Incontinence in dementia often go hand in hand. As dementia progresses, many people lose control of their bladder or bowels. This change can feel overwhelming for both the person and their carer.
In this blog, we explore why incontinence happens in dementia. We also look at practical ways to manage it. By understanding incontinence in dementia, families and carers can offer better support at home.
What are Incontinence and Dementia?
Dementia is a condition that affects how the brain works. It slowly damages memory, thinking, and behaviour. Over time, many people with dementia struggle with using the toilet.
Incontinence means a person cannot fully control their bladder or bowel. It can cause leaks, accidents, or complete loss of control.
Together, incontinence and dementia create a real challenge. People may not know they need the toilet or may forget where it is. This can be upsetting and embarrassing for them.
Why Does Dementia Cause Incontinence?
There are many reasons why dementia leads to incontinence. Let’s look at some of the most common ones:
- Memory Loss: A person might forget the feeling of needing to go.
- Confusion: They may not recognize the bathroom or remember how to get there.
- Mobility Issues: Moving slowly or needing help can delay reaching the toilet.
- Communication Trouble: They may not be able to say what they need.
- Toileting Routine Changes: Dementia can break daily habits.
As a result, many people with dementia start having accidents as the condition gets worse.
Types of Incontinence in Dementia
Knowing the type of incontinence can help you respond better. Here are the main types found in dementia patients:
1. Urge Incontinence
This means a person feels a strong need to urinate right away. They may not make it to the toilet in time.
Example: Mary, age 80, feels the urge suddenly and cannot walk fast enough.
2. Functional Incontinence
This happens when someone cannot reach the toilet due to confusion, poor planning, or slow movement.
Example: Peter knows he needs to go, but forgets the way to the bathroom.
3. Overflow Incontinence
The bladder does not empty fully, causing leaks later. This type is common in men with prostate issues but may also affect people with dementia.
Example: Alan uses the toilet often, but still leaks throughout the day.
Dementia Types and Incontinence
Each type of dementia distinctly affects the brain. This can change how and when incontinence appears.
Alzheimer’s Disease and Incontinence
This is the most common form. People may forget where the toilet is or how to use it.
Example: Janet stops using the toilet and starts having accidents, even though she once managed fine.
Vascular Dementia and Incontinence
This type often affects planning and movement. Incontinence may appear early, especially after a stroke.
Example: After a stroke, David has both memory loss and trouble walking, which leads to accidents.
Lewy Body Dementia and Incontinence
This causes changes in thinking, sleep, and movement. Sudden episodes of confusion are common.
Example: Fiona is fine one day but wakes up wet the next, with no memory of what happened.
Frontotemporal Dementia (FTD) and Incontinence
People with FTD may lose control over their actions and ignore social norms.
Example: Liam removes his pants in public and doesn’t realize it’s wrong.
Home Care Tips for Incontinence and Dementia
Managing incontinence and dementia at home is possible. Here are easy ways to help your loved one stay clean and safe.
Set a Routine
Take them to the toilet at regular times, even if they don’t ask. Try every two hours during the day and once before bed.
Example: Sarah takes her mum to the toilet before meals, walks, and bedtime.
Use Visual Reminders
Add clear signs or photos showing the way to the bathroom. Place a picture of a toilet on the door.
Example: A bold arrow and picture help George find the bathroom without help.
Choose Easy Clothing
Use pants with elastic or Velcro. Avoid buttons, belts, or zippers that take time to undo.
Example: Anna wears pull-up trousers that are simple to remove in a hurry.
Use Incontinence Products
Absorbent pads, waterproof bedding, and toilet seat covers reduce mess and stress.
Example: Mike uses disposable pants and a mattress protector to sleep peacefully.
Healthy Habits that Help
Some simple habits can make a big difference.
Watch Fluid Intake
Encourage water throughout the day, but limit drinks to two hours before bed. Avoid caffeine and alcohol.
Example: Linda gives her dad herbal tea in the morning and stops drinking after 7 p.m.
Keep a Good Diet
Avoid spicy, sugary, or acidic foods that upset the bladder. Add fibre to prevent constipation.
Example: Eric eats soft fruits, grains, and vegetables to keep things moving.
Maintain Skin Care
Clean the skin after every accident. Use soft cloths, pH-balanced wipes, and gentle creams.
Example: Amy changes her mother’s pad right away and applies barrier cream.
Spotting Incontinence Early
You can often see signs before full incontinence begins. Watch for:
- Fidgeting or pacing
- Holding the groin area
- Restlessness or sudden anger
- Soiled clothes or strong smells
Example: When Susan starts wringing her hands, her son guides her to the toilet.
Managing Incontinence at Each Dementia Stage
Dementia has different stages. Knowing what to expect can guide your care.
Early Stage
People may still know when they need the toilet but forget where it is.
Strategy: Offer reminders and install clear bathroom signs.
Middle Stage
They may lose track of time or wait too long before going.
Strategy: Stick to a strict toilet schedule and use pads for protection.
Late Stage
The person may lose all control and need full support.
Strategy: Use a mix of products, bed protection, and gentle care.
Incontinence and Dementia- Adapting Your Home
Make small changes to help with incontinence and dementia.
- Install handrails near the toilet
- Use night lights to light the path
- Remove rugs and clutter that may trip them
- Keep the bathroom door open
Example: Helen added grab bars, and now her father uses the toilet more safely.
Staying Calm and Kind
Accidents can be hard for everyone. But it’s important to stay patient. Never scold or shame the person. Dementia makes it hard for them to know what’s happening.
Speak slowly and use simple words. Offer help with dignity.
Example: Instead of “Why didn’t you say something?”, try “It’s okay, let’s get cleaned up.”
When to See a Doctor
Incontinence can sometimes be treated. A doctor may check for:
- Urinary tract infections
- Constipation
- Diabetes
- Medication side effects
A GP or nurse can also suggest better pads, home changes, or specialist support.
Support for Caregivers
Caring for someone with incontinence and dementia is tiring. Make time to rest. Ask for help when needed. You’re not alone.
Join a support group, speak with a dementia nurse or book respite care.
Example: Paula attends a local carers’ group once a week. It helps her feel seen and supported.
Final Thoughts
Incontinence and dementia are deeply connected. As the brain changes, so does body control. But with planning, patience, and care, people can still live with comfort and dignity.
Use these tips to guide your care. Focus on what the person can still do. And most of all, show love and understanding each day.