It can be difficult caring for someone living with dementia, particularly if you’re caring for a relative and have not had any experience with this type of care previously. As a carer for a person with dementia, you will find that their needs will change and increase as time goes on. One of the aspects that carers need to consider is how they can help with incontinence in dementia. Continue reading to find out how carers’ actions can help people living with dementia and incontinence.
Dementia is a general term that covers the symptoms associated with the ongoing decline of a person’s brain function from diseases such as Alzheimer’s, Lewy Body Dementia and Vascular Dementia which all fall into this description of dementia.
For the purpose of this blog, we will use the term ‘dementia’ to cover many of the degenerative brain diseases that mainly affect older people, but also people living with young onset dementia, too.
Urinary incontinence is common in dementia patients. Between 60 and 70% of patients with Alzheimer’s experience incontinence, but this doesn’t need to be seen as inevitable or as something that just needs to be endured and lived with.
There are a variety of reasons why someone with dementia might experience incontinence and the severity can range from leaking a relatively small amount of urine when coughing, sneezing or laughing to double incontinence. This is when someone experiences urinary and faecal incontinence at the same time.
Understanding the reason for the incontinence means that the patient’s medical team can make recommendations that may reduce the intensity of the issue which may, in turn, alleviate the distress felt by the patient and their carers.
Episodes of incontinence can begin in the middle stages of dementia when the individual begins to experience increased confusion and disorientation. They may no longer recognise signs that they need to use a toilet or they might not remember where the toilet is located.
They may also be unwell with other illnesses and no longer understand how to communicate that they have a problem or manage their needs in line with their illness. They also may not recognise signs and symbols on the doors which can add to their upset and distress while trying to hold on to their independence.
They can also feel too embarrassed to ask for help or feel like a burden on their loved ones, so might try to hide what is happening which can be difficult for loved ones who want to help and minimise their upset.
There are many reasons why someone might experience dementia and incontinence, and some of these reasons could just as easily affect someone of the same age who does not have dementia. For example, they may also experience incontinence as a result of other health issues.
A person who has given birth might have pelvic floor weakness, hormones could impact continence, or people who have had prostate problems may consequently have trouble with their bladder. Particular medications can also cause problems such as increasing the frequency that someone needs to use the toilet or causing loose stools.
The difference between someone with dementia and another older person without dementia is that the dementia patient may gradually begin to experience the following:
If you’re a first-time carer for somebody living with dementia, you might not be aware of the signs to look for that could indicate the start of a problem with incontinence. The person you’re caring for may not want to share that they’re experiencing problems with using the toilet but, as a carer, you can look out for:
This is not an exhaustive list of signs to keep an eye out for. However, you might spot other behaviours that lead you to believe that the person you’re caring for needs additional help.
One of the most important things a carer can do to help a dementia patient with incontinence is to understand that this is a difficult and upsetting subject for them to deal with. When we are busy, it can be difficult to find the patience to make them feel safe and reassured and that their dignity is being considered and maintained.
If you’re unsure of how to handle the continence care of a patient with dementia, here are some suggestions that may help:
It may seem counterintuitive but reducing fluid intake can make incontinence worse as it can bring about urinary tract infections and constipation.
Somebody who feels rushed may not fully finish what they’re doing and then could need to go again in a short period of time. Not fully emptying the bladder or bowel can lead to other problems like a urinary tract infection or constipation.
A person might need to be reminded that they could need to go to the toilet. Once every two hours should be sufficient.
Some people may struggle to identify the bathroom or the toilet. Symbols for the toilet such as ‘WC’, a wheelchair or a ladies/gents sign may lose meaning as dementia progresses. By labelling the door with the word ‘toilet’, you can potentially avoid confusion. You can also leave the light on in the bathroom at night so if they wake up in the night, they’ll more likely gravitate towards the light.
The purpose of visiting the toilet is for the person to empty their bladder and/or bowels so removing any distractions, like colourfully decorated bottles or soaps might help keep their focus on the task at hand.
As dementia progresses, a patient may struggle to identify a toilet so making it visible and available is important. Removing waste paper bins and offering a range of suitable alternatives to the bathroom such as a bedside commode or a urinal bottle can help. At Complete Care Shop, we have a range of bathroom aids that can make using the toilet much easier for people with dementia.
Dementia patients may forget the steps for using the toilet so verbal assistance about what to do next can be helpful. For example, you could ask, ‘Would you like to flush the toilet?’ or ‘Shall we wash our hands now?’
If a patient is hurrying to use the toilet then buttons can impede their progress. However, elasticated waists, velcro and poppers can be much easier to work with.
Accidents do happen and having absorbent washable pads on beds and chairs can make cleaning up much easier as well as protect mattresses and chairs.
Incontinence pants and incontinence pads have come a long way and many are far more discreet than many people realise. They can be extremely helpful for people living with dementia and incontinence.
Being a carer can be hugely rewarding but if you’re a first-time carer looking after a relative, it can be an overwhelming experience. There is support available to carers looking after people with dementia either through your GP, or clinical staff like dementia specialist nurses at the memory clinic may be able to help.
Carers may also be entitled to financial support with carer allowance and possibly other benefits. For practical support, Alzheimer’s Society has resources that can help you understand what technology or home adaptations may be helpful. Alzheimer’s Society also offers a postcode checker so you can see what help is available in your area, such as carer support groups, daytime activities and transport assistance.
At Complete Care Shop, we stock a comprehensive range of incontinence aids for dementia that are specially designed to help people with continence issues. From incontinence underwear to disposable bed pads and barrier cream, there are many ways in which the right products can help you and the person you care for manage incontinence.
We also have a wide selection of memory aids for dementia, mobility aids for dementia, and more. If you’d like to speak to somebody at Complete Care Shop about caring for somebody with dementia, or our range of helpful products, don’t hesitate to contact us.
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