Improve Urinary Continence for People with Alzheimer’s
As Alzheimer’s diseases progresses urinary incontinence can be a common problem. People with these types of neurodegenerative diseases become more disoriented and confused. They may no longer recognize the signs that they need to pass urine or they forget to go to the bathroom or don’t remember where it is.
Jed (aged 75) lives at home and his main caregiver is his daughter. Two years ago he was diagnosed with Alzheimer’s. Just before Christmas last year he started becoming regularly incontinent of urine. It has caused a lot of problems in their crowded house. Still, there are some things to try that may help improve the situation:
Exclude Disease or Conditions as Causes of Urinary Incontinence
Sudden changes in health or the onset of chronic conditions may cause health problems that affect continence and are not the result of Alzheimer's. This is why regular health checks for people with Alzheimer’s are important. Infections, medication side effects and disease can all contribute to incontinence and if successfully treated may resolve the problem of urinary incontinence completely.
Identify Any Precursors to Incidence of Urinary Incontinence
Sometimes events, people, places, moods and behaviors seem to cause incidents of urinary incontinence. If you can identify the event, or events, it can help. If you see a pattern record the incidents then change routines, introduce activities, change the toileting program, whichever works best. Change one thing at a time so you find the best solution.
Establish Routine Bathroom Trips
- Begin your timed toilet trips every 2 hours. You can use a baseline recording (diary) to work out the best times of day. Include toilet trips before and after meals, on getting up first thing in the morning and before getting into bed.
- Factor in any regular toilet trips you have established before with good results.
- Always take them to the bathroom if they ask to go.
- Talk to the person with Alzheimer’s with respect
- Allow privacy whenever possible
- Never shout or hurry them
- Assist when necessary but allow them to do as much as possible to maintain skills
- Use short conversational prompts using language that is familiar in order to to keep them “on-track”. For example:
“Amy, we are in the bathroom. Try to urinate (pass water, pee, etc.). Saying their name can help them orientate and telling them where they are and what is expected gives a short verbal prompt. A close relative will give you information on their familiar use of language, or slang names for urinating.
Fluid Intake and Urinary Incontinence
Fluid intake is important. Your loved one should drink about 1.5 litres each day (unless a doctor advises you otherwise). Decrease fluid intake before bedtime to avoid frequent urination. It is important to maintain a healthy bowel and digestive system.
The Importance of Routine
Keep to as rigid a timetable as is practicable. A new toileting pattern should show results after a couple of weeks. 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 to avoid too much loss of sleep.
During the day and after a few weeks have lapsed, you can try to decrease toilet trips from every 2 hours to every 3 hours. Introduce any changes very gradually, one change at a time is best to evaluate success over time.
Consult a doctor or nurse specializing in incontinence problems for more information. There are drugs for Urinary Incontinence.