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  • Miriam Green

Incontinence


Passover is a little more than two weeks away, and I am overwhelmingly sad about Mom’s inability to participate in the Seder. I’m thinking of suggesting she stay home this year with her caregiver. What with many guests, a late dinner, and an even later bedtime, I’m not sure she’ll be able to navigate the social and religious challenges this evening brings. I will miss her haunting rendition of Ha Lachma Anya, the Aramaic declaration that begins the maggid or narrative section of the Haggadah.

It pains me to even think these words, but I know that we will have a more relaxing experience without her. Lately, I’ve been laden with a sad heaviness that seems to sit on my shoulders wherever I am, whatever I do. I don’t want to feel this way. Perhaps it is inevitable with the conflict of caring for Mom as her abilities to function decrease and yet wanting to be able to participate fully in other things in my life. My focus is split. Even my kids sense my sadness with deep concern.

One of the new issues we’re dealing with now is incontinence. Incontinence is defined as: “lack of voluntary control over urination or defecation.” Such polite words to explain a most embarrassing problem.

While trying to avoid particularly intimate details of our dealings with Mom, I must say that it is humbling and eye-opening to now explore the world of absorbent undergarments.

Mom has had several “incidents,” and even when she gets to a bathroom on time, she does not always remember what to do there.

What a maze of prices and products! There are so many options, companies, and websites that sell these items. Several companies posted helpful articles on the range of products they offer, and I was grateful to learn the differences between them. There are issues about how these products close and open, how much they absorb, the materials they’re made of (i.e., crinkly plastic or a noiseless cloth covering), and the sizes that they come in.

I want something that will give Mom the feeling that she’s still wearing “regular” underwear that will continue to allow her independence in using the facilities. It is cruelly ironic to have to seek solutions like this for a parent who once sought such solutions for me as a child. As a child grows, so does an older individual decline.

Mom isn’t at a stage yet where she needs adult diapers. She still demands privacy when she is on the toilet, something I am thankful for because it shows her independence. And yet, she is basically incapable of taking care of her own needs. She is far from compliant in these issues, and we are all weary of forcing her to be intimately cleaned by someone else. So for now, we’re going to try protective undergarments. I hope that she won’t realize there’s a difference between these new underwear and what she’s been using until now.

Alzheimer’s brings on incontinence. It might be medications or the dreaded but common UTI (Urinary Tract Infection) that once racked Mom’s body with pain and sent her on a spiraling descent into delirium. Or, it might just be that the mind doesn’t recognize the body’s signs any more. Add to this Mom’s inability to “find” the bathroom on time, or even recognize what a toilet is, and we’ve got a recipe for disaster.

An article in the American Journal of Alzheimer’s Disease and Other Dementias examined ways to cue the residents of two care facilities who were in various stages of Alzheimer’s, with words like “toilet” vs “restroom,” arrows on the floor, and graphics of toilets on the outside of bathroom doors. They discovered that “a series of arrows on the floor with the nomenclature ‘toilet’” produced the best results.*

We can do those things, too. The bathroom doors in her house already display the word TOILET on them. We’ve taken to leaving the door open and the light on so she can see it every time she walks by. It won’t prevent all accidents, but it might jog her mind into action before they occur.

We are in such a different place than we were this time last year. Can I bring to this holiday the anticipated joy of celebrating together with my family? This year’s Passover to do list:

  • Clear my mind of leavened thoughts;

  • Let God into my heart to lead me in all ways;

  • Find my way out of this narrow place to one filled with love and light;

  • Give Mom all the love I have for her so that she’ll flourish, even in her limited state;

  • Don’t fret too much over cleaning; and

  • Enjoy the now. It won’t last much longer.

And there is light! Last night, my youngest son, who is home for Passover vacation from his yeshiva, played a private concert for Mom and Daddy on his guitar. They sang and clapped along, and it was joyous. It restored my love and faith for two of the most important people in my life. It gave me back a sense that Mom was present and accounted for. I have to carry those thoughts with me into the holiday.

I’ll be taking off the next two weeks to focus on the holiday. Wishing all who celebrate this Passover, a truly memorable experience.

Yes, I’m slowly getting ready for Passover, dusting out the chametz, or leavened foods, and making way for matza. As so many recipes that I use during the year can be adapted for Passover, I thought I’d try something that was wholly associated with the holiday. The first thing I make when my kitchen is ready are matza rolls. And then the wild rumpus starts! Here’s a recipe for matza borekas, an annual favorite among my kids.

Matza Borekas

Borekas are baked-filled pastries stuffed with all manner of ingredients. The dough is flaky and soft with a crisp top layer. I miss these during Passover. But there is a solution. Here’s a Passover version that creates crisp, pocket matza pastries worthy of their name.

6 matzas

5 large potatoes, peeled and cubed

Water for boiling

1 Tbsp olive oil

2 onions, sliced

3-4 cloves garlic

1 tsp paprika

Salt and pepper to taste

Olive oil for brushing

Directions:

  1. Place potatoes and whole garlic in a small pan and cover with water. Let boil then reduce to simmer until potatoes are tender and can be poked easily with a knife. Set aside to cool.

  2. Take each matza and run it under water in the sink. Place on flat surface. Wet paper towels and lay one on top of each matza for up to 10 minutes. Remove paper towel. Matza should now be soft enough to bend without breaking.

  3. Sauté onions in oil until golden brown.

  4. Mash potatoes and add in onions and spices.

  5. Cut wet matzas into halves. Place a heaping spoonful of potato mixture in the middle and fold in half, forming a triangle, and pressing the edges together. (For smaller “borekas,” cut matzot into fourths.)

  6. On a large baking tray, brush top of each triangle matza with oil.

  7. Bake at 400° for 20 minutes until tops of matza are browned.

  8. Add a spicy mayonnaise for flavor with 2 Tbsp mayo and 2 Tbsp sweet & sour sauce.

This recipe is based on Jenny Kdoshim and Debbie Bevans, Matza 101: An Innovative Cookbook Containing 101 Creative Recipes Simply Made with Matza!, CA, Alef Judaica, 1997

*http://journals.sagepub.com/doi/abs/10.1177/153331759100600605

Kevan H. Namazi, PhD, Beth DiNatale Johnson, MA, “Physical Environmental Cues to Reduce the Problems of Incontinence in Alzheimer’s Disease Units,” November 1, 1991,

#incontinence #Passover #matza #matzaborekas #adultdiapers

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