Managing Incontinence in Your Loved One With Dementia

Supporting your loved one through the later stages of dementia often includes helping them manage incontinence, which can be very upsetting for both you and your loved one. Incontinence is especially common in the mid to late stages of dementia.

At The Bill House, we understand the importance of navigating care with confidence and making sure you have the right support in place for your loved one. From supporting dementia residents with personal hygiene to meeting their care needs during the different stages of dementia, our specialist dementia care is tailored to your loved one’s needs, including when incontinence first appears or worsens.

What is incontinence?

Incontinence is the unintentional leakage of urine, faeces or both – which is known as double incontinence. It can affect anyone at any time, but it often increases as people get older due to physical changes or if they are living with dementia.

Urinary incontinence may be a small occasional leak, continued leaking after using the toilet, or a total loss of bladder control. There are several types of urinary incontinence, but one of the most common in people with dementia is an overactive bladder. This causes a sudden, intense need to go to the toilet, often more frequently than usual.

Faecal incontinence is less common, but it can range from accidentally leaking a small amount when breaking wind to having no bowel control at all.

Continence problems usually appear in the mid to late stages, so they are rarely one of the first changes families notice when detecting early signs of dementia in your loved ones.

The link between dementia and incontinence

Individuals living with dementia are more likely to have accidents, incontinence or difficulties using the toilet compared to a person of the same age who does not have dementia. This is because as their cognitive function declines, they may be unable to recognise that they have a full bladder or bowel, or to control them.

Incontinence can develop in your loved one with dementia because:

• Messages between the brain and bladder or bowel don’t work properly: this means your loved one might not be able to feel, interpret or act on physical cues from their bladder or bowels because damaged brain cells stop processing signals correctly.
• They can’t get to the toilet in time: this could be because they can’t react quickly enough to the sensation of needing the toilet, limited mobility or being unable or forgetting how to undo clothing.
• They are unable to tell someone they need the toilet: this could be because your loved one has difficulty communicating or because they are embarrassed or unable to understand an offer of help.

Incontinence is not an inevitable part of dementia, and other causes are common. A urinary tract infection, constipation, prostate problems or the side effects of medication can all affect continence and are often treatable, so it is worth speaking to your loved one’s GP before assuming the cause is dementia. Your GP can also refer you to an NHS continence service for specialist advice and products.

At The Bill House, our staff are dedicated to increasing quality of life with specialist dementia care and can provide expert support for your loved one as they deal with incontinence.

How to manage incontinence in dementia residents

Managing incontinence in dementia is one way in which care homes can support independence for residents. It requires a person-centred approach that focuses on establishing a routine, simplifying clothing, adapting the environment and identifying triggers and cues.

Establish a routine

The value of routine for dementia residents is important because it provides structure, comfort and reassurance for your loved one.

A regular routine can help reduce confusion and anxiety, and a predictable schedule makes it easier to empty the bladder and bowels before problems arise. Offering regular toilet visits, especially after meals and before bedtime, can provide reassurance and support independence.

Sensible fluid and diet management is an important part of supporting brain health, and also helps prevent the dehydration, constipation and urinary infections that can make both types of incontinence worse.

Simplify clothing

Simplifying clothing can help your loved one by reducing physical frustration, shortening the time needed to undress and preserving their independence and dignity during urgent trips to the bathroom.

Clothing that is easy to remove, including elasticated waistbands or Velcro fastenings, can help your loved one reach the toilet more quickly and independently. Avoiding complicated buttons, zips and belts can reduce frustration and the risk of accidents.

Adapt the environment

Adapting your loved one’s environment can reduce spatial confusion, improve visual recognition and remove physical barriers.

These changes target functional incontinence, where your loved one may be unable to physically find, recognise or access the toilet in time, despite having a healthy bladder.

For individuals who struggle with incontinence, making the bathroom easy to find and access can help them manage their toileting needs. Clear signage, good lighting and a familiar bathroom layout can make the environment more accessible and reassuring.

Identify triggers and cues

Being able to identify triggers and cues can provide caregivers with sufficient time to prompt bathroom use before an accident occurs. This helps to preserve your loved one’s dignity and reduce distress.

Changes in behaviour, facial expressions, restlessness or repeatedly going to a particular area may indicate that a person needs to use the toilet, even if they struggle to communicate this verbally.

Recognising these cues allows you to offer timely support and identify patterns that prevent accidents.

Helping your loved one with dementia maintain a healthy bladder and bowel

By helping your loved one to maintain a healthy bladder and bowel, you can help them preserve their dignity and self-esteem, prevent painful physical complications and reduce distress and confusion.

This can be done by encouraging them to:

• Drink plenty of water: staying hydrated helps maintain bladder and bowel function whilst reducing the risk of urinary tract infections and constipation.
• Eat a balanced diet: foods rich in fibre, fruit and vegetables can support regular bowel movements and help prevent constipation.
• Stay active: taking part in nature-based therapy and keeping up hobbies and activities can support healthy digestion, bowel regularity and mobility.

The Bill House provides specialist dementia care

At The Bill House, we understand that helping your loved one deal with dementia and related incontinence can be extremely difficult.

One of the benefits of a dementia diagnosis is being able to get the specialist dementia care and support your loved one needs, to help relieve the pressure from you and your family.

Contact us to find out what to expect when moving into our care home and to see how we can guide your loved one through living with dementia.