Alzheimer's and Incontinence: Answers to Caregiver Questions
Caring for someone with Alzheimer's can be a very trying experience, especially for someone who is not formally trained to do so. We have prepared some frequently asked questions and answers regarding Alzheimer's and incontinence that we hope will be helpful.
Q: Typically at what stage of Alzheimer's does incontinence occur?
A: Inevitably at stage 7 of Alzheimer's, a person will experience a loss of control over their movements, including their bowel and bladder muscles. Though, it is important to remember that every person living with Alzheimer's experiences different symptoms, so it is not uncommon for someone in the middle stages to be incontinent.
Q: What are the causes of incontinence in people living with Alzheimer's?
A: The causes of incontinence vary depending on the person with Alzheimer's. It could be a temporary incontinence because of the medicine your loved one was prescribed, or it could be a urinary tract infection (UTI). It could be due to the signals that are normally sent to the brain to let a person know the need to use the bathroom are no longer functioning. Also, it may be that your loved one is not able to recognize the need to use the bathroom anymore. Incontinence could be caused by the inability to locate the bathroom or they may not be able to remove their clothes in time.
Q: What should I do if my loved one constantly wets the bed?
A: Limit the amount of drinks they have at night. It may be easier for them to have a portable commode next to their bed, so they do not have to search their home or rush to the bathroom. Also, try using an overnight incontinence product like an underpad sheet or disposable absorbent underwear. If your loved one isn't used to the idea of sleeping with an incontinence product, place the underpad sheet underneath the bed sheets to cut down on having urine soak into their mattress.
Q: My loved one forgets the location of the bathroom. What should I do to help my loved one find the bathroom?
A: Try leaving the bathroom door open. Using colored duct tape you can make a path that leads into the bathroom. Also, post a picture of a toilet on the bathroom door, this can help your loved recognize what is in the room. Install night lights in the bathroom, especially making sure to light up areas near the toilet, so if the sun goes down and the house is dark enough the night lights will go on. Changing the color of the toilet seat can help your loved one distinguish between the toilet and the floor. Make sure that the toilet is comfortable for the person, by raising the toilet itself and by adding grab bars to hold on to.
Q: My loved one makes it to the bathroom, but once inside forgets the process.
A: This is a typical problem that many Alzheimer's patients have; the best solution is for you to enter the bathroom with them giving them either step by step instructions or for you to assist them in the process.
Q: Could it be a Urinary Tract Infection (UTI)?
A: Yes, it could be. Don't rely on asking your loved one if it hurts when they use the bathroom, it could be considered a 'silent' UTI, meaning there may be no symptoms. It is best to go see a doctor right away to either diagnose or eliminate the reason for incontinence being an UTI.
Q: What are some tips to traveling with an incontinent loved one?
A: Locate where the bathrooms are in a building when first arriving. If traveling by driving, be sure to make frequent rest stops to allow the person to use the bathroom. Don't be afraid to either use the family bathroom, or if not provided to take your loved one that's a member of the opposite sex into a women's or men's bathroom with you, using the handicap stall. Men feel more comfortable bringing their wives or mothers into the men's restroom, while women feel more comfortable bringing their husbands or fathers into the women's restroom. Be prepared and bring extra incontinence products, wipes, and an extra change of clothes
Q: What signs can I look for that my loved one needs to use the bathroom?
A: Signs for bathroom use include restlessness, tugging at pants, pacing, crossing legs and putting hands near their genitals.
Q: What should I do if my loved one doesn't realize they had an accident?
A: The best way to go about this is to not punish them for having the accident. Use the “I think you spilled something on yourself” approach, rather than the “why didn't you just tell me that you needed to use the bathroom?” approach. Simply have your loved one follow you to have them get a new set of clothes on.
Q: My loved one keeps sticking his/her hands down their incontinence products and plays with its contents. Is there any way to prevent this?
