Currently there are about 900,000 people with Dementia in the UK. It is projected that over 1 million people will have Dementia in the UK by 2025.
Dementia mainly affects people over the age of 65, though dementia can affect younger people too.
People with dementia face the same risk of developing incontinence as they grow older as the general population. Incontinence could also be caused in people who have dementia by something that is easily treated such as:
- A urinary tract infection
- Constipation caused by a poor diet or dehydration
- Problems with the prostate in men
- Certain medications
In order to remain continent and use traditional toileting facilities on own, a person requires several interrelated cognitive and physical skills. This chain can be broken at any time due to disease, disability, environmental events. In some cases, the messages between the brain and the bladder and/or bowel may not function correctly, and this can lead to incontinence, which may include:
- Not being able to react to the sensation of urination and emptying bowels
- Mobility issues
- Not being able to communicate their need to void
- Forgetting how to go to the toilet e.g., forgetting to remove clothing
- Not trying to find the toilet
- Getting disorientated and forgetting where the toilet is
There are ways of managing incontinence caused by dementia by using conservative methods, which can be easily incorporated into a routine during the day.
Diet and Lifestyle
To keep bladder and bowel healthy it is important that the person concerned eats a healthy and balanced diet with plenty of fibre and fluid intake. It is best to limit or avoid caffeine, fizzy drinks and alcohol which can irritate the bladder.
Individual routine management is essential to maximise the person’s self-care ability. Creating a routine can help to avoid accidents. Toileting assistance can be in form of taking the person to the toilet after every meal and make sure they are eating and drinking at regular time. Limit drinks two hours before bedtime to avoid accidents overnight, it is important to make sure that they have had enough to drink during the day.
There are number of things that can be done to improve a person’s ability to remain continent and reduce incontinence episodes.
Appropriate clothing will help with easily removal, elasticated waists without zips and buttons can help those who struggle with dexterity and need to manage urge incontinence.
Limited and restricted mobility can be improved with use of walking aids, handrails, commodes etc.
Toilet environment should be kept uncluttered and as accessible as possible.
Continence products may be required in order to main skin integrity and a person’s dignity.
Incontinence pads and pants – these are available in variety of sizes and absorbencies to help draw fluids away from the skin and to allow management of light to heavy incontinence.
Male continence sheath – these can be worn over the penis and attached to a leg bag.
Bed pads and mattress protectors – these can help keep the hard to clean surfaces like beds, chairs, car seats clean and dry.
Managing continence for people with dementia is complex due to the nature of the disease. Management should also be aimed at maintaining self-care and independence for as long as possible whilst ensuring the patient’s comfort and dignity.
- Alzheimers Society (2021) Toilet problems, Continence and Dementia
- Alzheimers Society (2022) How many people have Dementia in UK?
- Independent Nurse (2014) Understanding Incontinence in People Dementia