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Home > Education > Causes in Adulthood > Dementia


Dementia and Incontinence Management


Alzheimer’s disease and other forms of dementia in the elderly can pose unique challenges.  Urinary and fecal incontinence in particular can create feelings of embarrassment and shame in the person affected.  It can also be a source of frustration and concern for caregivers. 


Common Causes of Incontinence in Persons with Dementia


Medical conditions like urinary tract, bladder, and kidney infections, diabetes, Parkinson’s disease, stroke, seizures, diarrhea, constipation, or arthritis may cause or exacerbate incontinence.  A person with dementia who has suddenly developed incontinence or experienced a change in their bladder or bowel habits should be seen by a doctor immediately to rule out serious medical conditions.   


Diuretics and certain medications can significantly impact incontinence issues.  Prescribed diuretics (a.k.a. “water pills”) to remove excess water from the body in the form of urine or drinks with caffeine, a natural diuretic, have been known to aggravate urinary incontinence.  Stool softeners can do the same for fecal incontinence.  Individuals being prescribed sleeping pills or sedatives can experience loss of bladder/bowel control or be unable to move quickly enough to reach the bathroom in time.    


Symptoms of dementia can contribute to functional incontinence.  Confusion and forgetfulness can leave a person with dementia unsure of where the bathroom is, how to remove their clothing, or how to use the toilet.  A confused individual with dementia may also mistake items like a wastepaper basket or chair for the toilet.  Poor depth perception or trouble finding a bathroom door or toilet that blends into the surroundings can also contribute to accidents.  People with expressive aphasia- brain damage common to dementia that leaves a person unable to communicate their thoughts coherently- may not be able to clearly communicate to a caregiver that they need to use the bathroom. 


Tips to Manage Incontinence in Persons with Dementia


-         First and foremost, a person suffering from dementia should never be made to feel embarrassed or ashamed for having an accident.  Help them maintain their sense of dignity by quickly assisting them without acting upset or drawing unnecessary attention. 

-         Use clothing and bedding that is easy to change and clean.  Incontinence products like briefs, pull-ups, and bed pads can assist with this. 

-         Keep pathways to the bathroom clear of obstacles and mark the bathroom door if the person is easily confused. 

-         Use devices that will enable the person to use the toilet as easily as possible.  Raised toilet seats, grab bars, nightlights, and bedside commodes can be purchased from local medical supply stores and may be covered under some insurance plans. 

-         Provide ample fluids throughout the day to avoid dehydration, but limit fluids closer to bedtime.

-         Talk to the person’s doctor about making adjustments to their diet or medication that could decrease the frequency of accidents. 

-         Observe when and how often the person typically uses the bathroom so you can prompt them to go before an accident occurs. 

-         Observe for signs that the person may need to use the toilet if they are unable to clearly communicate their needs. 

The following links may be useful in learning about incontinence in those who suffer from dementia.
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