A: Try using the incontinence log to monitor when your loved one uses the bathroom or has an accident. By knowing what the bowel movements are you can get your loved one to the toilet before they have contents to play with. Another alternative would be to make sure you have the right size incontinence product so that they are not too loose. Also, using a belt helps to limit the amount of room that your loved one will have to put their hands in.
Q: My Alzheimer loved one has been having accidents recently, how do I take him/her out for a while with avoiding having an embarrassing accident?
A: Don't be afraid to ask your loved one to wear “special panties” when you two have plans to go out. You don't want either of you to miss special events like a graduation party or a wedding because of you or your loved ones dignity. Simply bring extra products and a change of clothes to wear, to be on the safe side.
Q: My loved one doesn't want to wear incontinence products. They think of them as something young children wear. How can I get him/her to change her mind?
A: Simply tell them the truth. Tell them that incontinence briefs are back up just in case they don't make it to the bathroom on time. It will make both of your lives less stressful, because for as much as you want them to be able to use the bathroom correctly, they do too. Don't give them a choice by asking them whether or not they would like to wear them, incorporate it in their routine of getting dressed in the morning. Also, make sure to not refer to them as diapers or by their brand name, this will have a negative connotation associated that your loved one may recognize.
Q: My loved one feels the need to go to the bathroom every few minutes, why could this be?
A: One possible reason could be either your loved one is constipated or has an impaction. Another reason could be that he/she may possibly have an UTI. The problem can also be linked to urge incontinence, the frequent and sudden urge to urinate with little bladder control. They may be nervous to have an accident and would rather not chance it by not using the bathroom. It is best to schedule an appointment with a doctor to determine what the possible cause could be.
Q: On occasion, my loved one forgets to wipe after using the bathroom. It makes it harder to clean up, any solutions?
A: You can use flushable wipes when you notice that your loved one forgot to wipe. At some point you are going to have to enter the bathroom with them if it gets to be an everyday problem. When you get to this point, it may be easier to give them a quick wipe when you are helping them to stand up. They may not even realize that you are wiping because they are focused on getting off of the toilet and pulling their pants back up.
Q: I've noticed that my loved one doesn't wash their hands after using the restroom? What can I do to help?
A: Try giving them a squirt of hand sanitizer when they get out of the bathroom, or tell them you are going to pamper them for a few minutes. Then take a warm, soapy wash cloth to their hands then rub in their favorite lotion.
Q: My loved one can spend hours sitting on the toilet, why?
A: Just as you are concerned with your loved one making it to the bathroom on time, they are discouraged by it too. They could be sitting on the toilet because they are afraid of having an accident. However, don't overlook the possibility of constipation or a UTI. It is best to schedule a doctor's appointment to make sure.
Q: My loved one has anxiety over using the bathroom; he/she won't let me to help them. How can I help without intruding on their privacy?
A: If they are worried about their privacy, tell them that you will turn away or leave the room once they are sitting on the toilet. It is best to continue to treat them with respect, and after a few minutes of them sitting on the toilet, come back and check in on them, looking to see if they went to the bathroom. If it's embarrassing for you, imagine how they must feel when they have an accident that causes a mess. It is better that you assist your loved one for their safety and to avoid a clean up on your part.
Q: Could medicine affect my loved one's bladder?
A: Yes, several medications can cause muscles that control bladder and bowl movements to ease, causing incontinence, it is best to see a doctor as soon as possible to make sure that the medicine they are taking is not interfering with your loved ones ability to use the bathroom. Use the Incontinence Log to track occurrences and identify incontinence issues.
Q: What are the signs that my loved one should start wearing incontinence products?
A: Typically a loved one should begin wearing incontinence products when you notice that they are unable to reach the toilet in time, they cannot remember where the bathroom is located, can't remember what to do when they get to the bathroom, or if they confuse objects for the toilet, like a waste basket. If multiple accidents keep occurring from any of these reasons, it may be time to use incontinence products, whether it’s an absorbent pad or an adult brief.
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