Dementia and Incontinence: What You Should Know

Did you know that more than 55 million people around the world are living with dementia - with this number expected to double within the next 20 years or so? Around half of people with dementia will also experience some form of incontinence, which can lead to low self-esteem and feelings of embarrassment.

Since dementia is a progressive disease, you can generally expect incontinence symptoms to also worsen over time. While this reality may sound intimidating, the good news is there are many ways you can manage this condition.

Whether you have been diagnosed with dementia yourself or care for someone with this condition, equipping yourself with the right tools and knowledge is absolutely essential.

In this article, we'll examine both conditions closely to help you understand how dementia and incontinence are linked. We'll also discuss symptoms, causes, and the most effective management techniques.

The Link Between Dementia and Incontinence

Dementia is a collective term used to refer to several diseases that affect a person's cognitive abilities, including memory and thinking. It is typically only prevalent in older adults (65+), and the risk increases as you age.

There are over 100 different types of dementia, and they all work in slightly different ways. For example, vascular dementia happens when there isn't enough blood flow to the brain, which leads to damage to brain cells.

Since dementia causes a decline in brain functionality, the signals between the brain and bladder can get confused. This confusion, as well as memory issues, is what often leads to incontinence, although there can be many other factors at play.

There are two main types of incontinence that people experience, namely:

• Urinary incontinence: Loss of bladder control, leading to urine leaks.

• Faecal incontinence: Loss of bowel control, leading to stool leaks.

Those with dementia are generally more likely to experience urinary incontinence than faecal incontinence but can experience both. When someone experiences both types, it is referred to as double incontinence.

Incontinence usually only occurs in the middle and late stages of dementia, but there are also many cases of premature transition where people develop incontinence in the early stages of dementia.

Symptoms

Some of the most common symptoms associated with dementia include:

• Loss of memory

• Difficulty concentrating

• Struggling with daily tasks

• Mood changes

• Communication challenges

Additionally, some of the most common symptoms associated with incontinence include:

• Overactive bladder

• Difficulty urinating

• Lose control of bladder and bowel movements

• Urine and/or stool leaks

• Bowel problems

Risk factors

You may have a greater risk of developing dementia if you:

• Have high blood pressure and blood sugar

• Are overweight or obese

• Smoke cigarettes

• Drink alcohol

• Don't exercise

• Suffer from depression

• Have suffered a traumatic brain injury

Therefore, you can greatly reduce your risk of developing dementia by leading a healthy and active lifestyle. The sooner you start, the better. By lowering your risk of dementia, you're also lowering your risk of incontinence.

Causes Of Incontinence in People with Dementia

While people with dementia often develop incontinence due to cognitive decline, there may be other contributing factors, including:

Medications

Certain medications commonly used by people living with dementia can act as diuretics and lead to incontinence problems.

Obstacles

A person with dementia may find it difficult to navigate steps, doors, and other obstacles standing between them and the bathroom. Clothing with zips, buttons, and clasps may also pose a problem. This can lead to functional incontinence.

Underlying medical conditions

The person could have other contributing medical conditions, including:

• Diabetes

• Parkinson's disease

• Prostate issues

• Constipation

• Stroke

• Physical disabilities

The above conditions are also typically prevalent in older adults and can lead to things like urine leaks, frequent urination, and loss of bladder and bowel control.

Managing Incontinence in People with Dementia

Here are a few ways in which you can help manage incontinence symptoms if you are living with dementia or caring for someone with dementia.

Incontinence pads

Incontinence pads and leak-proof underwear are among the best ways to manage incontinence and avoid accidents. These products are designed to absorb urine and keep moisture away from the skin so that the user can go about their day with confidence. Other aids you may want to use include waterproof mattress covers.

Here at Jude, our bamboo pads have been designed to hold up to 5 teaspoons of urine while remaining odour-free. Additionally, our washable incontinence underwear has been created with comfort, functionality, and style in mind.

Medication

It is important to discuss medication with your doctor to consider options. One class of medications sometimes prescribed for overactive bladder or urge incontinence are called anticholinergics. These have actually been linked to worsening memory problems hence they typically should not be prescribed in people living with dementia. However, there may be other types of medication including mirabegron which may be considered for those with overactive bladder or urge incontinence symptoms.

