When you gotta go, you gotta go. But what happens when you don’t know you gotta go? Or when you can’t?
Incontinence and constipation are not, of course, conditions exclusive to people with memory loss. But dementia can increase frequency and certainly makes them trickier to deal with, physically and emotionally.
“It’s not surprising that incontinence and constipation can be sources of great embarrassment for people with dementia,” says Suzy McCann, Community Relations Director of YourLifeTM of Pensacola, a Memory Care community in Pensacola, Florida. “Beyond that, people who fear accidents may avoid activities they enjoy and socializing with others, adding anxiety and depression to their embarrassment.”
In this post, we’ll discuss how to manage your loved one’s private issues respectfully and efficiently to give them the confidence they need to participate in daily activities without embarrassment.
Incontinence can happen to anyone and is more common in older people, especially women. Urinary incontinence can range from occasional to daily episodes and from a few drops to moderate amounts of urine. Non-medical or medical issues could be causing your loved one’s accidents – the good news is, many of these are manageable and treatable. To help determine the cause, consider which type of urinary incontinence your loved one may be experiencing.
Stress Incontinence: leakage of urine when pressure is exerted on the bladder, for example, coughing, sneezing, laughing, exercising, or lifting a heavy object.
Urge Incontinence: sudden, intense urge, followed by involuntary loss of bladder on control. Often this occurs with an increased frequency of urination throughout the day and night.
Overflow Incontinence: frequent or constant dribbling of urine due to the inability to completely empty the bladder.
Functional Incontinence: cognitive impairment or physical impairments such as arthritic hands or limited mobility prevent the person from making it to the toilet in time.
Total Incontinence: the bladder cannot store urine.
Non-Medical Incontinence Triggers for People with Memory Loss
Accident frequency can increase as your loved one’s disease progresses. Dementia may render them unable to communicate toileting needs, cause them to forget how to – or be physically unable to – undress to void, or not recognize they need to urinate until it’s too late. They may refuse to stay on the toilet until completion, become angry, or resist toilet prompting. If they forget where the bathroom is, they may void in inappropriate places (trash cans, potted plants).
The Alzheimer's Association offers these tips for managing incontinence at home:
- Watch for nonverbal cues such as tugging on clothing, restlessness, facial expressions, pacing, sudden silence, or hiding behind furniture.
- Track when accidents occur, then plan for them. If they happen every two hours, set a timer and get the person to the bathroom before that time.
- If the person is mobile, remind the person to use the bathroom just before their usual time.
- Consider using incontinence products, such as waterproof mattress covers, incontinence pads on the person's bed.
- Give the person plenty of time in the bathroom to empty their bladder and bowels.
- Run water in the sink or give the person a drink to stimulate urination.
- Check the toilet to see if the person has urinated and/or moved their bowels.
- Consider padded undergarments or adult briefs. These aren’t your grandmother’s Depends! These sleek, comfortable yet absorbent designs are discreet confidence boosters that allow seniors to participate in daily life without embarrassment or fear. Whatever you do, just don’t call them diapers.
Other Tips for Successful Toileting:
- Avoid displaying frustration, either with the frequency of bathroom trips or cleaning up messes. This can embarrass your loved one and deter them from telling you the next time they have to go.
- Choose pants with elastic waistbands.
- Avoid shirts that hang below the waist – navigating the extra material can waste precious time and, in some cases, be a tempting substitute for toilet tissue.
- Clear signage and lighting can help direct your loved one to the bathroom. Placing a picture of a toilet across from theirs can remind them where they are and why.
- A cold bathroom can be unpleasant to undress or spend adequate time in. Keep temperatures at your loved one’s comfort level.
- Stay near them in the bathroom, or right outside for privacy, reassuring and encouraging them to stay until completion.
- Avoid coffee, tea, or other irritants. Limiting the amount of fluid in the evening may prevent overnight accidents, but never deny water to your thirsty loved one.
- Keep the right supplies on hand, including your loved one’s bedroom and the family cars.
- Medical gloves and moist wipes can make accident clean up easier.
- Barrier creams can be used to protect from skin irritation.
- Use cell phone alarms for bathroom reminders and apps for locating bathrooms when away from home.
Medical-Related Contributors to Incontinence
- Consult your loved one’s doctor if you suspect any of these common culprits:
- Vaginal infection or irritation
- Medications such as diuretics
- Weak bladder or pelvic floor muscles
- Overactive bladder
- Damage to nerves that control the bladder from conditions such as multiple sclerosis, Parkinson’s disease, or Type 2 diabetes (all of which can also increase risk and severity of fecal incontinence)
- Blockage from an enlarged prostate in men; arthritis or declining motor skills that make it difficult to unfasten pants.
RELATED: Bowel (Fecal) Incontinence
About one-third of adults 60 years or older report at least occasional constipation. It may be accompanied by pain and discomfort, be a temporary or recurring problem, or increase confusion, irritability, or aggression in people with dementia. Constipation can also trigger incontinence. It is important to talk to a doctor about constipation issues, as they could indicate a more serious problem.
- Side effects from medications like opiates for pain (Percocet, Oxycontin, Norco), antidepressants, anticonvulsants, and antihistamines
- Medical conditions like tumors, Parkinson’s disease, or hypothyroidism
- Slowing or weakening of the digestive system due to aging or frailty
DailyCaring.com suggests 6 effective home remedies for relieving constipation in seniors:
1. Avoiding constipating foods such as:
- White rice and other refined grains
- Unripe bananas
2. Regularly eating and drinking facilitators such as:
- Whole grains, especially bran
- Fresh and dried fruit
- High-fiber foods
- Water, which softens stool and stimulates the bowel
3. Exercising regularly and as vigorously as possible
4. Establishing a regular bathroom time and also responding immediately to the urge to go
5. Adding a daily soluble fiber supplement like Benefiber or Metamucil to beverages
6. Using laxatives properly
As with incontinence, it is essential to talk with your loved one’s doctor about chronic constipation issues. Consulting a licensed dietitian might also help your loved one get things moving.
Learn about YourLife™ of Pensacola’s promise to deliver dignified, respectful care through all stages of memory loss. Give us a call today. 850-290-2632
The Memory Care Your Loved One Deserves.
Offering the very best in Memory Care, YourLife™ of Pensacola was designed specifically with residents in mind. We’ve created a community where residents can define their own lifestyle, based on their preferences, needs and story, all while having the peace of mind of 24-hour support and the freedom to define their own lifestyles.
Because we focus solely on Memory Care, all our resources and attention are on catering to each resident’s needs while providing unmatched peace of mind for families. Our licensed nurses and YourLife™ Personal Care Specialists are on site 24 hours a day, seven days a week, to provide personally inspired care and support, no matter your needs. With such dedicated care, our residents have the support they need to live as independently and engaged as possible.
At YourLife™ of Pensacola, YourStory comes to life. Whether you want to enjoy our exclusive activities and YourStory programming, spend time exploring our services and amenities, relax in our easy-to-navigate Memory Care neighborhoods and living areas or try something new, the choice is entirely up to you.
Call us at 850-290-2632 for more information or to schedule a personal visit today.