Dementia is an irreversible cognitive condition that affects millions of people worldwide, affecting memory and cognitive skills, and eventually leaving the person dependent on daily care. Incontinence, both urinary and fecal, are often present in dementia patients.
Nursing home residents with dementia are twice as likely to have urinary incontinence as their peers without dementia, since the brain damage caused by the disease also affects the ability to control the bladder. In addition, many of the incontinence problems experienced by dementia are due to functional incontinence.
Incontinence in dementia patients can be caused by a number of factors, including certain medications, physical or medical conditions, stress, or not being able to recognize or find the bathroom. If a person with dementia suddenly starts experiencing incontinence, consulting with a health care professional to determine the possible cause is important.
For patients with dementia, the loss of bladder control is likely inevitable with time, but several things can be done to help the dementia patient remain independent and maintain a high quality of life for as long as possible.
A thorough check of medications by a health care professional can determine if medications or diet are causing incontinence, or perhaps making it worse. Sleeping pills and anxiety-reducing drugs may relax the bladder muscles, while certain beverages can work as diuretics or irritate the bladder. In addition, medical conditions such as urinary tract infections, prostate problems or diabetes may be making incontinence symptoms worse.
Lastly, check for environmental or functional obstacles that contribute to incontinence. For patients with dementia, this may include barriers or obstacles on the way to the bathrooms or clothing that is difficult to remove. By removing or limiting functional barriers, independence and quality of life can be maintained for a longer period of time.
Navigating the special care needs of patients or residents with dementia and incontinence is difficult and time consuming. Continence care takes up a great deal of effort and care when it comes to overall care for a dementia patient.
Poorly managed continence care affects overall health and creates extra work load in the form of laundry, washing, bathing and changing clothes. All of these activities can be stressful for a dementia patient, who, depending on the progression of their illness, may either be embarrassed or stressed about the situation, or may not understand why they have to be bathed by a stranger.
If a patient uses incontinence products, minimizing the amount of product changes while still avoiding leaks can be a major challenge. It is important to choose the right incontinence product and take the condition into account when choosing.
Patients with incontinence are at extra risk of developing skin conditions related to incontinence, such as incontence associated dermatitis, and urinary tract infections. To avoid these, ensure they do not spend time in wet products or bedding and take preventive skin care measures to avoid IAD.
Developing an individual routine, based on the continence pattern, progression of dementia and overall health of the dementia patient, is essential for good continence care. For some, a toileting program may be recommended, with automatic reminders and timetables to prompt a visit to the toilet or changing of an incontinence product.
Patients with dementia are especially prone to bedsores and incontinence associated skin disorders. Dry and thin skin is extra sensitive to skin problems, especially when exposed to urine or feces over a longer period of time. This gives bacteria and yeast the chance to grow and crawl under the skin. That is why it important to pay special attention to the skin in order to avoid rashes, infections and wounds.
Good hygiene and the right choice and use of incontinence product is vital to preventing incontinence associated skin conditions and maintaining a high quality of life. Enforce routines to take preventive skin care measures to avoid IAD.
It can be difficult to approach the topic of using incontinence products with a person suffering from dementia, as it in most cases requires accept by the person concerned. If the person is still lucid but has not accepted that they suffer from incontinence, they may not be able to be convinced to use continence aids.
Incontinence products should be chosen individually based on the type, cause and needs of the individual dementia patient, and it is important to promote and maintain self-management for as long as possible to promote independence and acceptance.
Be aware that patients with dementia may try to remove the product, for these people a snug fitting product with fixation pants may be a good option. For those patients who want to maintain independence, discrete pull-up pants can be a good choice.
Supplement incontinence products with bed protection and skin care products as needed.
Types of incontinence
There are several different types of incontinence.
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