Caring for someone with dementia can be both rewarding and challenging.  Among the various difficulties caregivers may encounter, managing incontinence is a common concern.  Incontinence refers to the loss of bowel or bladder control without intention.  It is essential for dementia caregivers to approach this issue with empathy, patience, and understanding while maintaining the dignity and comfort of their loved one.  This article provides practical strategies to effectively manage incontinence in individuals with dementia.

1.  Understand the Causes

It is important to understand that incontinence is a prevalent symptom of dementia.  It is difficult for individuals to recognize bodily sensations, remember the need to use the restroom, and recall where the restroom is located.  As dementia progresses, and there is a loss of cognitive function, incontinence may begin as an occasional episode of urinary incontinence.  It is to be expected that the incontinence will increase in frequency and will include both bowel and bladder.

Keep in mind, that if the incontinence is a new onset, it’s always best to consult with your healthcare provider to rule out any underlying medical concern, such as a urinary tract infection, overactive bladder or prostate issue that could be contributing to the symptom.  

2.  Create a Routine

Establishing a toileting schedule can be beneficial for both the dementia caregiver and the person with dementia.  Encourage regular visits to the restroom, even if your loved one doesn’t indicate that they need to use the restroom.  Predictability with toileting reduces accidents and fosters a sense of familiarity.  A great starting point is to toilet immediately upon waking, then every 2 hours while awake, and certainly directly before going to sleep.

3.  Appropriate Clothing

Choosing the right clothing can make a significative difference in managing incontinence.  Choose clothing that makes it easier to dress and undress.  Elastic waistbands and Velcro closures are great choices.  Tying drawstrings, zippering pants, and buttoning clothing can be complicated for someone with dementia so these items should be avoided.  During a sense of urgency to use the restroom, fumbling with clothing can cause stress, anxiety and incontinence.

4.  Adapt the Environment

Ensure that the environment is free from any fall risks, such as cluttered or narrowed pathways.  Create a well-lit environment and utilize a night light at night.  If your loved one has difficulty remembering where the restroom is located, place a simple picture of a toilet on the restroom door.  Consider grab bars or an elevated toilet seat to enhance safety and independence.  Think about changing the color of the toilet seat to a bright color so it’s easier to locate.  You want to make it easy to navigate towards the restroom and maintain safety while it’s in use.

5.  Incontinence Products

Use appropriate incontinence products to manage accidents discreetly.  Many options are available, including adult diapers, incontinence briefs and pads.  There may be a bit of a trial-and-error period to find what product is most comfortable, absorbent and best for your loved one.  Follow each incontinence episode with proper personal hygiene to maintain good skin integrity and avoid any possible odor.  If your loved one has incontinence while sleeping, use an absorbent pad on the bed and a waterproof mattress cover.

6.  Fluid Intake

While it’s certainly important to remain well hydrated and avoid dehydration, it’s best to minimize consumption of fluids one hour before bed.  Avoid caffeinated beverages.  Caffeine is a diuretic which increases urine production and stimulates the bladder.  If your loved one enjoys coffee, tea or soda, opt for caffeine free.  Encourage fluids throughout the day, and sips of water work well, in conjunction with the toileting schedule.  

In summary, by creating a supportive environment, maintaining routines and following the guide above, dementia caregivers can help their loved ones maintain dignity and comfort while navigating this aspect of their dementia journey.  Remember to prioritize the well-being of both the individual and the caregiver by being proactive in managing incontinence.  As always, seek guidance from healthcare providers who specialize in dementia care when you feel unsure or need additional support.