Incontinence is a common symptom experienced by individuals with dementia, especially in its later stages. Sometimes, this is a direct result of dementia, while others experience it for other reasons, such as physical health conditions and ageing.
Incontinence can be distressing for individuals with dementia and their carers. However, there are several ways to manage incontinence and maintain your loved one’s dignity.
What Is Dementia Incontinence?
Incontinence is when an individual unintentionally passes urine, faeces or both, known as double incontinence. The National Institute for Health and Care Research (NIHR) states that people with dementia are at least three times more likely to have urinary incontinence and four times more likely to have faecal incontinence than those without dementia.
Common signs of incontinence in people with dementia include:
- Leaking urine or faeces: Both small and large leaks apply, from small amounts to complete loss of control.
- Urgent need to use the toilet: Sudden and frequent urges to use the toilet may be a sign of an overactive bladder.
- Frequent accidents: These may be due to the individual not realising that they need to use the toilet, often resulting from confusion or cognitive impairment.
Some people also experience obvious signs of incontinence. For example, you might not notice it straight away, but you may find soiled clothing or bedding later. Incontinence may occur day or night.
What Causes Incontinence in Dementia?
Dementia can affect various areas of the brain, including those that control the bladder and bowels. This may mean that the individual’s brain doesn’t signal when they need to go to the bathroom.
Other symptoms of dementia may increase the likelihood of incontinence, such as:
- Reduced mobility: This may make it difficult for the individual to reach the toilet in time.
- Memory difficulties: An individual with dementia may forget to use the toilet or where it is located in the house.
- Issues recognising physical signs: Forgetfulness and confusion can make it harder to recognise the physical signs of needing the toilet.
- Communication troubles: If an individual needs assistance with getting to and from the bathroom, they might not be able to communicate this in time to avoid an accident.
- Problems with coordination: Individuals might find it too difficult to unbutton their clothing to use the bathroom efficiently.
What Other Health Conditions Can Increase the Risk of Incontinence?
Along with dementia and natural ageing, there are several other health conditions that may increase the risk of incontinence.
If your loved one has a history of any of the following and dementia, they might have a higher risk of experiencing incontinence:
- Constipation
- Diabetes
- Prostate problems
- Stroke (mini or full)
- Muscular problems, such as Parkinson’s
- Urinary tract infections (UTIs)
- Bladder or kidney infections
- Prescribed medication that can affect bladder/ bowel control
Medications often come with side effects that can worsen incontinence.
These include:
- Muscle relaxants and sedatives
- Diuretics
- Strong painkillers
- Alpha blockers and calcium channel blockers
- Antihistamines
If you believe your loved one is currently taking any medication that increases the risk of incontinence, it’s important to monitor their symptoms and notify their healthcare team.
How to Help Someone Living with Dementia Manage Incontinence
Incontinence can be embarrassing for the individual experiencing symptoms and their primary carer. However, with the correct management techniques, you can help your loved one lessen symptoms and move on without associating them with negative emotions.
Create a Dependable Routine
One of the most effective ways to manage incontinence is by establishing a dependable routine tailored to the individual’s toileting habits. To do this, keep a log of how often your loved one typically uses the toilet and the times of day.
Look for non-verbal signs of needing to use the toilet, such as fidgeting or pacing and make a note of these for other caregivers or loved ones to watch for.
Take the information you’ve gathered and create a daily schedule where you’ll prompt your loved one to use the bathroom, even if they haven’t mentioned needing it or shown non-verbal signs. This can often reduce the number of accidents.
Read more in our helpful guide on caring for someone living with dementia.
Support Practically to Preserve Dignity
It’s essential to preserve the dignity of individuals experiencing incontinence and dementia. While it’s common to feel embarrassed by conversations about needing to use the bathroom, it’s essential to talk candidly with your loved one so they know you won’t judge them.
People with dementia may use euphemisms to describe their need for the toilet, such as ‘I need to go out’. Pay attention to what they’re saying and whether it could be a sign that they need to use the toilet.
Your loved one may begin hiding their soiled bedding or clothing due to feelings of embarrassment. To preserve their dignity, instead of pointing it out and shaming them, quietly remove the soiled textiles and replace them with clean ones. Place the wash basket in their room and label it to remind them of its purpose.
Take Care of Skin Care and Hygiene
When individuals experience frequent incontinence, their skin can become irritated and prone to infections due to prolonged exposure to moisture. As soon as you notice your loved one has soiled themselves, carefully clean their skin with warm water and fragrance-free soap.
Pat the skin dry with a soft cotton towel to avoid fungal infections. If you notice any sore or dry skin, book an appointment with your loved one’s GP to get it checked in a timely manner.
Use Incontinence Products
There are numerous protective products available to manage incontinence, including pads, disposable underwear, bed and chair protectors, and specially designed clothing. These products are often easily accessible at pharmacies and supermarkets. The NHS may also cover the cost of certain products.
When using incontinence products, dignity and comfort are essential. Routinely check whether the product needs to be changed and help your loved one use it independently where possible, as this can make them feel less embarrassed.
When to Seek Medical Advice
It’s often advisable to inform your loved one’s GP when you notice a pattern emerging between their incontinence and dementia. Some causes, such as medication and infections, can be addressed to reduce the number of accidents they experience.
They may also refer you to the NHS continence service, where specialist staff can investigate the cause of your loved one’s incontinence and suggest treatments to help. They’ll work with you to create a management plan tailored to your and your loved one’s needs.
Helping an Individual With Dementia Use the Toilet
Some individuals with dementia may need help going to the bathroom in a timely manner to avoid accidents. If you feel that your loved one requires help, ensure that you consider their dignity and privacy first. Ask them if they need help rather than telling them or taking over and encourage them to help you.
Your loved one may only need guidance to the bathroom, so gently steady them as they walk themselves and guide them if they get confused. Once they’re in the bathroom, ask them if they need help in small steps.
Guide them slowly to sit on the toilet. Give your loved one plenty of time to use the toilet, so they don’t feel pressured or hurried. They may want you to step out while they use the toilet or you can lay a towel over their lap to protect their modesty.
When to Look for Support
Handling incontinence can be difficult for family members and loved ones, especially when symptoms of dementia need to be monitored and handled with care. You may feel uncomfortable with tending to your loved one’s toileting needs and they might prefer professional help from live-in or visiting care.
At Patricia White’s, we take pride in providing exceptional care to our clients and their families. Our dementia care offers essential support with day-to-day tasks, such as toileting, bathing and dressing, companionship and mobility assistance.
Whether you require short-term respite care or ongoing complex personal care at home, our fully trained and compassionate carers are available to help. We’ll create a living care plan for your loved one to adjust as symptoms evolve, ensuring they always receive the best care possible.
Talk to Our Dedicated Team of Experts Today
The standards set by Patricia White 30 years ago still apply today. Call our experienced team today on 01293 224708 to discuss your home care needs and receive a free, no-obligation quotation.
Or feel free to send us a message using our online enquiry form. A member of our expert care team will respond as soon as possible, typically within 24 hours.
