Dealing with Incontinence

Did You Know

To help with incontinence in early to middle stages of dementia, a timer can serve as a reminder to your loved one to go to the bathroom. Set the timer to go off every 2-3 hours and leave a note on it explaining what your loved one is supposed to do when it rings.

Caregiver Story

I remember the first time Dad had an "accident" while he was with us. We had no change of clothing, no adult briefs, no wipes, nothing! And I don't know who was more embarrassed, him or us. Now we plan ahead when we go on a trip, taking regular, intentional bathroom breaks before there's a crisis and being prepared with supplies in case their needed.

Incontinence is a term used to describe loss of bladder or bowel control. People with incontinence may not be able to tell when they need to use the bathroom or may not be able to control urination or bowel movements.

Aside from issues with using the bathroom, individuals with dementia may also have problems with incontinence, especially in later disease stages. Furthermore, though they may feel ashamed or embarrassed when they have an accident, they may not understand what they should do next (i.e. finding clean pants, cleaning themselves, etc.). They may not even realize that they have wet or soiled themselves, which can lead to skin problems or infections. There is no effective medical treatment for incontinence, but health professionals have some good suggestions for dealing with it.

Suggestions for Caregivers

Identifying a Pattern and Planning Ahead

Caregivers can try keeping a record of accidents and daily trips to the toilet to see if there are patterns to when their loved one has accidents. Additionally, it can be helpful to note the following information:

  • Do they have accidents while they are trying to get to the bathroom?
  • Do they forget to even go to the bathroom?
  • Do they need to urinate first thing in the morning?
  • How often do they make bowel movements?
  • Do they have accidents when they laugh or get excited?

Identifying a pattern can help caregivers plan a schedule for bathroom trips. Setting up regular times during the day when they can go to the bathroom can help prevent potential accidents. Caregivers have found that it is usually easier to encourage good toilet behavior by praising loved ones after successful trips to the bathroom. If scheduling is still a problem, using adult diapers can help keep the problem of incontinence under control and help them avoid the embarrassment and other issues that can result from incontinence.

Taking Cues From Your Loved One

However you decide to arrange trips to the toilet, be sure to remain aware of the gestures and words that your loved one might make when they need to go to the bathroom. Even if someone with dementia may not speak up when they want to go to the bathroom, there may be body language that can let you know this, such as fidgeting, pulling at their clothes, or touching their genitals. If your loved one does let you know when they need to go to the bathroom, be sure to use their language for it – if they talk about needing to “do some business” or “go pee”, then use this language as well with them.

Incontinence in Late Stages of Dementia

Eventually, your loved one may not be able to use the toilet and you will need to use adult briefs and bed pads.

Resources
Source: 
Alzheimer's Association
Description: 
This printable fact sheet examines some of the causes for incontinence and provides tips for dealing with this problem.
Source: 
Alzheimer's Association
Description: 
This web page offers information on why many people with dementia have bladder and/or bowel incontinence, and emphasizes the importance of determining possible causes of the incontinence. It also gives tips on how to deal with incontinence, such as reminders to use the bathroom, insuring easy access to toilets, monitoring incontinence, and tips for toileting.
Source: 
National Institutes of Health
Description: 
This article discusses the different types of catheters available to help address urinary incontinence in older people.
Source: 
Caregiver.com
Description: 
This article discusses treatments available for women with incontinence problems.
Source: 
Alzheimer's Association (United Kingdom)
Description: 
This factsheet discusses the two types of incontinence, how it affects people with dementia, how the carer can help, reasons for incontinence, practical considerations, and how to help prevent incontinence and treat its effects.
Source: 
Mayo Clinic
Description: 
This web page describes the different types incontinence and their causes and treatments.
Source: 
ElderCare Online
Description: 
This webpage provides a printable list of things that may cause problems with toileting and incontinence, and gives skill building tips and techniques on how to handle urinary incontinence, constipation, and bowel incontinence.
Source: 
ElderCare Online
Description: 
This web page, written by a caregiver, gives tips on using protective products when dealing with incontinence. The writer describes the use of diapers as a useful means of dealing with incontinence, and emphasizes that they are not an indignity to the wearer.