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Caring for someone with dementia
People with dementia have memory loss and may be confused and may not know where they are. This can cause bladder control and bowel problems.
People with dementia lose control of their bladder or bowel because they:
- Forget where to find the toilet
- Forget how to undo their clothes
- Forget what to do when they get to they toilet.
They may also forget how to clean themselves or and forget how to wash their hands after toileting.
People with dementia can experience bladder and bowel control problems for other reasons, such as urinary tract infections or an enlarged prostate gland. These problems will make the person's bladder and bowel problems worse if not found and treated.
Have a look at the brochure Dementia and Bladder and Bowel Control.
Managing difficult behaviours
People with dementia can become very distressed when toileting because of embarrassment, anxiety or forgetting where to go and what to do. Carers need to remain calm, gentle, firm, patient and accepting. Sometimes a sense of humour can help.
If the person is passing urine in the wrong place, find out why this is happening so a plan can be made to re-direct the person. Distraction can be useful for people who toilet often, those who are anxious or bored, or those who have forgetten when they last went to the toilet.
Knowing a person's past habits can help to plan how to manage bladder and bowel problems. Knowing the person's past work, interests, standards of living, where they lived, where their toilet used to be (such as outside in the garden) can all help in making a management plan.
Never hurry a person with dementia, use short step-by-step instructions and watch for body language that they may need to go to the toilet (such as pulling at clothes or wandering).
Understanding difficult behaviours
The person being cared for may not be able to tell you that they feel unwell because of headaches or tiredness caused by a urinary tract infection, or that they are not hungry because their stomach is sore due to constipation.
Bladder or bowel control problems may upset the person you are caring for, making them more anxious than usual. Look for changes in how they act and watch their patterns of toileting.
Behaviours & possible causes
While the following feelings and actions may be due to more other problems, they can be due to bladder and bowel problems.
If the person with dementia is angry, agitated, yelling and hitting or being disruptive with constant questions, they may be in pain or have trouble because of:
- Constipation
- Feeling the need to pass urine and not being able to
- Being upset by their bladder or bowel problem.
If the person with dementia is restless and wandering, this may be because they:
- Feel hungry
- Feel thirsty
- Feel the need to pass urine or open their bowel urgently
- Cannot find the toilet.
If the person with dementia has trouble sleeping, this may be because they:
- Have a urinary tract infection
- Are constipated
- Feel the need to pass urine or open their bowel urgently
- Have problems with their prostate, if male.
If the person with dementia is paranoid (feeling that someone is against them) or hallucinating (seeing things that aren't really there), this maybe be because they:
- Have a urinary tract infection
- Are badly constipated.
If the person with dementia is lethargic (tired or fatigued) or more confused than usual, this may be because they:
- Are constipated
- Are dehydrated
- Have a urinary tract infection.
If the person you are caring for is acting different to usual or as described above, contact your local doctor or the National Continence Helpline on 1800 33 00 66.
Page last updated 19 Nov 2006