Many people with dementia experience bladder and/or bowel incontinence. Here, we share expert advice for managing these difficulties.
Incontinence is the unintentional passing of urine (urinary incontinence) or faeces (faecal incontinence). Some people have both types (double incontinence).
Problems with incontinence and using the toilet may be due to dementia itself, or other reasons such as physical health conditions.
Incontinence can be distressing for the person with dementia and those who care for them. However, there are ways to manage incontinence and maintain their dignity.
Reasons for incontinence in a person with dementia include:
Many physical conditions can also cause incontinence, including:
If a person with dementia is experiencing incontinence, book a check-up with their GP, as some causes can be treatable.
You can also arrange an assessment with an NHS continence service – you can request this yourself, or ask the GP to refer you.
These clinics are staffed by specialists who can investigate the causes of incontinence, suggest treatments that may help, and advise you on managing the problem.
A person with dementia may need you to guide them to the toilet.
You might need to help them with their clothes, but if possible, encourage them to do it themselves in small steps: for instance, “Can you undo your zip? Now can you pull down your trousers?”
Loose clothes such as tracksuit bottoms, or clothes with Velcro fastenings, might be easier for some people.
The person may need you to help them sit down on the toilet – but if it’s appropriate, give them some privacy while staying close by. If they stand to urinate, encourage them to sit down at least once a day to open their bowels.
Allow the person plenty of time to use the toilet, then check the bowl to see if they have passed urine or stools. If you notice any irregularities, such as blood, inform their GP or nurse.
Afterwards, encourage or help them to wipe themselves and wash their hands.
There are many protective products for incontinence, including pads, disposable pants, bed and chair protection such as absorbent mats and waterproof sheets and adapted clothing.
Some of these may be available free of charge on the NHS. They are also readily available from pharmacies, some supermarkets and online.
The person’s district nurse or a continence clinic adviser can help you decide which products to use.
Wet and soiled skin is more prone to sores and infections, so it’s important to help the person with dementia stay clean and dry using soap-free products. Pat the skin dry gently.
If you use barrier creams or ointments, be aware that they can reduce the absorbency of incontinence products.
If the skin becomes red or broken, arrange an urgent appointment with the person’s GP to prevent infections and further skin damage.
To speak to a specialist Admiral Nurse about continence or any other aspect of dementia, please call our free Dementia Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm, every day except 25th December), email helpline@dementiauk.org or you can book a phone or virtual appointment with an Admiral Nurse.
You may also find the following helpful:
Our free, confidential Dementia Helpline is staffed by our dementia specialist Admiral Nurses who provide information, advice and support with any aspect of dementia.
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