Alzheimer’s and Incontinence: Understanding the Complex Relationship

Understanding the direct and indirect causes of incontinence in patients with Alzheimer’s disease

What are the — direct or indirect — causes of incontinence in people suffering from Alzheimer’s disease? What can a person with a progressive illness of the brain do to reduce the loss of bladder or bowel control?  How can a caregiver restore quality of life for a beloved patient? The complex relationship between Alzheimer’s and incontinence sheds light on a dark and sensitive issue.

A loss of bladder or bowel control is common in the latter stages of Alzheimer’s disease, but not everyone with Alzheimer’s experiences incontinence. The relationship is often obvious and direct. Cognitive capabilities decline, and eventually interfere with even the most basic daily self-care functions. Patients lose the ability to recognize the need to use the bathroom.

The relationship can also be indirect. Issues of mobility or confusion may prevent the person from making it to a bathroom in time. Medical causes independent from Alzheimer’s disease may also contribute to incontinence, including urinary tract infection, weak pelvic muscles, an enlarged prostate gland, or as a side effect of certain medicines. Certain anti-anxiety drugs and sleep aids relax the bladder muscles, and contribute to incontinence.

Regardless of the cause, the critical first step in finding relief is consulting with a doctor for evaluation, and, in some cases, medical intervention. Beyond the care of a doctor, patients and caregivers alike can take several steps to reduce incontinence frequency and severity.

  • Limit intake of diuretic liquids. A diuretic is any liquid that stimulates urination: caffeine often the main culprit. To reduce incontinence, restrict or even eliminate most coffees, teas, and colas, especially close to bedtime. Alcohol is another diuretic to avoid. The exception to the rule is water. Hydration keeps you healthy.
  • Make bathroom access easy. Create a simple route to the bathroom free of obstruction. Move any furniture or area rugs blocking the path. Inside the bathroom, keep clutter to a minimum. Illuminate the routes — from the patient’s bed or from the chair by the TV — with low-wattage nightlights, and keep a small light on in the bathroom through the night.
  • Avoid cumbersome clothing. For quick access to underwear, wear loose-fitting clothing. Select something easy to slip on and off. Poor coordination makes removing clothing difficult. Even simple buttons and clasps can confuse a person suffering from Alzheimer’s.
  • Get into a bathroom routine. Frequent trips to the bathroom, even without a sense of urgency, help reduce “emergency” situations.
  • Maintain dignity. Just the thought of incontinence can create a trying experience for Alzheimer’s patients and caregivers. When caregivers focus on privacy and autonomy, patients maintain dignity. As a caregiver, never overreact to a loss of bladder or bowel control. Avoid using shaming, scolding, or condescending words. Instead, use matter-of-fact language, communicating a message of “accidents happen.” A little encouragement goes a long way to help your patient feel less embarrassed.
  • Use incontinence products. For a higher quality of life, consider using incontinence products, from washable panties and briefs, to waterproof underpads and bed pads. More than just control leakage, and eliminate odor, today’s selection of advanced incontinence products protect your chairs, wheelchairs, mattresses, and bedding.

Looking for more helpful tips on incontinence? Reach out to Salk today!