Managing Incontinence in Patients with Alzheimer’s

A majority of those with Alzheimer’s disease encounter incontinence at some point, though it primarily occurs in the later stages as the disease progresses.

The Fisher Center for Alzheimer’s Research Foundation identifies incontinence as occurring in the moderately severe stage. “The incontinence can be treated, or even initially prevented entirely in many cases, by frequent toileting.” As the disease progresses, other strategies—such as bedding and absorbent garments—become necessary. Other symptoms of this stage include an inability to dress oneself.

For those who encounter incontinence earlier, it is important to visit a physician to rule out incontinence related to a urinary tract infection or side effect of medication.

There are a number of reasons why those with Alzheimer’s encounter incontinence, including failing to understand a prompt from a caregiver to use the toilet or embarrassment at needing help. Some who encounter incontinence may hide soiled clothing and then forget about it. Others may forget what a toilet looks like and relieve themselves somewhere else.

Caregivers should manage intake of fluids and foods, taking care to avoid those with a diuretic effect (such as liquids containing caffeine). A regular routine can assist with toilet issues, as well as many other aspects of Alzheimer’s disease.

Caregivers also should focus on helping the person with Alzheimer’s maintain dignity by respecting their privacy. Dressing in clothing that is easy to remove quickly may help. Identifying the bathroom prominently and adding a bright cover to the toilet to help it stand out can assist a person who has difficulty remembering the bathroom’s location.

Incontinence can be uncomfortable and embarrassing for both the person with Alzheimer’s and the caregiver. Adjustments to routine and environment can help for a time, but it often becomes a regular part of the disease progression.

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Sources:
Alzheimer’s Association https://www.alz.org/care/alzheimers-dementia-incontinence.asp
Alzheimer’s Society https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=136
Bladder and Bowel Foundation https://www.bladderandbowelfoundation.org/bladder/bladder-conditions-and-symptoms/alzheimers-and-incontinence/
Fisher Center for Alzheimer’s Research Foundation https://www.alzinfo.org/understand-alzheimers/clinical-stages-of-alzheimers/