General continence advice for patients with dementia guide

Treatable conditions

Urinary tract infection: Some people may complain of pain or burning when passing water or may show an expression of pain if they have difficulty talking. You,  or the person,  may notice their urine looks cloudy or smells. Sometimes an infection can be present without specific symptoms.

Prostate gland trouble in men: Your GP will be able to assess if this is a problem and advise you about treatment.

The side effects of some medication: Unfortunately some medications do affect how your bladder and bowel work. It is always advisable to discuss this with your doctor or nurse.

Severe constipation may cause urinary incontinence through pressure on the bladder. Bowel leakage, where loose, smelly motion leaks round the hard stool blocking the bowel, can also occur.

Lack of recall: Sadly, when people become forgetful ,this may also mean they gradually lose the memory of what to do in a toilet or even where the it is. Advice can be given to help you manage in these circumstances.

It is important to try to help this person keep their own continence skills for as long as possible.

Help available

• Aids and adaptations to make using the toilet easier
• Advice about clothing so that the person can get quick access to themselves in the toilet (eg velcro rather than zips or buttons)
• Advice about diet to keep bowels healthy
• Advice about hygiene
• Advice about mobility
• Advice about special products to help manage any wetness and to keep the person dignified, comfortable and dry
• Listening to your worries, suggesting ideas and working with you.

How you can help

• Get to know the person’s habits. This may seem a strange and very personal thing to suggest, but usually our bladder and bowel actions have some pattern to them. It may be worthwhile noting when the person is most likely to use the toilet. As their memory deteriorates, you can help by reminding them to go to the toilet at the times when you know they are most likely to go. Keep this as a regular routine
• It may be the person finds it difficult to verbally let you know they need to use a toilet. If this is the case, you will need to become aware of other signs such as fidgeting, wandering or pulling at clothing and suggest they use the toilet
• Make sure they drink enough during the day to keep the bladder and bowels healthy. People can forget or be reluctant to drink
• When you think about it, using the toilet is a very complicated thing to do involving lots of different steps to be successful. Try to keep using the toilet to a few, regular, easy steps. Always use the same language to ask or describe what is happening and keep to the same routine inside the toilet
• Decide the toilet routine, keep to it and tell others. This is important so that if the person spends some time apart from you, the routine to use the toilet is the same and the skill is encouraged to remain
• Keep in contact with the health care professional who is helping you. Discussing and monitoring changes as they occur can help prevent them from becoming larger problems.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk