Dementia and incontinence

Incontinence is a common symptom for people living with dementia. As dementia progresses, changes in the brain can affect a person’s ability to recognise bodily signals, communicate their needs and use the toilet independently – so continence care can be an important aspect of daily support. 

What can cause incontinence in people living with dementia?

There are lots of reasons someone with dementia might experience incontinence. Dementia can damage the part of the brain that controls the bladder and bowels, meaning that they might not understand when they need to go to the toilet, or they might not have control of their bladder or bowels.  

They might also:  

• forget where the toilet is or how to use it  
• be unable to reach the toilet in time due to mobility issues  
• find it tricky to undo zippers or buttons on clothing  
• struggle to communicate the need to go to toilet. 
• Some medications can also cause or worsen incontinence, such as some pain killers, antihistamines and diuretics.  

For more information about dementia-related incontinence, visit the Dementia UK website

What are the emotional and practical impacts of dementia-related incontinence?

Continence issues can have both physical and mental impacts on someone living with dementia.

Physical impacts of dementia and incontinence 

Incontinence can lead to further health issues if it’s not managed correctly. Wet or soiled skin can cause infections or UTIs, so it’s important to ensure that skin is completely clean and dry if there’s an accident.

Emotional impacts of dementia and incontinence

It can also bring up feelings of embarrassment or shame. The person might also feel a sense of distress or confusion about what’s happening.

Helping someone living with dementia, experiencing incontinence, to maintain their dignity is an important part of care. This might include:

• Ensuring their privacy and providing support discreetly
• Making sure their care reflects their individual needs, and respects their choices, routines, and cultural background
• Involving them in making decisions that relate to their care as much as possible.

How can I support someone with dementia experiencing continence issues?

Supporting someone with dementia and incontinence means thinking about their emotional needs as well as their physical ones. Here are a few ways you can help.

Establish a routine

Establishing a routine which includes going to the toilet at regular times can help someone feel more secure. It means they don’t have to rely on understanding when they need to use the toilet themselves.

Make toilets easily accessible

Make sure that the person can get to the toilet as easily as possible. This might include getting them a walking aid or stairlift. Freestanding or wall-mounted grab rails can make it easier to get on and off the toilet too. Adding a raised seat to the toilet can make it easier to sit down. Some people experiencing dementia may find this equipment disorienting or confusing, so seek professional help before installing anything.

Choose adaptive clothing

Someone with dementia might struggle with undoing buttons or zippers in time. Choosing clothes that can be removed quickly and easily can help.

Use continence products

Treatment doesn’t always stop incontinence completely – but the right products can help manage the problem and reduce its impact on day-to-day life.

The NHS prescribes some continence products for people who meet specific criteria. There’s also a range of continence products available in supermarkets and pharmacies.

Contact your local integrated care board (ICB) for more information about who is eligible

It’s important that the person’s healthcare professional is involved in the conversation before they rely on products permanently. It’s important to identify if there are any other underlying problems, as there may be treatments that can help.

Manage fluids and diet

It’s important that someone experiencing dementia and incontinence eats a healthy diet and drinks plenty of fluids.

It’s worth being aware that tea, coffee and fizzy drinks can make bladder symptoms worse – as can alcoholic drinks or drinks with artificial sweeteners. Water and squash can be better options for staying hydrated.