Incontinence could be a result of reduced control over bladder and bowel functions or other reasons. If not managed well, it could disrupt people’s daily lives or their ability to socialise, leading to negative psychological impacts. Effective incontinence prevention can help people with dementia to preserve their dignity and quality of life.
Common causes of incontinence:
- Urethritis
- Hormonal changes
- Severe constipation
- Post-surgical side effects
- Side effects of drugs
- Diabetes
- Benign Prostatic Hyperplasia
Psychological Impact
Incontinence will have a psychological impact, manifested by these signs and symptoms:
Depression
- Isolating oneself
- Feeling embarrassed/shamed
- Reduce or refuse socialising to avoid others knowing about it
Nervousness/emotional
- Fidgeting with clothes
- Screaming non-stop
- Look nervous and uneasy
- Open and close the doors frequently
- Unpredictable behaviour
Anxiety
- Look worried
- Standup and sit down repeatedly
- Change in body language
- Frequent visits to the bathroom
Confused
- Take off clothes or hide soiled clothes
- Urinate inappropriately
- Difficult to communicate
- Lack self-control
How to Help the Incontinent
Communication
They may have difficulty expressing or understanding verbally. When there is a misunderstanding they may fight or seem uncooperative. Therefore, appropriate communication is vital.
- Use simple words and sentences to guide step by step
- Use phrases they are familiar with
- Do not hurry them
- Before nursing care, advise them in advance what you are about to do, and get their consent, to avoid causing objection due to misunderstanding
- Observe routinely their body language before going to the toilet, such as pulling clothes, loitering or fidgeting
- Ascertain how they feel, and understand that they may get emotional because they are embarrassed and not sure how to deal with it
- Avoid scolding openly and damaging relationships or causing negative feelings
Simple clothing
- Simplify dressing, by using clothing easier to take off, such as clothes with velcro instead of buttons or zippers, pants with rubber bands
- Choose easier to clean fabrics
Simplify the environment
Help look for toilets
- Remove the things they may confuse as toilets
- Put a toilet sign on the toilet door and turn on the nightlight or toilet light, and keep the toilet door open
- Use strong colour contrast between the door frame and the wall
Help to identify toilet bowl
- Use strong colour contrast between the floor and the toilet bowl
- Put toilet paper in visible locations, and use strong colour contrast for the wall
- Maintain adequate lighting
Safe and comfortable
- Make the bedroom closest to the toilet his/her bedroom
- Choose a bed of the right height that is easy to get out of
- When required, use a toilet bowl set higher and handrails to offer support for sitting down and then standing up (consult occupational therapist first)
- Maintain a pleasant indoor temperature
Build good habits
- Encourage him/her to drink water regularly, up to 6-8 glasses per day, to reduce the risk of urinary tract infection, and maintain good toileting habits
- Reduce diuretics such as coffee and strong tea
- Understand their toileting habit and encourage regularity
- It’s best to provide toilet training at an early stage
Appropriate nursing care
- Choose the right incontinence and assistive tools
- Help them clean up when needed, and keep the skin dry
- Choose diapers or diaper pants of the right size, with about one finger size’s leeway on either side of the waist
- After providing care, wash hands thoroughly to avoid cross-infection
