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Dementia and continence management
Incontinence is the term used to describe loss of control of the bladder and/or bowel. Being in control of these functions depends on awareness of bodily sensations such as the feeling of having a full bladder and the memory of how, when and where to respond. When a person has dementia there is a decline of these mental functions, which may result in incontinence.
This means that a person with dementia may find it hard to recognise the need to go to the toilet, be unable to wait until the appropriate time and may even have difficulties finding, recognising or using the toilet properly. Often this can be very distressing for the person with dementia as well as their carer, who may find it stressful and even embarrassing to deal with.
Where to get help
The first step is to see a doctor or continence nurse to get a full assessment of the situation. The doctor should be able to work out whether there are other causes of the incontinence, such as infection, constipation, hormonal changes or prostate enlargement. When you’re visiting your doctor it may help to take along a list of observations such as:
- how often the incontinence occurs
- whether it’s urinary or faecal incontinence
- when it all started
- whether there’s complete saturation or just a dribble
- whether there’s been any change of behaviour such as an increase in confusion
- whether the person you care for has had a fever or found it painful to go to the toilet
- what other medication is being taken, and
- whether the person you care for urinates in strange places.
How to manage incontinence
There are many ways to manage incontinence, respecting privacy and dignity in what can be a humiliating situation for people with dementia. You may wish to consider:
- observing patterns of when the person empties their bladder and/or bowel and using this pattern to remind them, at regular intervals, to go to the toilet
- watching for non-verbal clues such as pulling on clothes and agitation and using short, simple words to suggest they go to the toilet
- making sure the bathroom isn’t too far, the bed isn’t too high, the toilet paper can be easily seen and the toilet is clearly marked
- using raised bars to help the person get on and off the toilet
- simplifying clothing with elastic and Velcro waistbands
- using pads and protecting garments, and
- introducing regular low-caffeine drinks, a high fibre diet and regular exercise routines.
Read more: About managing continence
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