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Dealing with Incontinence in Dementia Patients in the Home

Introduction

Incontinence. . . It’s not something that people like to talk about, even though it’s very common in people with dementia. Urinary incontinence is the most common kind, and it’s something we had to address with my Grandpa, and while it was awkward for us, it was far more embarrassing for him.

Like most medical conditions, incontinence can range from mild to severe, with fecal incontinence being the more severe kind. Thankfully, Grandpa’s incontinence wasn’t too bad. Still, incontinence is something that happens to 60% to 70% of people in the later stages of dementia.

I quickly came to realize that, as his caregiver, I had to figure out what was causing his incontinence and how to manage it.

Causes of Incontinence

As I’m sure you know by now, dementia affects your loved one’s ability to react quickly and remember things. It makes sense then that they may stop recognizing when they need to go to the bathroom, or even forget where the bathroom is.

Incontinence can be caused by different things. My Grandpa, for example, struggles to get up and move around, so I found that even though he knew he needed to go to the bathroom, he struggled to make it there on time.

The most common causes of incontinence in people with dementia can be divided into three groups:

Medical

• Urinary tract infection (UTI): Lots of people get this infection, including people with dementia. It causes pain and the sensation of needing to urinate. In the worst case, it can also cause fever and become dangerous if not treated

• Constipation: If your loved one has dementia, chances are they don’t move around all that much. This can cause constipation and other gut upsets like irritable bowel syndrome

• Prostate gland trouble: Though only men can be affected, it’s still a serious condition that can cause incontinence if not treated properly

Medications

Muscle relaxants: Sleeping pills, anxiety medications, and even muscle relaxants can cause the bladder muscles to relax

My Grandpa has always had trouble sleeping. It wasn’t much of a problem until his dementia kicked in because it made him very irritable and kind fo aggressive.

His doctor prescribed him sleeping pills, and we replaced one problem with another. The sleeping pills helped with his irritability and aggression, but they caused him to become incontinent as well.

• Diuretics: Some medications and drinks (like coffee and tea), are diuretics which can cause increased urination

Obstacles

• Communication: If your loved one’s dementia has affected their ability to communicate, then they won’t be able to tell you when they need the bathroom and accidents are more likely to happen

• Mobility: Like my Grandpa, most people with dementia can’t move very well, so they struggle to get to the bathroom in time

• Clutter: Let’s be real, all of our houses have furniture and some clutter, but if your home is seriously cluttered and has a lot of furniture, then your loved one is guaranteed not to make it to the bathroom in time.

My Grandpa lives with me, so I had to make quite a few changes before he was able to move around my house safely

• Clothing: If your loved one wears layers of clothing which are difficult to remove, then they are more likely to have accidents since they won’t be able to remove their clothes in time to go to the bathroom

Management Tips

Now that you know what’s causing your loved one’s incontinence, here are some tips that can help you manage it:

Maintain Bladder Health

• Try and make sure that your loved one avoids carbonated and caffeinated drinks and limit their intake of liquids before bed – but be careful that you don’t cause dehydration!

My Grandpa was not my biggest fan when I limited his coffee intake, but it helped so much with his incontinence that even he was forced to realize that it was a pretty good management choice

• Help your loved one avoid spicy and acidic foods, and ensure that they eat plenty of fibre and exercise regularly

Use Pads And Pull-Up Pants

• Some accidents you can’t prevent, so using absorbent products like pads, adult underwear, and liners is an effective way of managing your loved one’s incontinence

• Just make sure that you check their skin regularly for irritation, inflammation, and infection

• TENA has a great range of products for both men and women, and a wide selection of products can be found on Amazon

Prevent Accidents

• The best way to prevent accidents is to learn the signs that your loved one needs to go to the bathroom.

I’ve found that my Grandpa fidgets and gets irritable when he needs to go to the bathroom, so I’m sure to watch him closely and help him to the bathroom when necessary

• I also make sure he wears clothes that are easy to remove and that the bathroom door is open and lit at all times. Installing grab bars next to the toilet is also a good idea

• Lots of people have found “prompted voiding” very helpful. With this technique, all you have to do is ask your loved one if they need to go to the bathroom or if they have had an accident every two hours or so. This helps promote a regular bathroom schedule and reduces accidents

• You can also check on them during the night or provide them with a portable toilet chair next to their bed. Getting a bed pad or waterproof mattress protector is also very helpful

• If you’re going out in public, make sure you always plan ahead, and that you make plenty of travel stops to bathrooms or bring along extra pads and clothes

Be supportive and Communicate

• Everyone reacts to incontinence differently, and your loved one is no different. They may find it upsetting and recognize that it’s a part of their condition, or they may not even be aware of the problem

• It’s best to approach the situation calmly and assertively with genuine understanding and interest. The best thing you can do is be respectful of your loved one’s privacy and calmly address them. Don’t ever scold them or get upset, and reassure them that it’s alright and that “anyone can have an accident.”

• Encourage them to speak to you about the problem and make sure that you speak to them kindly, even if they start to act out or get defensive

Remember

Incontinence isn’t a nice topic, and it’s something people try to avoid talking about, but the truth is that it’s a reality for you and your loved one. To ignore it or pretend it’s not a problem will lead to awkwardness and embarrassment for both of you, and it may even cause some long-term medical conditions further down the line.

Be open to talking about it with them as best you can, and seek help from a doctor or other medical professional if you find that you’re struggling to cope with it on your own.