Incontinence and Dementia: What Families and Carers Need to Know

Caring for a person with dementia comes with both emotional and physical responsibilities. When memory retention is further lost, the patient loses their sense of environment and time. Performing their daily tasks will become increasingly difficult and will require assistance.

Family members and professional support workers come in to help by providing reassurance and taking steps to help them rediscover themselves. You aid them in doing so by creating a firm daily routine and including them in this routine. Doing this makes them more aware of what happens around them and more confident as they take part in the activities.

None of these can be achieved if the care receiver does not feel safe and comfortable; hence, the need for caregivers to ensure that the home is as safe as possible for their care recipients. Professional support workers from Support Network understand this as a key component in dementia care. They know how to build a strong bond with the patient in order to promote trust and open-mindedness, which in turn leads to better results.

Building a Supportive and Familiar Routine

Established routines are very significant for assisting an individual with dementia. It ranks among the most powerful methods of keeping a dementia patient calm and self-sufficient. As stated by Alzheimer's Project, regular routines alleviate anxiety and stress since they enable all parties to be aware of what's going to happen at any time.

As you take care of an individual with dementia, you need to have a good schedule of activities that is followed every day. This is to create space for everything at a particular time. When they recognise this schedule as a routine, it is easier for them to take charge of their daily life activities.

First, you start performing these activities with them and allowing them to contribute as much as they can. As time progresses, try letting them do it by themselves under supervision. Find out their struggles and help them overcome them. Know when this approach doesn't work and adopt new strategies in case the condition progresses.

The Role of Support Workers in Dementia Care

Professional support workers are an important part of dementia care. They not only train on the physical aspects of support but also on the emotional and cognitive needs of persons with dementia. They work towards creating a safe, peaceful, and structured environment where the care receiver will continue to thrive within their capacities. They expected to accomplish the following;

Make the Home as Comfortable as Possible

The carer is expected to be capable of creating a warm and friendly environment around the home of the care receiver. They should be comfortable and secure around them at all times. This is achieved through kind words, reassurance and being there all the time. Without a comfortable environment, the care receiver may act indifferent towards the care provided, which is detrimental to them.

Ensure their Safety 

The foremost duty of the support worker is to keep the care receiver safe. This involves reducing any risks of falls or wandering. Clear out the way, supervise bath time and make sure the floor is not wet. It's also necessary to ask for handrails and bars to be installed in case the care receiver has a hard time going up the stairs.

Keep them Engaged 

Dementia patients often feel lonely as they mostly don't see or recognise the people around them. To help them, the care worker should provide necessary social networks. Social activities like arts, puzzles and games, music, yoga and group interactions help them stay sharp and connected to the world around them.

Take care of the Household 

Support workers should not only focus on taking care of the patient but also on their household. Taking care of a dementia patient in an unhealthy environment does not help their condition in any way. They also need healthy meals, which you're expected to make. Don't forget to clean the house and take care of laundry as well.   

Medication Monitoring 

The support worker should ensure that the patient takes his or her medication the way they should. Get a medication schedule and insist on a strict adherence to it. Report to the family or health professional in case of medication side effects.

Provide Updates on Patient's Condition 

The support worker should provide constant updates on the health status of their care receiver. Any new development must be reported to allow for immediate action.

Understanding and Managing Incontinence in Dementia

Incontinence is a common but also difficult topic in dementia care. It is the loss of bladder or bowel control and may occur intermittently or on a regular basis. For individuals with dementia, incontinence may be related to a variety of things, including:

• Loss of memory 

The patient either forgets they need to use the bathroom or has trouble remembering how to get there.

• Reduced perception of body signals

They may no longer recognise their body's way of telling them they need to use the bathroom.

• Health factors

Some factors, like urinary tract infection or medication side effects, may result in incontinence. 

• Issues with moving around 

They may recognise the need to use the bathroom, but they may not get there in time.

• Communication problems

They may have issues with expressing themselves when they feel the need to use the bathroom.

As opposed to some opinions, incontinence is not a direct symptom of dementia. It is, however, connected to dementia because certain factors associated with dementia may potentially lead to incontinence. But biologically, the latter is not caused by the former.

Important Tips for Carers and Families 

Support workers and family members can prevent potentially embarrassing situations by staying observant and putting certain strategies in place. Consistency in monitoring and providing care can make a huge difference in comfort and maintaining dignity. Here are a few good strategies to help carers and families caring for dementia patients with Incontinence:

• Create Clear Signage

Use clear visual cues to point to the bathroom. A sign on the door is helpful, especially if the person has trouble reading. An open and visible door is another simple but effective cue. Making a path to the bathroom may also be helpful. Maybe use cardboard to create a direct path from the room to the bathroom as a guide.

