Alzheimer's & Incontinence

CARE TIPS: Here are some good ways you can deal with incontinence in dementia care.

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A person with Alzheimer’s disease may have other medical problems over time. These problems can cause more confusion and behavior changes. The person may not be able to tell you what is wrong.

One problem, incontinence, means a person can’t control his or her bladder and/or bowels. This may happen at any stage of Alzheimer’s disease, but it is more often a problem in the later stages. Signs of this problem are leaking urine, problems emptying the bladder, and soiled underwear and bed sheets. Let the doctor know if you see any of these signs. He or she may be able to treat the cause of the problem.

Causes of Incontinence

1. Incontinence has several possible causes. Some can be treated:
2. Urinary tract infection
3. Enlarged prostate gland
4. Too little fluid in the body (dehydration)
5. Diabetes that isn’t being treated
6. Taking too many water pills
7. Drinking too much caffeine
8. Taking medicines that make it hard to hold urine

When you talk to the doctor, be ready to answer the following questions:

• What medicines is the person with Alzheimer’s taking?
• Does the person leak urine when he or she laughs, coughs, or lifts something?
• Does the person urinate often?
• Can the person get to the bathroom in time?
• Is the person urinating in places other than the bathroom?
• Is the person soiling his or her clothes or bed sheets each night?
• Do these problems happen each day or once in a while?

What To Do About Incontinence

Here are some ways you can deal with incontinence:

1. Remind the person to go to the bathroom every 2 to 3 hours. Don’t wait for him or her to ask.
2. Show the person the way to the bathroom, or take him or her.
3. Watch for signs that the person may have to go to the bathroom, such as restlessness or pulling at clothes. Respond quickly.
4. Make sure that the person wears loose, comfortable clothing that is easy to remove.
5. Limit fluids after 6 p.m. if problems happen at night. Do not give the person fluids with caffeine, such as coffee or tea.
6. Give the person fresh fruit before bedtime instead of fluids if he or she is thirsty.

Here are some other tips:

• Mark the bathroom door with a big sign that reads “Toilet” or “Bathroom.”
• Use a stable toilet seat that is at a good height. Using a colorful toilet seat may help the person identify the toilet. You can buy raised toilet seats at medical supply stores.
• Plan ahead if you are going out with the person. Know where restrooms are located. Take an extra set of clothing in case of an accident.
• Help the person when he or she needs to use a public bathroom. This may mean going into the stall with the person or using a family or private bathroom.

Accidents Happen

Be understanding when bathroom accidents occur. Stay calm and reassure the person if he or she is upset.

Incontinence supplies, such as adult disposable briefs or underwear, bed protectors, and waterproof mattress covers, may be helpful. You can buy these items at drugstores and medical supply stores. A drainable pouch may be useful for the person who can’t control his or her bowel movements. Talk to a nurse about how to use this product.

Some people find it helpful to keep a record of how much food and fluid the person with Alzheimer’s takes in and how often he or she goes to the bathroom. You can use this information to make a schedule for going to the bathroom.

MORE INFORMATION:

• Read the NIA booklet, "Caring for a Person with Alzheimer's Disease"

SOURCE:
The Alzheimer's Disease Education and Referral (ADEAR) Center