Alzheimer`s Disease/in dwelling catheter


Dad is 95 in late stage of dementia, with hallucinations, very bad sundowning (doesn't sleep at all many nights) with agitation and some aggression. Due to an enlarged prostrate he has had an indwelling catheter fro 3 1/2 years. with a leg bag. he is also bowel incontinent. Surgery is not an option the general anesthetic will probably kill him. he has never had surgery, takes so little medicine that even the liquid clones (rivotril) they give babies did not metabolize and only slowed him down that now he needs to learn to walk again. We need help with the sundowning and shouting but the most pressing is that within the last 24 hours, he removes the urine collection bag, sometimes I find it thrown on the other sid of the room. Obviously this makes a mess, but what concerns me more is the damage done to the uretha when he pulls so hard. So far no bleeding. he also has a nasty fungal infection that recurs on his scrotum, treated with anti fungal cream. this since he slowed down the walking. We discontinued the clones/rivotril 10 days ago. thank you and god bless

Hello Bayle:  I'm very sorry to hear of your father's decline and discomfort.  I'm sure it's extremely frustrating and upsetting for everyone involved.
I am not familiar with Rivotril, but when I looked it up, it appears to be a type of benzodiazepine (clonazepam) or anti-anxiety medication.  The term "clones" I believe refers to the fact that this is the generic version of the medication--again, I'm sorry, but I'm not familiar with that term.  I'm sure this medication was prescribed for him because of his inability to sleep, his agitation and aggression.  My guess is that once you discontinued that medication, his agitation or discomfort increased and that is why he's been pulling on the catheter.  You must speak with his doctor about an alternative medication that may take the edge off his agitation again and he may then stop pulling on the bag or catheter.  Ask for a liquid medication that can be absorbed much more easily than a pill--or possibly even a patch.  I would also strongly suggest you engage a hospice agency to help ease his way to the end of his life.   They would also be invaluable to the family for support.  The fungal infection will continue to be a problem as long as he's not getting moved around much and the area stays damp and moist.  There are some preparations that are better than others for that and again, the hospice agency or the doctor would know them.  It's highly unlikely he will ever walk again since he's already in the later stages of the dementia and he's likely forgotten how to walk by now.  He should, however, continue to be stimulated by position changes, music, animal or children therapy, massage of hands and feet, being exposed to different sights, sounds and smells.  Know what helps to calm him and use that when he starts to become agitated.  The fungal infection alone could account for a lot of his agitation since he can't do anything about it and it's uncomfortable.  The only way he has to show his discomfort is to act out.  I wish you much luck Bayle as you and your family continue to move with your father on this road through dementia.  Cindy

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner


As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.


I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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