• Make Clothing Easy to Remove

Sometimes, it’s the clothes that are the obstacles. The patient feels pressed, gets to the bathroom, and then soils themselves before they can take off their clothes. The solution? Clothes that are easy to take off. Elastic waistbands for pants and skirts, and velcro for tops. Nothing too serious. Thankfully, fashion-forward thinkers have found ways to style mundane materials like these, which you can adopt if style is important to you or your patient.

• Establish a Bathroom Routine

Another effective incontinence control technique is to establish a bathroom routine. Get them to use the bathroom more often. For example, establish a rule where they go to the toilet every two or three hours, even if they do not feel like it. This will result in them not having an unexpected need to go to the bathroom.

• Watch for Non-Verbal Cues

Some behaviours like restlessness and tugging at clothes may be indicators that they need to go. The better the carer is at understanding these behaviours and acting on them, the more chances of avoiding any incidents. 

• Reduce Fluids Before Bedtime

Fluid intake before bedtime increases the chances of frequent visits to the bathroom at night. Rather, let them take enough fluids during the day and reduce their intake in the evening. Consuming less caffeinated drinks like tea, coffee, and soda also helps as they irritate the bladder.

• Effective Use of Incontinence Products

Managing incontinence may also involve the use of some products. These products, such as pads and waterproof bed covers, are designed to reduce tension in patients and keep them more relaxed. You must understand that introducing these products is a sensitive action. That's why you need to discuss it with the care receiver and have their permission. In the event that they find the use of the products to be uncomfortable, discontinue use immediately. 

• Consult a Health Professional

Consulting a health professional may be important in severe cases. They can assess whether the cause is medical (like an infection) or cognitive and recommend further strategies or treatments. If it's as a result of an infection, it's pertinent that they start taking medication with your guidance.

• Respect their Privacy

There’s typically no privacy in dementia care. You may even have to sit and watch as the patient showers, just to make sure they’re safe and don’t eat the sweet-smelling soap. And in cases where having to go to the bathroom becomes a problem, you definitely have to sit in. But you can still respect their privacy even while keeping watch. Knock before you enter the bathroom, for one. Standing at the doorway is another. Also, watch what you say. That’s not the time to be talking about a dark spot on their skin.

Diet and Nutrition Tips to Support Bladder and Bowel Health

The right food and fluid choices can reduce the frequency of using the bathroom and accidents for people living with dementia. Carers as well as family members should take note of the care receiver's diet in order to help them improve their comfort and overall quality of life. Here are some tips to guide you on the type of nutritional care you should provide to your loved one or care receiver living with incontinence:

• Encourage them to eat more food with high fibre content 

Incontinence can be worsened by constipation issues as a result of pressure on the bladder. As such, giving the care receiver food rich in fibre content will help regulate bowel movements and reduce the chances of constipation. Common high-fibre content foods include:

• Wholegrain breads 

• Cereals

• Brown rice 

• Wholemeal pasta 

• Vegetables 

• Fresh fruits

• Legumes

Fibre should be introduced gradually, and ensure plenty of fluids are taken to help it move through the digestive system effectively.

• Stay Well Hydrated

Some people believe that reducing fluid intake can reduce incontinence. This is not true. Dehydration leads to bladder irritation, which can lead to frequent urges to urinate. It also promotes urinary tract infections. Encourage your care receiver to drink about 6 to 8 glasses of fluid, preferably water, per day. 

• Less Intake of Foods and Drinks that Irritate the Bladder 

Bladder-irritating foods and drinks should be reduced or avoided completely. Such foods or drinks may include:

• Coffee

• Tea

• Cola

• Spicy foods

• Oranges

• Alcoholic beverages

• Lemons 

• Carbonated drinks

The case is not always the same with everybody. It's important to monitor their body reactions to these meals and adjust accordingly.

• Reduce Salt Intake

Too much salt intake can lead to fluid retention, which increases blood pressure and consequently places more pressure on the bladder. To avoid this, eat fresh homemade meals as opposed to packaged foods.

• Offer Smaller but Balanced Meals

Large meals translate to longer digestion time (depending on the diet). This may lead to bloating, which doesn't help with incontinence. It's more advisable to serve smaller meal portions with more focus on the nutritional values. 

• Monitor for Food Sensitivities 

Observe to see if the care receiver is sensitive to dairy or gluten meals. Some people experience stomach upset after consuming such meals. It can consequently trigger loose bowel movements.

• Meal Presentation and Routine 

Well-planned meal presentation and routine help to regulate system functions, especially bathroom times. They should know when they expect their next meal and what happens after each meal. This helps them to subconsciously regulate their bowel movements.

