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

1 COMMENT

  1. My 76 yr old brother has various health issues including vascular dementia was urine incontinent before he went into hospital with urinary sepsis,when he came out 3 weeks later he was doubly incontinent and was given the thickest pads which he stuck all over his windows and walls so we got the thickest pullups on the market,he doesn’t seem to know when hes wet,and if he does no 2 he likes to spread it everywhere,I spend half my life in rubber gloves and go through gallons of disinfectant and bleach,I try to get him to the loo but he gets cross and will pull the pants down and pee where he stands which is usually nowhere near the loo.He has constant wet beds my washing machine is on 3-4 times a day the electric bills are almost as much as our rent,sometimes he does it on purpose (I can tell by the look on his face) when he’s just to lazy to get up and use any one of the 3 toilets in our flat,hes been checked by a continence nurse who says hes retaining urine when hes asleep,but he’ll wallow in the same wet pants all day if I didn’t urge him to let me change him,he has a carer come to shower him every morning,but before lunchtime he’s drenched again,it’s never ending,his GP was meant to get in touch with a urologist last september but has done nothing,I don’t tell him off,but I do show him the mess he makes and he just stares out of the window and denies everything,he doesnt drink much maybe 3-4 cups of tea or sugar free cold drinks he only has one kidney that really must be working overtime,I asked our admiral nurse what we could do to get through all this and she told me to dress him in Onesies,which seemed a bit silly to someone who wets himself from ankles to armpits every night and day,Ive managed to stop him hiding his poo in drawers and cupboards,but I have no family to help me with him I get a 4 hour sitter once a week so I can go shopping but have only been out of our flat 5 times since xmas,end of tether is well in sight now,and if we could actually get a social worker who visits more than once then disappears it might help.

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