Causes | Incontinence

Dementia Incontinence: Causes, Symptoms, And Solutions

Dementia is a complex and challenging condition that affects millions of people worldwide, and one of its often-overlooked symptoms is incontinence. In this article, you will learn about the correlation between dementia and incontinence, and how it can affect both urinary and faecal incontinence. You will also learn about the causes of incontinence in dementia, the factors that increase the risk, and practical tips in managing and reducing incontinence accidents. 

What Causes Incontinence With Dementia

Dementia is associated with cognitive decline, and affects a substantial portion of the elderly population, and among its many challenges, incontinence is a common issue. A recent study in 2021 revealed that more than 50% of people with dementia experience urinary symptoms, including urinary incontinence.


Cognitive decline plays a pivotal role in the development of incontinence in people with dementia. As dementia progresses, those affected may lose the ability to recognise when they need to use the toilet or may forget the location of the facility entirely. This cognitive impairment can lead to unpredictable urinary or faecal accidents.


Identifying the root cause of incontinence is crucial for effective management. Some cases may have underlying medical causes that are treatable. Consulting a healthcare professional is essential to determine if medical conditions are contributing to incontinence. Common medical conditions associated with incontinence in dementia patients include urinary tract infections, constipation, prostate problems, diabetes, stroke, and muscular disorders like Parkinson's disease. Additionally, physical disabilities that hinder a person from reaching the toilet in time can exacerbate the issue.


Several factors can increase the likelihood of incontinence in people with dementia. These factors include being overweight, as excess weight can put additional pressure on the bladder, and age, as older adults tend to have weaker bladder muscles. Pregnancy, childbirth, and menopause can also affect the pelvic floor and bladder muscles. In men, an enlarged prostate or prostate surgery can be contributing factors too. Certain medications may lead to incontinence, although some can exacerbate dementia symptoms.


While medications are available to manage an overactive bladder, carers should be aware that some medication can exacerbate incontinence or dementia-like symptoms. Furthermore, you could consult the patient’s GP for advice if you suspect that medication is causing unwanted side effects. Knowing how to control incontinence smells is essential here too, since certain medications could exacerbate symptoms further.

Managing And Reducing Incontinence Episodes With Dementia

In order to manage and reduce the risks of incontinence whilst battling dementia, consider the following factors:

dementia incontinence holding hand on head

Dehydration:

Dehydration can exacerbate incontinence in dementia patients. When people do not consume enough fluids, particularly water, it can lead to urinary tract infections, which may trigger or worsen incontinence. Beverages like coke, coffee, and tea act as diuretics, which increase urine production and potentially contribute to incontinence. Therefore, caregivers should be mindful of which fluids to offer to dementia patients.

Environmental Considerations:

Environmental factors can significantly impact the occurrence of urinary or faecal accidents. Caregivers should take steps to ensure a supportive environment, including:


  • Appropriate clothing: Choose clothing for the person with dementia that is easy to remove and put on. This simplifies toilet visits and minimises potential accidents.
  • Bathroom accessibility: Make toiletry facilities easily locatable and identifiable. Clear signage can be especially helpful for those with dementia who may struggle with spatial orientation.
  • Obstacle removal: Remove any obstacles or hazards between the person with dementia and the toilet. A clear path can facilitate quicker restroom visits.
  • Support with mobility: For people with reduced mobility, reaching the toilet in time can be a challenge. Consider when someone is sitting and how long it may take them to reach the toilet and how much support they may need.

Tips for Caregivers: 

Caregivers can employ several strategies and tips to reduce the frequency and impact of incontinence episodes. While not every approach will be equally effective for everyone, they can serve as valuable starting points:


  • Demonstrate understanding: Incontinence incidents can be embarrassing and distressing for those with dementia. Caregivers should adopt an understanding and empathetic demeanour. Ensure privacy, discuss accidents in a matter-of-fact manner, and refrain from making the person feel guilty. 

  • Effective communication: Communication is not limited to verbal cues either. Caregivers should encourage those with dementia to express their need to use the toilet. Look for non-verbal signs such as fidgeting or facial expressions that may indicate urgency.

  • Forward planning: Observing and understanding a person's toilet schedule can be invaluable. Caregivers can: monitor the individual’s toilet routine, create timely reminders for when they should visit the toilet as well as scheduling toilet breaks, identifying accident patterns in order to prevent future ones from occurring.

  • Hygiene protection: Maintaining hygiene for someone you care for helps to prevent urinary and skin infections, and is very important for the dignity and well-being of the person.

  • Consider incontinence products: We offer a wide range of incontinence products which fits different body types, and can offer practical solutions for managing incontinence. Ensure to use skin care products when applying these pads to promote maximum comfort and less skin irritation.

  • Aid in urination: If the person experiences difficulty urinating, running the tap or providing water while they use the restroom may help stimulate urination.

  • Protective bedding: Using incontinence bed protection can safeguard bedding from potential accidents, making cleanups more manageable.

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Bladder and Bowel Health: 

A caregiver's role extends to promoting and maintaining bladder and bowel health in people with dementia. Ways to maintain bladder and bowel health for those with dementia include:


  • Fibre-rich diet: Provide a diet rich in fibre to support regular bowel movements.

  • Hydration: Encourage the consumption of 6–8 glasses of water daily to maintain proper hydration.

  • Nutrition: Offer a balanced and nutritious diet comprising fruits, vegetables, whole grains, limited fats, and lean proteins.

  • Avoid triggers: Advise against the consumption of caffeinated, carbonated, or alcoholic beverages, which can exacerbate incontinence. You could also consider integrating bladder-friendly drinks. Switching to decaffeinated drinks is an alternative for those that enjoy coffee or tea, since those with dementia prefer tea as they find it calming; removing tea would therefore be detrimental to their well-being.

  • Exercise: For those capable of physical activity, regular walks and staying active can help regulate bowel movements. People who remain physically active are better able to manage getting to the toilet themselves when they need to. Keeping the person with dementia as active as possible (without pushing them beyond their physical capabilities) is another effective strategy for carers to adopt.

  • Developing a toilet routine: Carers should prompt those with dementia to adopt a toilet routine that is individual to them. 

  • Nighttime: For nighttime visits to the bathroom, consider placing a portable toilet chair near their bed. Motion sensor lights can be valuable in preventing accidents.

  • Responding to accidents: It's important to remember that those with dementia react differently to incontinence incidents. Some may find it distressing, while others accept it as part of their condition. You should always be empathetic, respectful, and have a genuine interest in improving their quality of life.

  • Respect Privacy: Ensure that the person's privacy is maintained throughout the process.

Manage Incontinence And Dementia

In conclusion, it is evident that incontinence is a significant challenge for those living with dementia, but with the right strategies and a compassionate approach, it can be effectively managed. By understanding the causes, anticipating needs, and creating supportive environments, caregivers can improve the comfort and dignity of those they care for. You can learn more here by reading about the loss of dignity in acute hospitals.
dementia incontinence carer holding patient's hand

FAQs

What stage in dementia is incontinence?

Incontinence can occur in various stages of dementia, often becoming more common as the disease progresses.

How do you manage urinary incontinence in dementia patients?

Management includes regular toileting schedules, using absorbent products, promoting hydration, and consulting a healthcare professional for guidance.

What are 3 things to never do with your loved one with dementia?

Avoid arguing, criticising, or leaving them unsupervised in potentially dangerous situations.

How can I help a dementia patient with toileting?

Provide clear cues, maintain a consistent schedule, create a familiar toileting environment, and offer assistance with patience and dignity.

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