• Collaborate with a Dietitian When Needed

You may need to consult a dietitian. With the right experience in managing incontinence in dementia care, the dietitian can recommend meals that work well with the condition. They are in a better position to also recommend meals that won't interfere with the care receiver's dietary restrictions in case of other illnesses.

Creating a Safe and Dignified Home Environment

Dementia care involves not just the patient but their environment. How the home is arranged can positively or negatively affect the patient. For positive results in dementia care, some improvements need to be made at home. These improvements include:

• Clear Pathways

Ensure the house is not cluttered. Get rid of clothes and other materials lying around the house. Clear the path around the house, especially to the bathroom. Also, make sure the floor is not wet to avoid slipping. 

• Proper Lighting

Good lighting, especially at nighttime, can reduce disorientation and help make the bathroom more accessible. In fact,  don't leave any part of the house dark, as you never know what they would be searching for and where they would go looking.

• Consistency in Layout

Keep the home arrangement consistent. Don't shift the furniture or alter positions of important things like the pee bucket and toilet paper. If you establish a routine, stick to it, and if there is a need to change anything, make sure they get used to it in time.

• Create alternative Bathroom options 

Using bathroom alternatives like commodes and hand-held urinals is okay. This is especially necessary if the patient has mobility issues. If using these alternatives will preserve the dignity of the care receiver, then it is definitely the way to go.

When to Seek Additional Support

Caring for a loved one living with dementia is one way to prove how much you love and care for them. It is not easy, but you do it out of obligation. However, it may get to a point where you should get professional help with caring for a loved one.  An example is when your loved one has incontinence as a dementia patient. Both conditions may be challenging to handle, and it is absolutely okay to seek help. It is not a failure or a lack of care for your loved one, but a kind and caring gesture, one intended to give them the best care there is.

Professional support workers can come in to take over from you and provide quality care for your loved ones just as you would. Carers from Support Network focus on providing personalised care at home. You can rest assured that your loved one is in good hands and that all their needs are being met. Respite care is also available in case you only need to take breaks in caring for your loved one.

Support Network has a number of strategies in place to preserve the dignity of your loved one. Workers respect personal boundaries while doing their job, in addition to being empathetic and compassionate. They know just the right thing to say or do in order to keep your loved one comfortable and in good health.

When Incontinence Signals a Medical Emergency

Incontinence can be managed effectively through lifestyle changes and supportive care. However, there are times when it may be a sign of a more serious underlying health issue. It's the duty of carers and family members to monitor the care receiver closely in order to recognise factors that may indicate a medical emergency. Here are some warning signs to look out for:

• Sudden Onset of Incontinence

If a dementia patient suddenly begins to experience incontinence without prior cases of bladder or bowel issues, it could be a sign of an acute medical condition. Such conditions could be UTIs or constipation. It's best to seek medical attention immediately for early diagnosis and prompt treatment when applicable.

• Blood in Urine or Stool

Seeing blood in urine is never a good sign. It is a sign of a serious medical condition, which may include infections, bladder stones or kidney issues. Blood in could still be a sign of gastrointestinal bleeding or even bowel cancer. Go to a healthcare provider immediately if you notice blood in the urine of your care receiver.

• Unusual or Foul-Smelling Urine

Urine with strong odours can indicate a UTI. It could also be a sign of dehydration. If it happens to be a UTI, it's best to be treated early, as the longer the infection lasts, the harder it is to treat or control. It also causes agitation and confusion in adults with dementia.

• Signs of Severe Constipation or Impaction

Infrequent bowel movements or hard stools may suggest constipation or impaction. This can lead to overflow incontinence. When untreated, this can cause anxiety and further complications. Medical evaluation is necessary to relieve the blockage safely.

• Pain or Discomfort When Urinating

If the person appears to be in pain or cries out when using the bathroom, it may indicate a serious case of infection. They may even start avoiding the use of the bathroom. In such cases, a GP should be consulted for further assessment and potential treatment.

• Skin Irritation or Breakdown

Prolonged exposure to urine or faeces can lead to skin irritation in the form of rashes or even open sores. If the skin becomes raw or infected with a foul smell, medical treatment is essential to prevent further degradation and ensure healing.

Conclusion

Incontinence in dementia may be challenging, but with the right persons and carefully designed approaches, it can be managed with ease. Hiring support workers who are trained in dementia care is one effective way of managing the condition. With professional support such as that provided by Support Network, your loved ones can enjoy comfort and maintain their dignity at home. Do the right thing today and get your loved ones the right support they deserve.