Hi BlairWit!

I'm sorry PSP/CBD/ etc. has entered your family.

The suggestions of my "chat" colleagues are wise and based on their different experiences. In my case they have been very helpful.

These kind of diseases manifests theyself in a similar but different way in each patient. The participants in chats like this offer practices and solutions to learn from, and through the "trial and error" method, achieve a quality of life with interesting moments despite everything.

I am not a phisicyan.

During the 8,5 years in which we was living with PSP I have been collecting our own experiences, symptoms and solutions and that of other members of the chat to offer some notes as a suggestion to PSP/CBD patients and caregivers. The mentioned notes are made with good will and with the best technical criteria that I could contribute, thinking above all in the support of the caregivers

Wishing the best for you and your family and if the notes-document with our experiences and our informations are of your interest, do not hesitate to let me know to send it by the private mail of this chat.

Hug and luck.

Luis