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Incontinence

How to manage incontinence in a person with dementia

Incontinence can be common in a person with dementia, especially as the person’s condition progresses. An involuntary leakage of urine (urinary incontinence), faeces (faecal incontinence) or both (double incontinence) can develop for several reasons:

  • A physical condition such as a urinary tract infection (UTI).

  • Side effects from medication.

  • The person not getting to the toilet in time due to a mobility issue, or not realising straight away that they need to use the loo.

  • Forgetting how to find the toilet.

  • Forgetting how to use the toilet.

  • Struggling with clothing, such as trouser buttons or zips.

  • The person being unaware that they need the toilet, due to poor communication between the brain and the bladder.

  • An overactive bladder – this can be common in a person with dementia.

  • Prostate gland problems – this can occur in men.

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Ways to manage incontinence

  • Speak to the person’s GP to rule out any medical issues. A UTI can be treated with antibiotics, or if the problem has been caused by certain medication, the person’s prescription might be changed.

  • Looking at the person’s diet – if the GP rules out medication being the cause of incontinence, you may need to look at the person’s diet and make some changes. If the problem persists, ask the person’s GP if they can see a continence adviser.

  • Choose simple clothing. Buttons or zips can become difficult to use over time. Use elasticated trousers, like jogging bottoms, that are easy to pull down.

  • Prompt the person about using the toilet with phrases such as, ‘The bathroom is free now if you’d like to use it’. Prompt, but don’t nag.

  • Ensure the person stays hydrated, to maintain a healthy urinary tract and ease constipation. If the person doesn’t like drinking water, remember they can get fluids from soups, jellies or fruits.

  • Leave the toilet door open if possible, so they can locate it, and guide them to the bathroom if necessary.

  • If the person struggles with mobility, making sure they have access to a handrail and having a raised toilet may help. The person may need to speak to their occupational therapist.

  • A commode may be a good idea if the person is unsteady on their feet and struggles to get to the toilet.

Coping with accidents

  • If the person with dementia has an accident, they may feel angry, upset or embarrassed. Be patient and explain to them that it’s not their fault.

  • Let them know it’s not uncommon and it can affect many other people.

  • Talk about it openly if it helps the person. Don’t make incontinence a taboo subject.

  • If you offer them incontinence products, make sure you refer to them as pads or products and not nappies.

  • Always try to spare their feelings and protect their dignity as much as possible.

What to do when travelling

  • If you are going on a trip with the person, make sure you are properly prepared. Take some incontinence pads, wipes, a change of underwear and clothes.

  • Keep some plastic bags with you.

  • If you are driving, plan your journey in advance so that you will be able to make regular bathroom stops.

Continence products

There are various continence products available that may help.  

  • Pads and pull-up pants can be worn day or night to soak up urine.

  • An absorbent bed pad which is available as a washable or disposable bed sheet.

  • A waterproof mattress protector.

The person may be able to get incontinence products through the NHS. They should ask their GP for details of their local service.

 

 

Sources:

https://dementiahelpuk.com/dementia-and-continence-issues/

https://www.alzheimers.org.uk/get-support/daily-living/toilet-accidents-support-advice#content-start

https://www.carersuk.org/help-and-advice/practical-support/continence-care/#:~:text=If%20you%20are%20looking%20after,if%20that's%20right%20for%20them).&text=It%20is%20best%20to%20not,that%20it%20will%20go%20away.