Continence

Incontinence is when you have trouble controlling your bladder or bowel movements.

Incontinence can happen to anyone. Dementia can make it harder to know when you need to go to the toilet, what to do when that need happens.

You might find that you:

can’t tell when you need to go to the toilet
can’t wait until you reach the toilet
find it hard to recognise the toilet or use it properly
have trouble emptying your bladder and bowel.

Incontinence can be distressing. If you’re having difficulty with continence, talk to your doctor.

Causes of incontinence

Incontinence can be caused by infection, constipation, menopause and prostate enlargement. It’s possible to treat these conditions.

Your doctor will ask questions and do tests to find out why the incontinence is happening.

Your doctor might ask you:

Are you experiencing incontinence in your bladder or bowel, or both?
How often does it happen?
When did it start?
Does it happen during the day or night, or both?
Is it painful to go to the toilet?
Have you experienced an increase in confusion or any behaviour change?
Have you had a fever?
What medications are you taking?

If they rule out other causes, they might tell you dementia is the most likely cause of your incontinence.

What you can do

Incontinence can be stressful and embarrassing, but there are things you can do.

Drinking

Drink enough water or other fluids. Try around five to eight glasses daily, but small amounts of jelly, custard or ice cream are also okay.
Dementia can make you forget to drink. It can also stop you knowing when you’re thirsty. Set reminders and leave notes to remind yourself to drink.
Reduce how much you drink before bedtime.
Caffeine makes you urinate more. Drink less coffee, tea or cola. Try decaffeinated versions.
Reduce alcohol and fizzy drinks, as these can irritate your bladder.

Setting up the toilet

Put clear signs on both sides of the toilet door at eye level. They’ll help you understand where you are and what you’re there for.
Make your toilet seat a different colour to the floor, so it’s easy to recognise.
Choose a toilet paper that’s a different colour to the wall.
Colour the water in the cistern with food dye or a cleaning tablet. This will help you identify the toilet bowl.
Install a raised toilet seat and handrails to help you get on and off the toilet.
Make sure the toilet seat is attached securely to reduce the risk of slipping.
Remove floor mats to prevent tripping.

Creating a comfortable environment

Ensure your mobility aids are always within reach.
Is your bed too high or low? Do you have difficulty getting in and out? If so, consider replacing the bed.
Use a night light or a motion sensor light so it’s easier to see at night.
Leave the bedroom and toilet doors open so it’s easy to get to.
Use a waterproof bed sheet to keep your bed dry.

Clothes

Buy clothes with elastic or velcro that are easy to get off and on.
Buy machine-washable clothing.
Try adult continence underwear or disposable pads.

Skin care

Clean and dry your skin to prevent rashes. Your doctor or local chemist can suggest soaps and skin creams.
Wear a layer of fabric under protective plastic. Plastic can irritate your skin.

Caring for someone with incontinence

Caring for someone with dementia who is experiencing incontinence can be challenging. But there are things you can do to make the situation less stressful for them and for yourself.

Suggest toilet breaks at times that follow their usual bowel or bladder patterns.
Watch for reactions that indicate they need to go to the toilet. They may pull on their clothes, get agitated or their face may become flushed. If they need to go, don’t rush.
If they’re restless and don’t want to sit on the toilet, let them to get up and down a few times. Music may calm them. Or try giving them something to hold to distract them.
Use short, simple words and give step-by-step instructions.
Make the toilet area more private, if this is a concern for the person.
Remove any objects that they may mistake for a toilet.

For more information and support, contact the Continence Foundation of Australia.