Body

Everything you need to know about the physical state and dementia, and how to manage your charge.

When nature’s calls get out of control

When nature’s calls get out of control

by ALZHEIMER'S SOCIETY

People living with dementia and Alzheimer’s will have accidents and difficulty using the toilet.

Incontinence is “the involuntary leakage of urine or feces, or both (double incontinence).” Some people with urinary incontinence may experience a small leak, while others lose bladder control entirely.

Most commonly, people with dementia have “overactive bladders,” and urinate frequently or feel sudden, urgent needs to use the bathroom. Fecal incontinence is less common, but also ranges in severity. It can mean anything from releasing a small amount of fecal matter when passing gas, to a complete lack of bowel control.

What might cause accidents in people with Alzheimer’s? Not being able to react in time to the need to use the washroom; not being able to get to the bathroom in time; not wanting to ask for assistance; not being able to communicate that they need the washroom,;or not being able to find or recognize the bathroom.

In  advanced cases of dementia, the nerve pathways that send the message that the bladder or bowel is full will degenerate. This is uncommon, though.

TIPS

Keep Bladders and Bowels Healthy:

This is a first step to preventing incontinence. Help people with dementia maintain by …

*Making sure the person drinks six to eight glasses of fluids daily

*Ensuring the person gets enough fiber, and eats a minimum of five servings of fruits and vegetables each day

*Keeping the person mobile as possible (this can facilitate bowel movements)

*Setting regular times to use the bathroom (for example, trying to go after meals is often effective)

*In the event someone has an overactive bladder, stay away from tea, coffee and alcohol, which irritate the bladder. Opt instead for herbal teas and fruit juices

*Pelvic floor exercises can sometimes benefit women with dementia.  These exercises may cure stress incontinence that occurs when pelvic floor muscles weaken as a result of childbirth or ageing.

Help to Reduce Accidents:

*Clearly show where the toilet is by putting a sign on the door that has words and pictures. Let people know when the washroom is available by keeping the door open when it’s not being used

*Move furniture that may prevent easy access to the bathroom out of the way. Keep hard-to-open doors left ajar. Make sure areas are always well-lit, especially for night-time. Motion sensor lights in the bedroom and bathroom can help with this

*If the person has mobility issues, make sure the bathroom has tools like handrails

*Some men may have trouble with aim, and may find it easier to sit down rather than stand

*Wearing clothing that is easily-removed may help those with issues with incontinence. Elasticated waistbands and velcro may be easier to deal with than zippers, snaps or buttons.

*When out in public, find accessible toilets in advance

*On daytrips, go prepared with spare clothes or pads, and an extra bag for soiled clothes

It’s particularly important to be able to deal with accidents in public, and help people with dementia cope with embarrassment.

Give Regular Reminders to Use the Washroom:

*Ask those with urinary incontinence if they need the washroom every 2-4 hours. If they ask for assistance, be encouraging.

*Keep track of whether the person has actually used the toilet. Sometimes people forget or get distracted. This can help cut down on accidents.

*Make sure you are sensitive when you check in, and make a conscious effort not to be patronising or overly-persistent. Look for signs—like pacing, fidgeting, or tugging on clothing—that suggest the person needs the washroom.

Make Night-time Easier:

People with dementia may feel disoriented or confused when they wake up having to urinate. Caregivers can help them find the bathroom quicker and easier by:

*Installing light motion sensors or night lights

*Having people use a urinal bottle or a commode

*Making sure the person does not drink liquid two hours before they sleep

HOW TO HANDLE ACCIDENTS

Some people may find it very upsetting, while other might accept the issue more readily. Either way, caregivers should be sensitive, direct, and maintain a sense of humour.

Don’t get angry: remember, it is not the person’s fault. Help them get over the embarrassment.

Maintaining Personal Hygiene:  

*It’s important clean up shortly after accidents. If left unattended to, skin irritation and discomfort can occur. Caregivers should that if someone becomes wet or foiled, they clean with soap and warm water. Don’t forget people must dry before putting on clean clothes.  Caregivers should provide assistance as needed

*If clothes can’t be washed right away, they should be put in water in an airtight container until they can be cleaned

*Be aware that moist towelettes can sometimes lead to rashes

Using Incontinence Aids: 

These can help keep clothing, bedding and furniture clean.

*Pads and pull-up underpants (make sure to choose the right absorbency, and to change often)

*Continence sheath for men (a condom which empties into a bag that is attached to the leg)

* Mattress protectors and absorbent bed pads (make sure they do not touch the skin, as they can cause pain and irritation)



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