Fecal incontinence affects many people who have Alzheimer's disease. It can occur at any stage of Alzheimer's disease, but is more common in middle stage and very common in late stage Alzheimer's. There are caregiving stratagies to improve and, in some cases, eliminate bowel incontinence. Here's How!

Exclude Diseases That Cause of Fecal Incontinence

Remember, people with Alzheimer's can get sick too. Fecal incontinence may just be a symptom of an underlying health problem and will require evaluation by a doctor and appropriate treatment. Examples of symptoms that require medical investigation include; blood and or mucus in feces, weight loss, changes in bowel movements (e.g. diarrhoea or impacted faeces), infection, excessive wind, pain.

Fecal incontinence can be caused by many diseases or conditions. These include; medication side effects, recent surgery, infection, trauma, cancer, diseases of the bowel such as ulcerative colitis, Crohn's disease, diverticulitis.

Most Common Cause of Bowel Incontinence is Constipation

Diet Can Contribute to Fecal Incontinence

Diet should be rich in fiber but not to the point where it causes diarrhea. A balanced diet is important to maintain health and efficient bowel movement.

More on Balanced Diets

Behavioral Treatment for Fecal Incontinence

Fecal Incontinence in people with Alzheimer's is often due to a combination of factors. Once disease has been excluded as a cause of their incontinence you can then begin to investigate the causes. Central to your investigation are improving effective communication and trying to limit the impact of confusion due to Alzheimer's disease. Physical problems that result from limited mobility and exercise, long periods of bed care, inadequate diet, poor fluid intake will also affect toilet programes and fecal incontinence.

Establish a Baseline of Current Toilet Behavior

Keep a diary of their current toileting habits for at least 3 days (7 days is best) before you begin to make any changes. Do an ABC chart.

A=Antecedant-in other words, their behavior leading up to the incidence of fecal incontinence. Record time, where they were, what they were doing, saying, if they asked to use the bathroom, became restless etc.

B=Behavior-where, how they were incontinent, who they were with, etc

C=Consequences-what happened, as a result of the incident of fecal incontinence. Their behaviour (agitated, calm etc), what they were talking/saying etc.

Also record the time of any normal bathroom trips and other bowel movements. From this diary you will be able to see any patterns in behaviour and can give clues to how any new interventions can be best programmed into their day and cut down or eliminate incidents of fecal incontinence. The program you establish can then be continued on inother settings such as day care centers, on visits outside the home, in respite care and nursing home facilities.

Keep your diary to refer back to establish whether a new behavioral toileting programme is effective. A new toileting pattern should show results after a couple of weeks.