If you are a caregiver and your loved one is starting to have accidents with incontinence, the challenges can feel enormous. You may be fearing that you will not be able to handle the incontinence and that you may have to turn to care options other than yourself.

You are not alone in this struggle, and we want you to know that there is hope. We have some practical tips for you that many caregivers follow to manage.

What Causes Incontinence

Even though incontinence is common in older adults, it is important to know that it is not “normal.” Incontinence always has an underlying cause.

It is estimated that 60 to 70 percent of people in the later stages of dementia develop incontinence. While confusion and changes in the brain can lead to the inability to control urinary and bowel function, the most common causes of incontinence in people with dementia are:

• Infection (UTI)
• Constipation
• Prostrate problem
• Loss of mobility (loss of gait, balance, or inability to get to the restroom in time)
• Medications (such as diuretics and sleeping aids)
• Worsening dementia (inability to recognize the need to use the restroom, not reacting in time, or not able to tell someone that they need to go)
• Fluids (drinking too many fluids, caffeinated fluids)

Related: Common ailments and illnesses in individuals with dementia

Incontinence Management Tips for Caregiving

Above all, help your loved one retain their sense of dignity. Incontinence can be extra challenging for a caregiver, but it is not easy for the beloved person experiencing it. It can be uncomfortable, messy, and embarrassing.

Rule Out Medical Conditions

When bathroom accidents develop, or when incontinence worsens, your loved one with dementia may not be able to articulate what is going on. You may notice a change in behavior or confusion, with no other symptoms.

Bring your loved one’s physician into the picture as soon as possible to rule out and provide treatment for any underlying medical causes.

Watch and Listen

Encourage your loved one to tell you when they need to use the toilet. Consider implementing the use of simple phrases, such as “Bathroom time!”

Prompt your loved one to tell you if they experience trouble when using the toilet (i.e., pain, constipation, issues sitting down or standing back up).

Watch for nonverbal clues. Your loved one may become restless, have facial expressions, or make sounds that can clue you in that they need to use the toilet. They may also walk towards the bathroom, but in confusion, end up standing in a corner or sitting in a chair.

Reduce Accidents: Make Home Toilet Use Simpler

Some of the common symptoms of dementia can make toilet use more difficult, such as poor judgment, confusion, getting lost or turned around, muscle weakness, or impaired motor skills.

Here are practical ways you can help your loved one use the toilet and reduce accidents:

• Ensure the path to the bathroom is clear of obstacles
• Leave the bathroom door open at all times
• Leave the bathroom light on at night
• Label each door (i.e., bathroom, closet, bedroom)
• Ensure the toilet is at a comfortable and safe height and install grab bars
• Ensure clothing can be easily removed (i.e., soft stretchable clothing, pants with elastic waistbands)
• Help your loved one remove their clothing once they are next to the toilet

Reduce Accidents: Liquids and Diet

Liquids and foods in a person’s diet are often top factors in incontinence.

Here are ways to manage liquids and diet to reduce accidents:

• Avoid or limit carbonated and caffeinated drinks
• Limit liquids in the evening (after dinner)
• Avoid or limit foods that may upset digestion (i.e., spicy, sugary, or overprocessed foods)
• Include fiber in the diet to prevent constipation

Fluid intake is vital to our overall health. Proper hydration can prevent urinary infection, dehydration, and constipation. The goal is to manage a balance between fluid intake that maintains your loved one’s health but also prevents accidents.

When Accidents Happen

Foremost, help your loved one cope with their incontinence. Avoid scolding when an accident happens. Calmly address the situation and avoid looking or acting frustrated.

Be respectful of your loved one’s privacy. If they can help themselves clean up after an accident, then allow them to do so. If you need to assist, grant your loved one as much privacy as possible.

Be prepared with warm water and soap, or disposable wipes, and encourage your loved ones to partake in thorough handwashing.

Incontinence Care Products & Measures

When toilet accidents begin to happen, incontinence care products and measures can help your loved feel more comfortable and less embarrassed, and these preventative measures can also help you feel much less stressed.

Pull-up undergarments (i.e., padded undergarments or adult briefs), as well as urinary incontinence pads, work wonders to protect both clothing and your loved one’s skin.

Use rubber pads or disposable absorbent underpads to protect chairs, beds, and car seats.

Use disposable gloves and flushable wipes if you help your loved one clean up or redress after an accident.

Have a container near the toilet for soiled pads or disposable undergarments. This can prevent your loved one (who can suffer from confusion) from flushing these items down the toilet.

Have everything that you need for incontinence on hand in the bathroom. This may include protective underwear, pads, wipes, creams, and lotions.

Encourage good hygiene and showers to discourage skin irritation and odor.

Planning and Routine

Routine is important for the mental health of a person with dementia. It helps reduce anxiety in both the caregiver and the loved one.

Observe and know your loved one’s toilet routines. Do they have a bowel movement first thing in the morning, or perhaps an hour after they have breakfast? Remind your loved one to get to the toilet at these times, or help them get there.

Set a regular schedule for toilet use. Consider a routine schedule every two hours for urination, as well as a bathroom visit after meals and before bedtime.

Consider a “don’t flush” routine if your loved one is in the habit of telling you that they have used the toilet, but then they have an accident afterward. This practice allows you to check the toilet before it is flushed.

You Are Not Alone with This

Incontinence is one of the most difficult and stressful aspects of caregiving, especially if it takes a turn to heavy incontinence.

After bringing in the physician and following all the incontinence caregiving tips, you may still feel the need to reach out for help.

Seeking help from others does not mean that you have failed your loved one.

You may be seeing signs that it is time for 24-hour care. It is intensely difficult for one person to handle increased caretaker demands. There is no shame in reaching out for assistance.

We Are Here to Help

We know that caretaking can be an overwhelming and stressful journey. We do not want you to feel alone with this. We know that you want the best care for your loved one and that every moment matters, and here at Sundara caring is what matters. Memory care is all we do…and we are really good at it.

We want to help! Feel free to request an appointment online or call us at 512-399-5080 if you want to schedule a tour or simply have questions.