Reviewed by Amanda LundbergAmanda Lundberg is a nurse with over 10 years of experience in clinical settings. She is an expert in family medicine as well as various specialties. Her holistic approach to health focuses on wellness and preventative care. She now writes content for health and wellness brands under her company name, Locksley Content.

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When a senior parent has dementia, there are many changes to their overall health. One common issue in those with dementia is incontinence. Incontinence is the inability to hold urine or fecal matter, which results in accidental urination or bowel movements. Understanding the underlying causes of and strategies for managing their symptoms is important for your parent’s health and comfort.

Key Takeaways

Urinary and bowel incontinence are common in those with dementia. Typically, the likelihood of incontinence increases as a loved one progresses into the middle and late stages of dementia.
There are causes of incontinence in the elderly besides dementia. Talk to your parent’s doctor if incontinence is a new issue or is increasing in frequency.
Managing incontinence can involve some planning around the home. This can include increasing the visibility of bathrooms and providing toileting reminders for your parent.
Changes in diet can sometimes help lessen the symptoms of incontinence. This can include removing caffeine from their diet and increasing their fiber intake.

How common is incontinence in seniors with dementia?

It is estimated that urinary incontinence affects more than 50% of people living with dementia.^[01] It occurs with far greater frequency in older adults with dementia than with other older adults. Additionally, incontinence is equally common in both male and female dementia patients. The most common form of incontinence in those with dementia is called functional incontinence. This means that someone has the need to relieve their bladder and bowels but may not go to the bathroom when they need to, such as forgetting to use the toilet due to memory issues.^[02]

While urinary incontinence is very common in elderly dementia patients, bowel incontinence is less common. However, it can still become an issue, especially as a loved one’s condition progresses.

In addition to emotional distress and dehydration, incontinence can also lead to skin irritation, especially when it happens frequently. So it’s important to address the issue as soon as possible.^[03]

Why does dementia increase the likelihood of incontinence?

As Alzheimer’s or other forms of dementia progress, your loved one may no longer recognize their body’s cues when they need to use the restroom. They may also forget where the bathroom is or how to use it. Additionally, some medications used for the treatment of dementia can also increase the likelihood of urinary or bowel incontinence.^[04]

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As dementia progresses, the likelihood of incontinence increases. A parent may experience disorientation in early stages, which can lead to issues with finding the bathroom, or have stress-related incontinence. However, it’s more likely that they will develop incontinence as they progress to the middle and late stages of dementia.

While bowel and urinary incontinence in the elderly with dementia is common, there are other potential causes. These include:

Diabetes
Stroke
Muscular disorders
Physical disabilities
Urinary tract infections ^[04]

If incontinence is a new issue with your parent, or has been occurring more frequently, it’s essential to bring up this information with your parent’s doctor.

Tips for managing the symptoms of incontinence

While incontinence may not be treatable for an elderly patient with dementia, there are ways to lessen the symptoms and discomfort for your loved one.

Communication and planning

Depending on the stage of dementia that your parent is in, there may be ways to help with incontinence by making sure they can communicate their need to go and can easily find the bathroom on their own. Consider incorporating some of the following tips into their care and routines:

Leave the bathroom light on and the door open. This will help ensure that your parent can easily find the bathroom. A sign on or near the bathroom door that shows a photo of a toilet may also be helpful in triggering an association.
Talk to your parent about going to the bathroom. This might include asking them if they need to go to help trigger their memory or stressing that they shouldn’t be embarrassed to talk to you about when they need to use the toilet. If your parent tends to use the bathroom around the same times every day, consider setting an alarm on your phone so you can ask them if they need to go at those times.
Consider purchasing more adaptive clothing. When buttons and zippers become hard to use, it can lead to accidents. Choosing clothing that is easy to take off, such as pants with elastic waistbands, can be helpful.
Use adult diapers or briefs. While your parent may not always need an adult brief, these can be helpful when going to a new place or somewhere with a bathroom that may be hard to access. These can also help with overnight accidents.
Use waterproof covers or incontinence pads on their bedding. If your parent experiences overnight accidents, these can prevent them from sleeping on wet bed sheets and protect furniture.^[04]

Diet changes

While it is important to stay hydrated during the day, there are some key steps you can take to lessen accidents. Additionally, ensuring that your parent stays healthy is important.

Discuss hydration with your parent’s doctor. Fluid intake is important. However, it may be possible to lower the amount of fluids being consumed later in the evening. This can help lower the risk of bed-wetting.
Try to cut down on, or cut out, drinks that tend to stimulate the bladder. These include caffeinated drinks and sodas.
Cut down on greasy or fatty foods and dairy products, as these can lead to more issues with bowel incontinence.
Ensure that your parent has enough fiber in their diet.^[05]

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Preventing health issues

Urine is highly acidic and can cause skin irritation, while fecal matter contains bacteria. So when either is left on the skin, it can cause skin breakdown which can lead to severe complications for your parent. Remember to always do the following:

After toileting, ensure that your loved one has properly cleaned themselves.
If an accident occurs, clean and dry their skin thoroughly and change them into clean clothing.
Encourage your parent to let you know if they soil themselves, and use empathetic language so that they feel comfortable telling you.

Incontinence is a common issue in those with dementia, but it’s always important to ensure that your loved one is comfortable and healthy. It’s also important that, as a caregiver, you have the support and resources you need. Senior Care Advisors will compassionately discuss care options with you, all at no cost to you or your family.

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References

Juliebø-Jones, P., Coulthard, E., Mallam, E., Archer, H., & Drake, M.J.. (2021, June 19). Understanding the impact of urinary incontinence in persons with dementia: Development of an interdisciplinary service model. Journal of Advanced Urology.
Orme, S., Morris, V., Gibson, W., & Wagg, A.. (2015, July). Managing urinary incontinence in patients with dementia: Pharmacological treatment options and considerations. Drugs and Aging.
Mayo Clinic. (2022, November 3). Fecal incontinence.
Alzheimer’s Association. Incontinence.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017, July). Eating, diet, and nutrition for fecal incontinence.

Meet the Author

Chloe Clark

Chloe Clark is a copywriter for OurParents. She has an MFA in Creative Writing, with a background in education and publishing. She has over a decade’s experience in writing for print publications and websites.

Reviewed byAmanda Lundberg

The information contained in this article is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom (of which OurParents is a trademark) and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not recommend or endorse the contents of the third-party sites.

Incontinence and Dementia: Causes and Caregiver Tips