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INCONTINENCE
Proper use of the toilet requires a complex mixture
of motivation, internal cues, visual recognition and
motor skills—all of which diminish with dementia.
Therefore, as the disease progresses, many people
develop incontinence, or loss of bladder or bowel
control. Typically, an individual first develops
episodic urinary incontinence that slowly progresses
over a period of years to total loss of bladder
control. A similar pattern is seen with bowel
control, which becomes impaired in the latter stages
of dementia. The rapid onset of incontinence
suggests a behavioral or medical change, and should
be evaluated by a physician.
Possible problems:
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Medical problems, such as enlarged prostate
glands and urinary tract infection, or
medication side effects.
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An individual cannot remember where or what the
bathroom is.
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Loss of verbal skills makes them unable to
express their needs.
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Clothing is hard to remove in time.
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Individuals are not able to perceive internal
signals for urination.
Tips:
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Treat the individual with respect and dignity.
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Be understanding and reassuring when accidents
occur.
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Establish a routine; for example, take the
person to the bathroom every two hours while
they are awake.
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Try to respond quickly to an individual's
request for the bathroom.
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Watch for non-verbal cues, such as facial
expressions or tugging on clothing.
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Put up signs (with illustrations) to indicate
the bathroom door.
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Use easy-to-remove clothing, such as those with
elastic waistbands.
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Avoid caffeine and other stimulants in the
evening.
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Continue to let ambulatory individuals use the
bathroom, even if they are managed with adult
continence products, until such efforts are
counter-productive, e.g., the individual fights
during attempts to place them on the toilet.
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Do not give liquids a few hours before bedtime.
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Place a commode in the bedroom at night for easy
access.
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