July 31, 2023

Four Facts on Dementia and Incontinence

Navigating a new diagnosis of dementia can be challenging for older adults and their loved ones. Even for those who have had dementia for many years, the onset of new symptoms such as bladder or bowel incontinence can be concerning or difficult in many ways.

Incontinence is a topic that can be sensitive to many, and often older adults and their loved ones are reluctant to discuss it with their caregivers or doctor. However, a qualified Alzheimer’s and dementia care provider will understand the care that people with dementia typically require as well as why incontinence is relatively common in this population.

Here are four facts that can help you understand the relationship between dementia and incontinence.

1. Dementia and Incontinence Are Sometimes but not Always Related
‍Dementia and incontinence are both relatively common among older adults. However, many adults with even advanced dementia will remain continent throughout the progression of their disease.

In fact, over 25 million Americans are thought to exhibit some form of incontinence on a daily basis. The vast majority of these will not be related to dementia, however. Make an appointment to speak with your physician or healthcare provider if you or your loved one is experiencing new incontinence and think it is dementia related. Regardless, it is a good idea to speak with a doctor about any new onset incontinence to rule out a more serious underlying cause.

One of the many signs of dementia is losing control of one’s bladder or bowels over a sustained period. In most cases, this is a symptom from the middle to late stages of dementia, meaning that by this point the diagnosis will typically be well-established and other signs of dementia will have already presented as well.

2. Changes in the Brain Can Cause Incontinence
One of the reasons why incontinence is so prevalent in people with dementia is that dementia can damage or destroy the nerve pathways in the brain that are usually responsible for letting a person know they need to go to the bathroom. Another reason is memory-related: As dementia can have severe effects on memory, people with dementia may not remember they need to use the toilet until it is too late to get there in time.

Some people with dementia can recognize and remember they need to use the toilet but will be unable to recall or recognize what the toilet is, where it is and what it looks like.

Sometimes, however, incontinence in people with dementia can be caused by communication and mobility difficulties. If you are unable to communicate that you need to use the toilet or have mobility problems that make it difficult to get undressed and onto the toilet in time, then incontinence may result.

3. There Are Many Emotions Associated with Incontinence in Dementia Patients
People with dementia are often embarrassed or humiliated at the appearance of incontinence episodes. It can be a very frustrating thing to go through for the first time. These feelings are valid and entirely normal. It is important to provide reassurance that caregivers are not upset with them or disappointed and they have not done anything wrong.

Sometimes, people with dementia may try to hide their incontinence, either by pretending they have not been incontinent and not changing their clothing and underwear or by attempting to conceal their soiled clothes and belongings by hiding them in a box or the back of a drawer. Destigmatizing incontinence can go a long way towards reducing these behaviors.

4. Some Strategies Can Reduce Incontinence
Just because a person with dementia experiences occasional incontinence does not mean that it cannot be managed or reduced.

For example, sticking to a regular toileting schedule where one spends a few minutes on the toilet a few times a day can give the body a regular time to go, and has been successfully used in many dementia patients. There are often body language indicators that a person with dementia needs to use the toilet, even if they are unaware or unable to verbalize it. For example, pacing, fidgeting and tugging at clothing or underwear are all common signs that it may be time for a toilet break.

Similarly, planning and preparation are essential to the personal comfort of anyone who experiences incontinence. This can mean things like knowing where the nearest toilet is when you are going out and making sure you pack extra pads or incontinence supplies with you when you are leaving the house for the day.

In-home care services can help you provide the best possible care for a loved one who is experiencing dementia and can offer tips and tricks for managing incontinence and other symptoms as well.