Incontinence, which is the inability to hold ones urine, is an embarrassing, yet common problem. It is especially common in individuals with advanced stages of Alzheimer’s disease. In many instances there is nothing the caregiver can do to prevent incontinence. However, there are steps one can take to reduce the occurrences of incontinence as well as reducing the negative health effects associated with incontinence. In this handout some of the common causes of incontinence are discussed as well as some precautionary measures the caregiver can take. It may be helpful to ask yourself the following:
Does it happen with activity?
What to look for: if it is associated with laughter, coughing, sneezing or physical exertion.
What can you do? This is known as stress incontinence and is caused by weak bladder muscles. This type is particularly common in women with multiple child births. Having them go to the bathroom more often can help keep the bladder less full and therefore less prone to leakage.
Are they unable to get to the bathroom fast enough?
What to look for: sometimes they will warn you they need to go, but by the time you get to the bathroom they have already wet themselves. This is called urge incontinence. Often times the desire to urinate comes on suddenly and leaves little time to go to the bathroom. If they complain of pain on urination, this could be a sign of a urinary tract infection.
What can you do? Try to limit the distance and number of obstacles between the person and bathroom. If an infection is suspected you should seek medical attention. Also, try to reduce bladder irritants such as carbonated beverages (e.g. soda) and coffee. Irritants and infections make the bladder more prone to contracting and thus leaking urine.
Could it be their medications?
What to look for: if the symptoms began after a change in the medications were made. Addition of blood pressure medications or “water pills”.
What can you do? Certain medications can increase urinary frequency as a result the incidence of incontinence may go up. If this is the case, you should discuss this with your physician to see if something can be done.
Although adequate hydration is important, one should be careful of overhydration. Try to limit their fluid intake as bed time approaches.
If they have arthritis it may be difficult for them to undue buttons or pull down a zipper. Try pants that have elastic banding instead.
Do not get angry or get frustrated with them.
Try to anticipate by taking them to the bathroom often (e.g. every 2hrs).
Consider using adult diapers to help maintain an acceptable level of hygiene.
In men, an enlarged prostate could be the culprit. Your doctor should be able to assess if this is the cause.
Mayo Clinic Staff, Urinary incontinence July 1, 2008. Web address: http://www.mayoclinic.com/health/urinary-incontinence/DS00404/DSECTION=risk-factors Accessed Nov. 21, 2008
The Merck Manual Online Medical Library: Urinary incontinence, October 2007. web address: http://www.merck.com/mmhe/sec11/ch147/ch147a.html?qt=incontinence+AND+alzheimer%27s+disease&alt=sh Accessed Nov. 21, 2008
The National Institute on Aging "Caregiver Guide: Tips for Caregivers of People with Alzheimer's disease" September 01,2001