Showing understanding

If you care for a person with dementia, their incontinence symptoms may be difficult to deal with at times. Managing faecal incontinence can be especially challenging. So, it's essential that you show compassion and understanding to maintain a healthy relationship.

Practice open communication and talk about the 'accidents' in a matter-of-fact tone. If the person has communication difficulties, look out for signs (such as fidgeting and facial expressions) that they may need to use the bathroom. Never make the person feel guilty about their continence problems.

Making the toilet more accessible

In the later stages of dementia, the person may forget where the toilet is located. You can help by removing any obstacles, creating a sign on the bathroom door, introducing an elevated toilet seat and safety bars, and keeping a portable toilet in the bedroom. The support of an occupational therapist can be helpful in getting special equipment and you can access this through your GP.

These days, there are plenty of continence aids out there to make using the toilet easier and more accessible.

Avoiding 'trigger' foods

Did you know that certain foods and drinks can irritate the bladder and bowels, leading to worsened incontinence symptoms? Some of the foods that should be avoided include:

• Tea and coffee (caffeine)

• Acidic food, like tomatoes

• Foods or drinks containing artificial sweeteners

• Citrus fruits

• Carbonated beverages

• Alcohol

Maintaining and improving bladder health

Living a healthy lifestyle can help maintain and even improve bladder health over time. Some changes that may help include increasing fluid intake, eating a balanced diet (full of fibre), participating in regular exercise (if possible), and performing pelvic floor exercises.

Improving bladder and bowel health can minimise the number of times accidents occur.

Prioritising hygiene

Depending on the stage of the person's dementia, they may need help wiping and cleaning themselves. Maintaining proper hygiene and personal care is essential if you want to avoid skin irritation and more serious issues like infection.

Creating a toilet schedule

Try to understand when the person in your care uses the bathroom or has an accident. From here, you can create a toilet schedule and remind them to use the bathroom at certain times throughout the day.

Additional Tips for Carers

Looking after someone with dementia and incontinence issues can be a tiresome and time-consuming task. It requires patience, attention to detail, and even physical strength at times.

If you are simply a friend or family member, there may come a stage when you need to seek professional help caring for a person with dementia. The carer's burden can be a heavy one to carry, and you shouldn't feel guilty if you can't handle the needs of your loved one all on your own.

There are other options available to you, including in-home care workers, adult daycare programmes, assisted living facilities, and more. If you need professional advice, you could always speak to a continence advisor.

FAQs

What are some of the other most common causes of incontinence?

The causes of urinary incontinence can be quite complex, but some of the most common causes include weakened pelvic floor muscles due to age or abdominal trauma, health conditions, pregnancy, constipation, nerve damage, and lifestyle factors.

Urinary incontinence is a very common symptom for anyone who has a urinary tract infection, so be sure to rule out the possibility of a UTI before considering other causes.

What are the different types of urinary incontinence?

The different types of urinary incontinence include:

• Functional incontinence

• Stress incontinence

• Urge incontinence

• Overflow incontinence

• Mixed incontinence

When should I see my doctor about incontinence?

As soon as you notice any of the symptoms associated with incontinence or dementia, you should make an appointment to see your GP. The sooner you or your dependant get a diagnosis, the sooner you can receive the care you need.

Final Thoughts

If you or someone you care for is living with dementia, you are going to face all sorts of struggles; however, it's important to know that help is available. There are plenty of ways to manage the symptoms and lead a fulfilling life despite your condition.

Unfortunately, incontinence is still very much a stigmatised topic. But, here at Jude, we are all about shattering stigmas and shedding light on topics that have been kept in the shadows. We do this by providing educational resources and useful tips for those experiencing urinary incontinence.

We have also created a range of specialised incontinence products, including incontinence pads, leak-proof underwear, and bladder health tablets (designed for stress incontinence and overactive bladder/urge incontinence), to help you on your journey. With Jude at your side, you can tackle your incontinence problems and go about your day with confidence!