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Helping Persons with Dementia with Incontinence

Last Updated: August 30, 2018

Incontinence, which is common in the mid to late stages of dementia, including Alzheimer’s disease, is a term used to describe loss of bladder or bowel control. People with incontinence may not be aware of when they need to use the bathroom or they may not be able to control urination or bowel movements. 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.

 

Causes of Incontinence

There are many potential causes of incontinence. These include certain medications (sleeping pills is one example), clothing that is not easily removable, stress, constipation, not remembering the location of the bathroom, physical ailments, and not being aware of the necessity to use the bathroom.

It is highly encouraged that persons with dementia who only recently have been unable to control their bladder and / or bowels see their physician. The cause of incontinence could be medically related, such as a urinary tract infection, muscle control issues in Parkinson’s disease (Parkinson’s disease can lead to Parkinson’s disease dementia), or a physical disability that prevents the individual from making it to the bathroom quickly enough.

 

Suggestions for Caregivers

There is no effective medical treatment for incontinence, but health professionals have some good suggestions for dealing with it.

Identify a Pattern and Plan Ahead

Caregivers should keep a record of accidents and daily trips to the toilet to determine if there are patterns as 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 loved ones can go to the bathroom can help prevent potential accidents. Caregivers have found that it is usually easiest to encourage good toilet behavior by praising loved ones after successful trips to the bathroom. If scheduling is still a problem, using adult diapers (learn more below) can help keep the problem of incontinence under control and help prevent embarrassment and other issues that may result from incontinence.

Take 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 he / she needs to go to the bathroom. Even if persons with dementia do not speak up when they want to go to the bathroom, there may be body language that indicates they need to go. Examples include 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 when speaking to them.

Set Reminders

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.

Other Tips

  • Offer reassurance, rather than scold, your loved one if he / she has an accident in order to prevent embarrassment and shame. For instance, you might say, “It’s okay. It can happen to anyone”.
  • Give your loved one as much privacy as possible when using the bathroom.
  • While you might think withholding liquids from your loved one can help to prevent incontinence, do not do so. Withholding fluids can lead to dehydration, agitation, and greater incontinence. However, limiting fluids prior to bedtime can be helpful.
  • Make the bathroom easy to find. For example, leave the door to the bathroom open and put colorful rugs on the bathroom floor to draw attention to the room.
  • Put a bedside commode in the bedroom of the person with dementia, making it easier for him / her to use the toilet during the night.

 

Adult Briefs, Bed Pads & Absorbent Products

Eventually, your loved one may not be able to use the toilet and adult incontinence products, such as adult briefs and bed pads, will be necessary. Adult briefs (also referred to as adult diapers) have tabs on the sides, making them easy to use, and some can hold as much as 25 fluid ounces. Therefore, the chances of them leaking is very minimal. Adult pull-ups are another option, and as their name suggests, persons pull them on like they do underwear. Disposable bed pads, which absorb liquid, are another great option for persons suffering from incontinence, and can be used either on top or underneath mattress protectors. There are also waterproof chair pads, both for wheelchairs and regular chairs, which are washable and reusable.