2. Things that might help

Think about underlying reversible causes – reversible causes of continence problems should be managed:

  • UTI
  • Constipation
  • Eating and drinking problems
  • Other underlying conditions, such as prolapse or prostate issues
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Bladder and bowel service help

  • Each service is different – check what your local service provides.
  • Provide specialised assessment and treatment if appropriate.
  • Some provide a limited range of products.

Supporting mobility & functioning

  • If the main problem is mobility or other functional problem, consider a physiotherapy or occupational therapy referral.

Assistive technologies

  • Absorbent products and other devices (e.g. handheld urinals, mattress protectors etc) can help the person with dementia stay independent or help the carer to cope.
  • There is a wide range of these available - click here for the continence product advisor website.
  • Many are not available via the NHS, but carers still need to know about them. An occupational therapist referral might be useful.

Negative emotions

  • Acknowledge that dealing with these problems can be very challenging. It is normal for many people to find these problems distressing.
  • The quotes in the DemCon carers website might help people to feel less alone with these problems.
quote

“Nobody had ever spoken to me until it actually started happening about the fact that he was going to become incontinent.”

Family carer

Behaviours that challenge

  • There can be a range of toilet related behaviours that carers may find really challenging. These can include refusing to use continence products, repetitive habits (such as shredding toilet paper) or smearing. A particular challenge may be dealing with aggression.
  • A referral to specialist dementia support might be beneficial.
  • More information on dealing with difficult problems can be found on the family and friends section of this website.

Giving practical advice – think of giving clear messages about:

  • The importance of skin care – keeping the skin clean, dry and intact.
  • Clothing – allowing enough time to adjust prior to and after toileting.
  • Adapting clothing – for example, elasticated waistbands.
  • Not rushing the person they are caring for when assisting them with toileting.
quote

“I found it very, very stressful I suppose. But there was nobody advising you.”

Family carer