Why do people with dementia become incontinent?

It can be traumatic for everyone when a loved one becomes incontinent, but sadly it's a common symptom of dementia and you might find it easier to manage if you're forewarned and know what to expect. Here's what you need to know...

What is incontinence?

Incontinence happens when you involuntarily leak urine or faeces (or both). If you have urinary incontinence, you may find you get a sudden urge to pee and need to do so frequently, which can mean you don’t always reach the toilet in time.

Faecal incontinence is less common, and can happen when you break wind, or sometimes pass faeces without you realising.

Why might someone with dementia become incontinent?

There are many reasons why someone may become incontinent – some are age-related and others are related specifically to dementia. These include:

Age:

- Urinary tract infections
- Prostate gland problems – common in older men
- Constipation – although you may assume this would reduce the chance of faecal incontinence, what can actually happen is that liquid faeces slips round the hard impacted stool.
- Pre-existing bowel-conditions such as irritable bowel syndrome (IBS)
- Side effects of medication

Dementia:

- Damage to nerve pathways in the brain that are involved in bladder and bowel control.
- Not being able to communicate that you need the toilet
- Forgetting that you need the toilet until it’s too late
- Mobility problems which mean you can’t get to the toilet in time, or having difficulty undoing clothing or getting onto the toilet.
- Struggling to recognise or remember where the toilet is

When may someone with dementia experience incontinence?

Most people only experience incontinence when the illness has progressed considerably, however it could occur at any point, depending on other pre-existing medical or health issues.

Emotional effects

For the person with dementia
Incontinence can be an incredibly distressing experience for someone with dementia. They might feel embarrassed, frustrated and even angry with themselves. After all, incontinence is seen as a loss of control - we’re trained to know and recognise when we need to visit the bathroom from a young age - so it’s totally normal and understandable to feel all these emotions. They may try to hide the fact that they’ve had an accident, hiding damp or soiled clothing away at the back of drawers rather than telling anyone.

For the carer…
Your first experience of incontinence will probably be a shock. If you're caring for a loved one it can be very upsetting too and you might feel as embarrassed as they do when it first occurs, or just really sad that they're suffering such an indignity. Sometimes you might be angry, particularly if you'd asked them several times if they needed to go... only for it to happen anyway.

But it’s important to remember that this is not their fault, but in most cases, simply a side-effect of the dementia, so patience is key. Likewise, getting angry or upset, will only create even more of an issue, so keep calm if you can. Try to overcome any embarrassment or distaste you may feel by adopting a practical, matter-of-fact attitude. Whilst it’s not pleasant for either of you, it's happened and it needs to be dealt with.

Good to know

There are lots of ways to help prevent accidents or make them easier to cope with. Click here for tips on setting up strategies to reduce the risk of accidents, both in the home and while out and about, and find out what incontinence products might help manage the problem.