Toileting and incontinence
Dementia can affect many aspects of a person's daily routine, including control over urination or defecation (incontinence). For a lot of us, this can be a touchy or awkward subject because it can be difficult to accept help in this intimate area of our lives, particularly from someone we’re close to.
Tips for reducing accidents
In some situations, bowel or bladder control issues may be preventable. If toileting becomes a challenge, try the following to help with your specific situation:
|Is urine being released with the pressure of a sneeze, cough or laugh? Is the person taking medication that may be causing them to need to go to the bathroom often?
- Make an appointment to get a full medical assessment to rule out treatable medical issues and review medications. It could be a bladder infection, constipation, loss of bladder tone, weakening of control muscles, decreased bladder capacity or, for men, prostate problems.
|Can the person communicate that they need to go?
- Watch for cues that the person needs to use the bathroom. For example, they may get restless, make unusual sounds or faces, or pace around the room.
|Do they understand the body’s message that it is time to go?
- Give the person reminders to go to the toilet regularly, about every two hours or before going out.
|Can the person find the bathroom? Are other objects being mistaken for a toilet? Is the person more confused at night?
- Make the toilet easy to find:
- mark the path on walls and/or floors,
- make sure there are no obstacles,
- label bathroom doors with words or a picture of a toilet.
- Use a contrasting coloured toilet seat, coloured tape around the toilet or coloured water. It may help prevent accidental misses due to loss of perception or vision.
- For men, try putting a decal inside the toilet bowl to have something to “aim at.”
- Put lids on waste paper baskets and other containers that could be mistaken for toilets.
- Remove door locks if the person isn’t able to unlock the door without help.
- Make sure there is good lighting and nightlights in the bathrooms and hallways.
- Change the environment in any way that helps.
|Is it difficult for the person to get up from their bed or chair?
- Install hand rails beside the toilet, bed, or chair, and install a raised toilet seat to make sitting down and getting up easier.
|Are they able to undress in time?
- Choose easy-to-remove clothing, such as velcro closings or elastic waists.
|Is going to the toilet too complicated? Is the person able to go through all the steps, for example, finding the toilet, undressing, etc.?
- Direct the individual to the front of the toilet before removing clothes.
- Give a cue to get started, such as running water, prompting, or showing them what to do.
- Hand the person toilet paper. You may need to help the person get started.
- Using wipes can be easier than toilet paper if you need to wipe for them.
- Give the person some privacy, but stay nearby. Explain that you are “just outside the door if anything is needed.” Make sure there is no medication or dangerous objects the person could have access to.
- If staying seated is a problem, play music or have a favourite item on hand, like a book or a magazine.
- Use a commode toilet or a urinal in the bathroom.
- If accidents happen during the night, consider getting a bedside commode toilet.
Dealing with accidents
Accidents happen. Stay calm and try to ease any embarrassment the person might be feeling.
Keep the person dry and clean. If accidents continue, disposable underwear, panty liners (for women) or protective bedding might be helpful. Use them only if necessary and continue to take the person to the bathroom regularly.
Download our printable tip sheet When Toileting Becomes a Challenge: Tips and Strategies or connect with the staff at your local Alzheimer Society for more information and support.
The Canadian Continence Foundation
Last Updated: 03/27/17
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