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
Common Causes of Incontinence in Persons with Dementia
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
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.