When caring for your loved one with dementia it can be a traumatic experience when they start becoming incontinent. It is distressing both for the person with dementia as well as the person who is caring for them. Incontinence is defined as the involuntary leaking of urine or faeces, and unfortunately dementia and incontinence are linked. Someone with dementia may only experience incontinence in the later stages of their illness with about 60 to 70 percent of people with dementia ever developing it.
As the caregiver, the more you understand about the condition the better you can prepare and manage with the emotional and physical side-effects of this progression.
Why it occurs more frequently in people with dementia
People with dementia are far more at risk of developing incontinence, first of all it could have a lot to do with being of an advanced age but also because of their memory problems and medical issues. The memory related issues that put them at risk include their inability to react quickly or recognise the urge to urinate or have a bowel movement.
Mental reasons they may experience incontinence include:
- Not remembering where the bathroom is
- Damage to nerve pathways in the brain that are involved in bladder and bowel control
- Remembering too late that they need to go
- Being unable to communicate that they need to get to a bathroom
- Not being able to get there in time
There is also a myriad of medical causes that contribute to a loved one experiencing incontinence, and these could include:
- Having decreased mobility due to age, injury or illness
- An enlarged prostate gland in older men
- Experiencing constipation
- Neurological complications from having a stroke
- Diseases such as Parkinson’s, multiple sclerosis or prostate cancer
- The relaxing or laxative side-effects of certain medications such as sleeping pills or tranquilisers
- Urinary tract infections
How to manage caring for the emotional side-effects
When incontinence happens, the person with dementia will often have feelings of embarrassment, frustration or even anger. Incontinence makes them feel like they no longer have control, which can make the whole experience extremely distressing for them. There are ways that you can preserve some of their dignity when you handle each situation.
Try to remember that it is not their fault, as it is easy to feel frustrated yourself, and exercise as much patience as possible. It is absolutely natural to feel embarrassed or sad in this situation, but outwardly you need to adopt a matter-of-fact attitude and call it an accident so as not to assign any blame.
Tips to manage the physical effects
If you’ve already accepted that incontinence is going to happen or it has already happened in the past, then it is best to be prepared at all times.
Here are some tips to reduce accidents:
- Start looking out for signs that a person needs to go, such as straining or tugging at their clothing, so that you can prevent an accident
- Keep a regular bathroom schedule, eg. take them to the bathroom every two hours
- Remove obstacles in their path to the bathroom
- Offering a portable toilet chair next to their bed at night
- Use absorbent pads and pull-up pants
- Use rubber or disposable plastic protection on beds, chairs and car seats
How to handle accidents when they do happen:
- Use disposable gloves and flushable wipes and always wash your hands before and after to keep you both safe
- If your loved one has bowel incontinence, it is best to give them a shower to wash with soap and water
- Have everything you might need in the bathroom with you, including more pads, gloves, wipes, creams, etc. as well as somewhere to dispose of these things when used
Caring for a loved one when they need you most can be very rewarding, but managing incontinence can be one of the most challenging aspects. If you are prepared for the eventualities and are aware that there are Livewell Dementia Support Groups where you can go to for advice and emotional support, then you know that you are never alone.