Understanding Incontinence in Dementia
Incontinence, or the inability to control bladder and bowel functions, is a common occurrence in middle to late-stage dementia patients. As the disease progresses, the patient loses the ability to recognize bodily signals indicating a need to use the restroom. They may also forget where the bathroom is located or how to get there. Incontinence is not the patient’s fault, and it’s important for caregivers to respond with patience and preserve the patient’s dignity.
Incontinence can be caused by various medical issues like urinary tract infections, medications, dehydration, diabetes, strokes, or muscular disorders. The first step is to have the patient assessed by a doctor to rule out any treatable causes. If the incontinence is related to the progression of dementia, there are ways to manage it discreetly at home.
Tips for Managing Incontinence
Communicate and Observe
- Gently encourage the patient to tell you when they need to use the restroom. Watch closely for signals like restlessness, pacing, unusual facial expressions or sounds. These could indicate bathroom needs.
- Learn the patient’s unique words or phrases that signify they need to use the toilet. The patient may use odd sayings like “I can’t find the light” as their way of communicating this need.
- Gently remind the patient to use the restroom every 2 hours during the day. More frequent reminders may be needed based on the patient’s routine and stage of dementia.
Make the Bathroom Accessible
- Keep the bathroom door open and widely visible. Use large signs with images/icons to help the patient recognize and identify the bathroom.
- Install grab bars, night lights, and raised toilet seats to make using the restroom safer and more accessible.
- Place a portable commode or urinal in the bedroom if the patient has difficulty making it to the bathroom in time.
Establish a Bathroom Routine
- Note when accidents tend to happen and preemptively get the patient to the bathroom before that time.
- Take the patient to the bathroom at consistent times throughout the day – first thing in the morning, after every meal, before bedtime, and every 2 hours in between.
- Limit fluid intake about 2 hours before bedtime to avoid middle-of-the-night accidents.
Use Appropriate Products
- Use absorbent, easy-to-remove clothing and disposable incontinence pads or briefs to contain leaks and accidents.
- Protect the mattress with waterproof pads and change bedding promptly after accidents.
- Gently wash the patient’s skin after every accident to prevent painful rashes and skin infections.
- Stay calm and reassuring when accidents occur. Offer the patient privacy to preserve dignity.
- Remember that incontinence is a symptom of the disease, not the patient’s fault. Focus on providing comfort.
- Get respite care or call a helpline if managing incontinence becomes overwhelming. Don’t hesitate to ask for help.
With preparation, routine bathroom visits, and the right supplies, incontinence can often be managed discreetly at home. The key is responding with understanding, patience and preserving the dementia patient’s dignity throughout the process. Consistent reminders, communication and observation can help reduce accidents. Your compassionate care and support makes all the difference.