A person with dementia may develop continence issues, which can be distressing. But whatever the cause, there are lots of ways to help manage the situation. We asked the experts at Christies Care for their advice on managing continence problems…
If you are caring for a loved one with dementia, it can be challenging enough to manage household tasks and ensure the person is being properly cared for. In addition, a person with dementia can develop continence issues over time. An involuntary leakage of urine (urinary incontinence), faeces (faecal incontinence) or both (double incontinence) can develop for several reasons:
• A physical condition, most commonly a urinary tract infection (UTI) or constipation.
• A side effect of new medication.
• The person not getting to the toilet in time, due to a mobility issue.
• The person forgetting how to find or use the toilet.
• The person struggling with clothing, such as trouser buttons or zips.
• In more advanced dementia, communication between the brain and bladder or bowel might break down, meaning the person might not recognise the fact they need the toilet.
Managing continence issues
While incontinence can be frustrating and upsetting, try to be patient and supportive.
‘Stay calm, even if you don’t feel it,’ advises Helen Drain, dementia expert at Christies Care in Saxmundham, Suffolk (https://www.christiescare.com). ‘The person might feel upset or embarrassed, so it’s important not to make a big fuss, to help reduce their anxiety.’
Here are some tips to help improve continence:
• Consult the person’s GP, so they can rule out any medical conditions. A UTI can be treated with antibiotics, or if the continence issue has been caused by medication, the GP may be able to alter the prescription.
• Keep clothing simple. ‘A person with dementia might find buttons or zips difficult,’ reminds Helen. ‘Elasticated trousers that can be pulled up and down are best.’
• Prompt, but don’t pester. ‘Continually asking whether they need the loo might wind them up,’ explains Helen. ‘At Christies Care, we suggest saying, “I’m going to the bathroom now,” or “The bathroom’s free if you’d like to use it.” It’s a little prompt, rather than asking outright.’
• Ensure the person stays hydrated, to maintain a healthy urinary tract and ease constipation. Ensure they drink six to eight glasses of water a day. ‘They can also get fluids from foods such as soups, jellies or fruits,’ reminds Helen.
• Leave the toilet door open if possible, so they can locate it, and guide them to the bathroom if necessary.
• You might be able to request a continence assessment from a district nurse, who can advise about products such as incontinence pads and waterproof mattresses. Ask your GP for details.
Christies Care is a family-run, live-in care agency, rated Outstanding by the CQC. For more information, please visit www.christiescare.com