Guide to Coping with Urinary and Fecal Incontinence

Incontinence Can Be a Challenge in Dementia
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One of the challenges as Alzheimer’s disease progresses is urinary and fecal incontinence. Incontinence can be a difficult topic to discuss with others, but it's an important aspect of caring for your loved one.

What Is Incontinence?

Incontinence is the loss of the ability to control urination or bowel movements. In a medical setting, this may be referred to as being incontinent of bowel or bladder, or fecal or urinary incontinence.

How Is Incontinence Related to Dementia?

As dementia progresses, a person’s ability to control his body diminishes. Often in the middle to later stages of Alzheimer’s, people may experience difficulty getting to the bathroom in time. They might not be able to locate it right away, be able to physically move fast enough or recognize the need to urinate. This is complicated by the fact that as individuals age, some people also develop physical conditions or take medications that can cause incontinence.

Incontinence Facts and Figures

According to the Bladder and Bowel Foundation, it's estimated that 60-70 percent of people with dementia develop incontinence. Typically, urinary incontinence develops first and then fecal incontinence follows as dementia progresses.

Urinary and fecal incontinence is one of the top reasons nursing home placement is chosen. Caring for someone who is incontinent can be physically tiring.

This can be compounded at times since your loved one with dementia might not understand what you're doing and react with challenging behaviors such as resistance or combativeness.

Incontinence also increases the financial cost of care. One study published in 2006 estimated that women with frequent urinary incontinence spend an extra $900 per year on supplies such as pads or liners.

Although that study focused on women without dementia, it gives us an idea of the potential increase in cost due to incontinence.

Why Is Incontinence an Important Issue to Address?

Incontinence can affect your loved one’s skin, causing it to be prone to open areas and sores. Incontinence is also a dignity and emotional concern. It can contribute to feelings of depression and embarrassment, and if not handled appropriately, can cause others to react negatively due to odors.

Preventing and Reducing Incontinence

By being proactive, we can adjust some environmental aspects including commode placement and adequate lighting to assist in locating the toilet. We can also anticipate toileting needs by noting typical patterns of urination and bowel movements and bringing the person to the bathroom prior to those times of the day.

7 Tips on How to Respond to Incontinence in Alzheimer's

If you walk into the room and discover that your loved one was incontinent, do you know what to do? Clearly, she will need some assistance in getting cleaned up, but your approach can sometimes make the difference between this being a very difficult part of the day or simply a few minutes of care.

Know When to Get Help

Remember that there are resources available to help you. If the challenges of incontinence are too much for you or your loved one (for example, her skin is breaking down or you're hurting your back), you may need to enlist the help of home health care, the physician, or a nursing home. You might also benefit from a support group, either in person or online where you can exchange ideas and encouragement with others in similar situations. Finally, don't forget to ask your physician for suggestions to handle the challenge of incontinence.


Alzheimer’s Association. Incontinence.

Alzheimer's Association, NYC. Incontinence and Toileting. Accessed July 30, 2012.

Alzheimer Scotland- Action on Dementia. Continence management - advice for carers of people with dementia. Accessed July 23, 2012.

Alzheimer’s Society. Coping with Incontinence.

Bladder and Bowel Foundation. Dementia Including Alzheimer's Disease. Accessed July 31, 2012.

Obstetrics and Gynecology. 2006 April; 107(4): 908–916. The “Costs” of Urinary Incontinence for Women. Accessed July 31, 2012.

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