Incontinence and Alzheimers

What Is Incontinence

Many people with dementia have loss of bladder or bowel control (Urinary or Fecal incontinence).
This may happen all or most of the time, or may just be a case of occasional leakage.

Urinary incontinence is far more common than Fecal. Both types may be treatable, so it is always important to consult the doctor.

It can be humiliating for a person with Alzheimers or other forms of dementia and upsetting for those around them.
The first steps to dealing with it are to get properly informed about the problem and to find out what help and support is available.

Causes

If a person with Alzheimer’s has recently started to lose control of his or her bladder and bowels, the first and most important step is to determine the possible causes.

Incontinence is not an inevitable symptom of dementia, but there are a number of reasons why someone with dementia could become suffering.

Medical Causes Include:

Urinary tract infections − These usually respond to treatment with medication.
Prostate gland trouble − This affects men, and may be resolved with an operation.
Side-effects of medication − The GP can address this by changing the person's prescription or altering the dose.
Severe constipation − Constipation can put pressure on the bladder, and can also lead to faecal incontinence. Eating foods that are high in fibre, drinking plenty of fluids and keeping physically active can help prevent this.
Physical disabilities that prevent the person from reaching the bathroom in time.
Medications and Diuretics
- Sleeping pills and anxiety-reducing drugs may relax the bladder muscles.
- Drinks such as cola, coffee and tea can act as diuretics; a diuretic increases urination.

Non-Medical Causes May Include:

forgetting to go to the toilet
not recognising the need to go to the toilet, because of the damage caused by dementia
forgetting where the toilet is.

General Advice

Help the person retain a sense of dignity. Reassure the person to reduce feelings of embarrassment.
Say, “Something spilled on you” instead of saying, “You wet yourself.” Be matter-of-fact; don’t scold or make the person feel guilty.

Ideas To Reduce Accidents

When someone has problems with incontinence, the first thing to check is whether they are able to get to the toilet without any problems. They may want to use the toilet but be unable to use it, or even to find it. The following ideas may help:

Make sure the person knows where the toilet is. A sign on the door may help. A visual reminder, such as a picture, may be more effective than words.
Clear the path to the bathroom by removing furniture or clutter; make sure the path is well-lit. Make sure that the door isn’t hard to open.
Leave the toilet door open when not in use to show when the toilet is vacant.
Make sure the toilet is easy to use. Maybe aids such as handrails might be helpful.
Consider changing the color of the toilet seat. A black seat and a white pan can make it easier to see. People with dementia may experience orientation difficulties if the bathroom facilities are all the same color.
Provide clothes that are easy to remove and unfastened. Some people find Velcro fastenings easier to use than zips or buttons.
When away from home, be sure to take an extra set of clothes in case of an accident.
Remind the person to go to the toilet, or take them there, at regular intervals.
Be aware of signs that the person wants to go to the toilet. These may include fidgeting, getting up and down, or pulling at their clothes.
If the person is incontinent at night, encourage them to avoid drinks for two or three hours before going to bed. However, make sure that they drink plenty of fluids during the day.

Ensuring Good Personal Hygiene

Incontinence can lead to skin irritation. After someone has had an accident it is important to act quickly, to make sure they feel comfortable again and to ensure good hygiene.

If someone has become wet or soiled, help them to wash afterwards with mild soap and warm water, and dry them carefully before putting on fresh pads and clothes.
Wash dirty clothes or bedding immediately, or put them in an airtight container until they are washed.
Put used diapers in an appropriate container.
Use moist toilet tissues for minor accidents.

Back to the previous page:

From Incontinence and Alzheimers back to Alzheimers Diagnosis