- Posted by Samantha Hall
- On October 30, 2017
- 0 Comments
Many of us think of incontinence as being a condition suffered mainly by the elderly. Although young people can also suffer from incontinence, this assumption is on some levels true. Prevalence of urinary and faecal incontinence increases with age, with urinary incontinence affecting around 39% of women over 60, and an estimated 30% of men over 65.
Research conducted over the years has found that seniors with Dementia are much more likely to experience incontinence than those who do not have it. Dementia is a term for a set of symptoms that include memory loss, problems with communicating and mood changes. The most common cause of incontinence is the death of brain cells caused by conditions such as Cerebrovascular Disease or Stroke. Post-traumatic Dementia is directly related to brain cell death caused by injury.
The reasons why so many people with Dementia experience incontinence can vary. It can be due to not being able to act quickly enough, failing to get to the toilet in time and even problems with communication. For many people, messages between the brain and bladder or bowel do not work properly. This can mean they do not realise they have a full bladder or bowel, or do not have the control needed to empty them. This problem often occurs in the late stage of Dementia. Urology specialist Mariama Barrie asserts, “functional difficulties that cause incontinence in seniors with Dementia may include poor mobility, poor dexterity and memory loss.”
Helping a loved one with Dementia and Incontinence
The involuntary loss of urine and faeces is socially stigmatizing. For a person with Dementia, incontinence can be a confusing and distressing experience. They are likely to feel embarrassed, ashamed and angry about the condition. Empathy and an understanding attitude are essential when taking care of someone with Dementia and Incontinence. We are taught to recognise when we need to go the bathroom from a young age, so it is normal and understandable for them to feel all of these emotions. It is therefore important to be supportive and reassure the person that incontinence is a common condition to reduce feelings of embarrassment. Preserving dignity can be as simple as stating how many people suffer from the condition and not making the person feel like a burden or a problem. Respect the need for privacy as much as possible. The Royal College of Nursing, the world’s largest union and professional body for nursing staff states, “An important element of care is to be aware of and sensitive to the features of a person’s life, including their values, feelings and beliefs. Being in need of support, both physically and emotionally, can make anyone vulnerable”.
In addition to ensuring you have an understanding attitude, you can follow these tips to help your loved one to stay healthy and reduce accidents:
- Establish a convenient routine. Try to build going to the toilet into the person’s daily routine, and allow enough time for the person to empty their bowels and bladder. People with Dementia are often uncomfortable with drastic change, therefore making toileting part of a routine can be incredibly effective.
- Make sure they eat a balanced diet with at least five daily portions of fruit and vegetables. Ensure the person with Dementia is getting enough fibre to ensure regular bowel movement. Fibre can be found in cereals, brown rice and potatoes, for example. If a health professional has diagnosed your loved one with an overactive bladder, they may also advise avoiding drinks which may irritate the bladder. This could include replacing tea, coffee, cola or alcohol with water, herbal teas, squash and diluted fruit juices.
- Ensure they are drinking six to eight glasses of fluids each day. Do not withhold fluids. This can cause dehydration, which can even lead to a urinary tract infection. Lack of fluid can even cause agitated behaviour and increased incontinence. Not drinking enough fluids, or not drinking them for long periods of time can cause constipation.
- Make it easier for the person to find their way to the toilet. Managing Dementia and incontinence is often particularly difficult when the person is unclear of their surroundings. By clearing pathways and making their route to the toilet as clear as possible, a person with Dementia will feel more confident and be able to get to the toilet much more quickly and easily. People with Dementia can find it difficult to remember where the toilet is, so a picture of a toilet on the toilet doors, as opposed to a written word, can be useful to help the individual remember where the toilet is. Having a brightly coloured toilet seat in a contrast colour to the bathroom suite or floor is preferable so the person can easily identify the actual toilet.
- Encourage your loved one to stay active. Interestingly, doing gentle exercise every day can help with regular bowel movements. Even small, gentle walks can be effective in increasing their health.
- Ensure they are provided with the correct incontinence products. There are different types of incontinence that your loved one may have. It is firstly vital to establish an accurate continence assessment. This will identify what type of incontinence the individual is experiencing and thus should ensure an appropriate management plan. People who have Dementia may also have a continence issue that is not related to their Dementia, but simply to another disease or due to the ageing process. The condition they are suffering from may be one of the following:
Urge incontinence is the second most common type of incontinence. People with urge incontinence experience an urgent desire to pass urine. Sometimes they pass urine before they are able to reach a toilet. Urge incontinence is caused when the bladder muscle contracts too early and the normal control is reduced. Urge incontinence is commonly experienced by people with certain neurological disorders such as Parkinson’s disease, Multiple Sclerosis, spinal cord injury or after a stroke.
Overflow incontinence occurs when there is an obstruction to the outflow of urine. The obstruction prevents the normal emptying of the bladder. A pool of urine constantly remains in the bladder that cannot empty properly.
Stress incontinence is the most common type of incontinence. It occurs when the pressure in the bladder becomes too great for the bladder outlet to withstand. This is usually caused by weak pelvic floor muscles. Stress incontinence is often related to childbirth, obesity, the menopause and increasing age. With stress incontinence, you will leak when pressure is applied to the bladder.
Nocturnal Enuresis occurs most frequently in children but many adults are also affected by the condition. Symptoms of Nocturnal Enuresis are similar to those of Urge Incontinence with the person experiencing an urgent need to pass urine and being unable to reach a toilet in time. This condition occurs at night time.
Faecal Incontinence, otherwise known as Bowel Incontinence, is an inability to control bowel movements, resulting in the involuntary passage of stools. The experience of faecal incontinence can vary from person to person. Some people feel a sudden, urgent need to go to the toilet, and incontinence occurs because they are unable to reach a toilet in time. Faecal incontinence is not a condition in itself. It is a symptom of an underlying problem or medical condition. Many cases are caused by diarrhoea, constipation, or weakening of the ring of muscle that controls the opening of the anus. It can also be caused by long-term conditions such as Diabetes, Multiple Sclerosis and Dementia.
Once you are aware of the type of incontinence your loved one has, you should ask your specialist to provide you with advice on the most convenient type of product for them.
For guidance on choosing a product for your loved one, you can read our blog on choosing an incontinence product.