5 Steps to Managing Urinary Incontinence in Alzheimer's

Christine Kennard Health Pro
  • Urinary incontinence is a distressing but very common problem in people with mid to late-stage Alzheimer's disease. There are lots of things you can do to help.


    1st-Exclude diseases and conditions that could be causing urinary incontinence

    Remember, people with Alzheimer's can get sick too. Urinary incontinence may just be a symptom of an underlying health problem so will require evaluation by a doctor followed by appropriate treatment. This may cure it. Examples of symptoms that require medical investigation include;

    • blood in urine.
    • prostate problems in men.
    • offensive smelling urine (could be a urine infection, dehydration, diabetes or other kidney problem).
    • weight loss could be a sign of other serious diseases.
    • severe constipation.
    • pain when passing urine, back pain, any pain (for instance headaches could be due to kidney failure).
    • Prescribed drugs can have side effects that affect continence.


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    2nd-Urinary incontinence can be multi causational

    Urinary incontinence in people with Alzheimer's is sometimes due to a combination of factors. Once you have excluded disease as a cause of their incontinence think about:

    • improving effective communication to try to limit the impact of confusion caused by Alzheimer's disease.
    • room layout and easy bathroom access. Good lighting is important. Big mirrors can confuse someone with Alzheimer's. A bright or distinct toilet seat may help to direct the person to the right place.
    • is the ‘patient' able to call for assistance?
    • minimize physical problems caused by limited mobility and exercise, long periods of bed care. This could include use of walking aids, more exercise, effective pain control and others you identify.
    • bad diet and amount of fluid intake will also affect toilet programs and incontinence.
    • poor clothing choices can inhibit their ability to use the bathroom.


    3rd-Incontinence Treatment Program Rules for People with Alzheimer's

    A toileting program is not difficult but there are some rules that will help make it more successful.

    • be consistent and keep to as rigid a timetable as is practicable.
    • always take them to the bathroom if they request to go.
    • factor in any regular toilet trips you have previously established in their routine that give good results.
    • never shout or hurry them. Talk to them with respect. Be reassuring.
    • allow privacy whenever possible.
    • help minimise confusion during bathroom trips.
    • orientate people with Alzheimer's. So for example say,"Dad I'm taking you to the bathroom/ restroom / lavatory (whatever is most familiar to the person). "Mrs Jones we are at in the bathroom/ washroom / etc now, try to go".
    • do not expect a result (voiding) on each visit and do not keep them in the bathroom or on the toilet too long.


    4th-Begin Incontinence Treatment Program

    Begin your timed toilet trips every 2 hours. (This does seem quite a lot but this can be changed over time once you establish the best toileting program for that individual.)

    • factor in bathroom trips before and after meals, and just prior to bedtime. Night toileting should be maintained on a regular time basis too, but it is more practical to decrease the bathroom visits to every 4 hours.
    • praise any positive results.

    5th_ And Finally!

  • Reassure the person that their behavior is appropriate. Talk with a soft reassuring tone. Remember that some people with dementia may require frequent redirection. Use brief statements.

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    Fluid intake is important. It should be about 1.5 litres each day (unless a doctor advises you otherwise). Decrease fluid intake before bedtime. It is important to maintain a healthy bowel and digestive system.


    After a few weeks you can begin to decrease toilet trips if 2 hourly is too often. Introduce any changes very gradually, one change at a time is best to evaluate success.


    If you have any problems consult a doctor or nurse specializing in incontinence problems.


    More information on urinary incontinence here at HealthCentral

    Information about Fecal Incontinence and Alzheimer's


Published On: March 28, 2012