Alzheimer's Foundation of America

Foundation of America

Managing Incontinence

Incontinence can be common in individuals living with dementia-related illnesses, and is nothing to be ashamed of. Dementia-related illnesses cause functional abilities to decline. They can inhibit someone from reacting quickly enough to the urge to use the bathroom.

Dementia-related illnesses may also limit the individual’s ability to recognize that they need to go—particularly in later stages. There may be difficulties remembering the toileting process, or remembering where the bathroom is located. Individuals may have difficulty communicating their needs, which complicates one’s bathroom-related needs. As a result, individuals with dementia are more likely to experience incontinence—difficulty controlling one’s bladder and/or bowels. Soiled underwear and bed sheets, leaking urine and problems going to the toilet are all signs of incontinence.

Is incontinence treatable?

Although incontinence affects people with dementia, it may not always be due to the illness itself. Incontinence can also stem from a variety of treatable conditions, including:

• Urinary tract infections
• Diet (caffeinated/carbonated drinks, chocolate, citrus fruits, and sugary/spicy/acidic foods can all stimulate the bladder)
• Medications
• Dehydration (highly concentrated urine can irritate the bladder)

Speak to your loved one’s physician when they experience incontinence, as there may be treatments that can help.

Preventing accidents with incontinence

While it’s not always preventable, caregivers can take steps to reduce the chances of an accident:

• Be proactive. Remind the individual to use the toilet periodically—don’t wait for them to ask. If you’re going out in public, plan time for bathroom stops. Schedule regular trips to the bathroom.
• Help them remember. Take the person to the bathroom or show them where it is.
• Look for warning signs. Watch for any pulling on clothes or other behavior that may signal a need to use the toilet.
• Keep things loose. Loose, comfortable clothing that’s easily removed (i.e., pants with elastic waistbands rather than buttons and zippers) makes toileting easier.
• Improve visibility and accessibility of the bathroom. Make sure the door is open and there is a light on. You can also label the door or provide a pictorial cue.
• Limit fluids in the evening. This makes overnight accidents less likely.
• If there are accidents during the night, try putting a portable commode near your loved one’s bed.

Incontinence supplies, such as adult diapers (or incontinence briefs that resemble underpants) or bed protectors (a waterproof mattress cover protects the mattress and large bed pads can protect the bedding), can be helpful. They are available at drug stores and medical supply stores.

When accidents occur

Maintain dignity. Incontinence can be embarrassing or depressing for the person experiencing it, so try to be understanding and avoid looking angry or upset. Staying calm and reassuring with your person will help both you and them.

Additional caregiver resources

Dealing with a loved one’s incontinence can be upsetting. Adult children may feel uncomfortable or anxious about the role reversal of helping their parent in the bathroom. Spouses and partners may feel a shift in their relationship. Talking about these natural feelings, in a support group or with a professional or trusted confidant, can be helpful. If it proves too difficult to comfortably help your loved one, look for a trained professional to meet both your loved one’s needs and those of your family.

AFA’s licensed social workers can provide you with additional information. Connect with them 7 days a week through the AFA Helpline by calling 866-232-8484, webchat, or sending a text message to 646-586-5283.

Related Articles and Resources

Role changes in Early-Onset Alzheimer’s Disease

Read more…

Understanding Behaviors as Forms of Communication

Read more…

Newly Diagnosed – Now What?

Read more…