Incontinence (loss of bladder or bowel control) frequently develops as Alzheimer’s worsens, especially in the middle and late stages. Incontinence has a wide range of causes and management options. The way you respond can help your dementia patient maintain a sense of dignity.
Some common causes of incontinence include the inability to identify natural urges, difficulty locating the bathroom, or adverse effects from medicine.
Causes of incontinence
If an Alzheimer’s patient has recently begun to lose control of their bladder and bowels, the first and most crucial step is the identification of potential causes. A physician should rule out any medical issues.
The following are common causes of incontinence:
- Urinary tract infection, constipation, or prostate dysfunction.
- Diabetes, stroke, or a muscular condition (like Parkinson’s disease).
- Physical impairments that make it difficult for the patient to reach the restroom on time.
Medications and diuretics
- Drugs that lower anxiety and those used to treat insomnia may relax bladder muscles.
- Coffee, tea, and other caffeinated beverages can function as diuretics, which cause increased urination.
Environment and clothing obstacles
- Ensure that the patient can locate the bathroom.
- Make the path to the bathroom clear by removing any furniture or clutter; make the path well-lit.
- Provide clothing that is simple to remove.
- When traveling away from home, have an additional set of clothes in case of an accident.
Do not limit liquid intake. It could lead to a urinary tract infection, increased incontinence, and dehydration.
TIPS TO COPE WITH INCONTINENCE IN ALZHEIMER’S PATIENTS
Although incontinence is more common in the middle or late stages of Alzheimer’s, each case is distinct. The following suggestions can assist caregivers of Alzheimer’s patients with incontinence.
- Bladder or bowel accidents can be humiliating. Find ways to maintain your loved one’s dignity. For instance, instead of saying, “You wet yourself,” say, “It’s okay anyone can have an accident.”
- Be direct; do not reprimand or make the person feel bad.
- Always respect your loved one’s demand for privacy.
- Encourage the person to use the restroom frequently and to let you know when they need to.
- Look for nonverbal cues such as pulling at clothing, restlessness, pacing, abrupt stillness, facial expressions, or hiding in nooks or under furniture. These cues suggest that they need to go to the bathroom.
- When referring to using the restroom, use adult terminology rather than baby talk.
- Learn the “trigger” words or phrases the individual uses when they need to use the bathroom. Even though they may say things that have nothing to do with going to the restroom, like “I can’t find the light,” you should know that they need to use it.
HELP YOUR PATIENT LOCATE AND USE THE TOILET INDEPENDENTLY
- Rearrange the furniture to clear the path to the bathroom.
- Keep the bathroom door ajar so your patient can see the toilet.
- Attach a toilet sign to the bathroom door.
- Paint the bathroom door a color that contrasts with the wall.
- Ensure that the toilet is secure and easy to use. Raising the toilet seat, installing grab bars on both sides of the restroom, and using nightlights to brighten the bedroom and bath are just a few examples.
- To make the toilet stand out, use colored rugs on the bathroom floor and colored toilet lids.
- To prepare for accidents at night, think about purchasing a portable toilet or urinal for the bedroom.
- Get rid of any plants, trash cans, or other items that could be mistaken for a toilet.
- Remove any throw rugs that could lead to tripping or a fall.
- Observe and determine the person’s regular timetable for using the restroom.
- Remind the individual to use the restroom a few minutes before their scheduled time.
- Set up a regular timetable for using the restroom. Help the individual to the bathroom, for instance, first thing in the morning, every two hours throughout the day, just after meals, and right before bed.
- Determine when incidents happen and make a plan for them. Get the person to the bathroom before their scheduled time if they occur every two hours.
- Limit the fluid intake of your patient before bedtime.
KEEP THE FOLLOW-UP
- Examine the toilet to see if the patient has used it.
- Assist the person in wiping and flushing the toilet as required.
- Wash the sensitive skin parts regularly.
CONTROL FLUID INTAKE
- Encourage fluid intake in general, but reduce fluid consumption before bedtime.
- Reduce your patient’s intake of liquids that stimulate urination, such as cola, tea, and coffee.
7 ELDERLY TOILETING TIPS FOR FAMILY CAREGIVERS
- Use easy-to-remove and easy-to-clean clothing.
- Think about utilizing incontinence items like rubber sheets, incontinence pads on the person’s bed, padded underwear, or adult briefs.
- Allow the person plenty of time in the restroom to empty their bowel and bladder.
- To encourage urination, run water in the sink or give your Alzheimer’s patient a drink.
- Check the restroom to see if the user has urinated or emptied their bowels.
- Assist the person in flushing and wiping the toilet.
- Apply powder or ointment to sensitive skin areas and wash them frequently.