Dealing with incontinence

As the disease progresses, many people with Alzheimer’s begin to experience incontinence, or the inability to control their bladder and/or bowels. Incontinence can be upsetting to the person and difficult for the caregiver. Sometimes incontinence is due to physical illness, so be sure to discuss it with the person’s doctor.

The changes in a person’s brain that occur with dementia can interfere with their ability to:
• Recognize the need to go to the toilet.
• Be able to wait until it is appropriate to go to the toilet.
• Find the toilet.
• Recognize the toilet.
• Use the toilet properly.
If your loved one is experiencing incontinence, the first thing to do is see a doctor. There may be other reasons for the problem, which may be treatable. If your doctor finds no other explanations for incontinence, the cause is most likely dementia.
Be aware of your loved one’s body language. If they are restless, undressing, pacing, or otherwise agitated, it may be because they feel the need to use the toilet. If you see this behavior, ask your loved one if they need to use the bathroom or guide them towards the bathroom without asking. If so, go with them and provide any assistance that’s needed. It may help to:
• Use short, simple words to give step-by-step instructions. For example, “Sit down.”
• Use words that are familiar to the person, such as “pee” or “tinkle.”
• Do not rush the person.
• Reassure them.
For the long-term incontinence management, try to develop a regular toileting schedule. This will help reinforce to your loved on why they are there. Here are some other things that may help:
• Use a contrasting color for the toilet seat, as many people with Alzheimer’s suffer from depth perception.
• Make sure there is a night light or motion light in the bathroom.
• If your loved one is the only one using the bathroom, remove the door.
• Purchase clothing that can be easily removed.
• Use a bedside commode or urinal.
• To help prevent nighttime accidents, limit certain types of fluids—such as those with caffeine—in the evening.
• If you are going to be out with the person, plan ahead. Know where restrooms are located, and have the person wear simple, easy-to-remove clothing. Take an extra set of clothing along in case of an accident.
If your loved one still faces challenges, adult diapers and protective bed pads are useful tools.