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Dementia including Alzheimer's Disease

Dementia is an umbrella term that describes the symptoms that occur when the brain is affected by certain diseases or conditions. Symptoms can include memory loss, behaviour or mood changes and problems with communication. Because dementia is progressive, it will affect someones ability to carry out daily activities.

Alzheimer's disease, the most common cause of dementia, is a physical disease of the brain. People with Alzheimer's lose certain mental functions such as memory, judgement and language. This loss of mental function can affect the ability to control the bowel and bladder. Alzheimer's disease can also make it difficult for the person to recognise, find and use the toilet.

Although 60 - 70% of people with Alzheimer's develop incontinence problems, incontinence is not an inevitable symptom of Alzheimer's. It is important to visit a health care professional who can assess whether incontinence is related to the disease or if there is another reason and possible treatment to prevent or manage it. For example treatable causes of urinary incontinence include urinary tract infection or the side effects of some forms of medication.

If a person with dementia such as Alzheimer's experiences incontinence there are a number of reasons that can explain this:

• The correct signals that are usually sent to the brain to tell a person that they need to go the toilet may not be getting to the brain or the person may not be able to recognise what the feelings mean.
• Not being able to move in time to reach a toilet.
• Not being sure where a toilet it is. Maybe the person can't remember where the toilet is or the toilet is no longer where they expect it to be.
• Not being able to identify objects correctly. A person living with dementia may not be able to identify what a toilet looks like and this may result in the person going to the toilet in the wrong place.

How to manage incontinence and Alzheimer's

It is possible to retain independence and avoid accidents by careful planning and routines. Below are some simple tips that may help carers:

• The most obvious step to take to avoid an accident is to take the person to the toilet regularly. If you are caring for someone with dementia you can contact your local continence service to help you plan a toilet routine.
• Consider appropriate clothing - clothing which is easy to remove quickly may help to prevent accidents.
• Try to make sure that the toilet is easy to find and use. Remove any obstacles that could make getting to the toilet difficult.
• Reduce the amount of fluids that the person has before bedtime.
• Use tact and sensitivity in dealing with issues of someone's personal hygiene.
• Consider using continence aids such as waterproof bed and chair protectors, mattress covers to protect the bed, disposable bed and chair pads - these products will help when accidents do occur. It is also worth investigating the use of body worn absorbent pads for the person to wear during the day. Visit your GP or Continence Nurse / Advisor for advice about how to arrange a supply.

Bladder and bowel health

It is important to consider fluid intake and diet as they play a vital part in keeping the bladder and bowel healthy.

Try to ensure that the person eats a good, balanced high fibre diet. Fibre rich foods such as fruit and vegetables, bran and wholemeal bread will help. Make sure that the person drinks plenty of fluids, it is important to drink approximately 3 pints of fluid each day.

Try to avoid too much caffeine or alcohol.

The person will also benefit from regular exercise. A Continence Nurse or Advisor will be able to advise you on appropriate exercise programme.

Further information

The information supplied on this page has been produced in association with the Alzheimer's Society. Should you require further information and support for people with dementia and their carers please contact one of the organisations below.

Alzheimer's Society - http://www.alzheimers.org.uk/site/index.php

Alzheimer's Trust - http://www.alzheimers-research.org.uk

If you are concerned about your bladder problem and it is starting to affect your day to day life make an appointment to see your doctor, continence nurse or specialist physiotherapist. A continence nurse and specialist physiotherapist are healthcare professionals who specialise in bladder and bowel problems. You can also call our specialist helpline on 0845 345 0165 (24 hour answerphone) for medical advice, or visit our Continence Clinic Database facility in the Specialist Services section to find out where your nearest clinic is or call our general enquiries line on 01536 533255 for details.