November 28, 2012

It’s a topic most people don’t want to talk about, but it’s too important to avoid: incontinence. As we continue to educate our readers throughout Alzheimer's Awareness Month, it's important to shed light on the tie between dementia and incontinence.

Unfortunately, many people faced with worsening dementia are dealt a second, unexpected blow when incontinence begins to happen regularly. It may be an uncomfortable topic, but it’s incredibly common; as dementia progresses, incontinence becomes almost inevitable, according to a 2006 study. Another reason to deal with this care issue head-on is that it is the most common reason a person with dementia is institutionalized.

Why do dementia and incontinence go hand-in-hand?

Incontinence can be caused by a variety of factors. Medical conditions such as a urinary tract infection, prostate problems, stroke, diabetes, or physical disabilities can all cause incontinence directly, or indirectly by preventing the person from getting to the bathroom in time. Certain medications can also cause incontinence. If your loved one is beginning to have accidents, it’s best to visit a doctor to rule out a treatable problem.

Adults with dementia often still retain the physical ability to go to the bathroom, but lose the mental capacity to know what the feeling means and to get themselves there. How a caregiver responds to incontinence can either cause the adult to become confused and agitated, or become used to a new routine.

How do I deal with an accident?

Incontinence can be an embarrassing and difficult problem to face. Here are a few tips for dealing with an accident, and preventing them in the future:

■Try your best to reduce your loved one’s embarrassment. Try saying “Looks like there might have been a spill,” or other wording that doesn’t place blame.

■Be matter-of-fact; don’t scold the person or express feelings of disgust.

■Consider using adult briefs.

■Use clothing that is easy to clean and put well-padded rubber sheets on the bed so the sheets and mattress won’t get soaked through.

■You might be tempted to limit your loved one’s fluids, but don’t: dehydration can happen easily in the elderly, and can be very dangerous.

■Provide helpful reminders: encourage the person to go regularly.

■Set a schedule: Go at the same times every day, such as first thing in the morning, every two hours, and right after meals. Try using a timer that will help remind both of you. Include yourself in the process: say, “It’s been a while! We should both use the restroom.”

■Make sure the path to the bathroom is clear and well-lit.

■Keep the bathroom door open and the light on so the toilet is visible (use nightlights after dark).

■Make sure the bathroom is easy to use. Install grab bars next to the toilet and raise the seat.

■If nighttime accidents are a problem, try using a portable toilet.

Incontinence can be difficult and stress-inducing on both the person suffering from it and his or her caregiver. Do your best to remain positive and supportive. If you’re a family caregiver, incontinence might be a problem that is too much for you to deal with alone. Consider an in home caregiver to help you out if this issue becomes overwhelming.


Tags:  incontinence, seniors, home care, dementia