Alzheimer's Disease, Dementia and Incontinence

How person-centered care can help carers manage incontinence in residents with Alzheimer's Disease or Dementia.
A professional caregiver helps a contented nursing home resident button their shirt A professional caregiver helps a contented nursing home resident button their shirt

Around 49% of nursing home residents have some form of dementia.* Alzheimer’s disease is the most common form of dementia and may contribute to 60–70% of cases.** Dementia can affect memory and other cognitive functions, and it impacts mobility and dexterity. All these symptoms can contribute to incontinence. Residents may forget where they are and why they’re there. They might not be able to ask to use the toilet or even realize they need to go until after they’ve had an accident.

Let’s see an overview of the condition and look at some of the ways that person-centered care can help you manage incontinence in residents with dementia or Alzheimer’s Disease.

What is dementia?

Dementia is an umbrella term to describe different symptoms which occur when the brain is affected by disease.

The World Health Organization defines dementia as an acquired permanent state of deterioration of memory and other cognitive features that has been there for at least six months and, affects work, social activity and eventually, the ability to lead an independent life.

Male residents laughing together with a nurse while sitting outside
. Male residents laughing together with a nurse while sitting outside

What is dementia?

Dementia is an umbrella term to describe different symptoms which occur when the brain is affected by disease.

The World Health Organization defines dementia as an acquired permanent state of deterioration of memory and other cognitive features that has been there for at least six months and, affects work, social activity and eventually, the ability to lead an independent life.

Nurse helping care home resident walking while wearing a face mask

Dementia caused by Alzheimer's Disease

More than half of all people with dementia have Alzheimer's disease, which affects the brain, causing memory loss and confusion, and slowing down or even stopping brain functions such as thinking, understanding, and interpretation.

Other types and causes of dementia

These include vascular dementia, dementia with Lewy bodies (DLB), Parkinson's disease dementia, and frontotemporal dementia. Old age, diabetes, heart disease and genes can all be contributing risk factors. Women are also more likely to experience dementia than men.

A smiling elderly female resident taking a walk outdoors with a professional caregiver
. A smiling elderly female resident taking a walk outdoors with a professional caregiver

Other types and causes of dementia

These include vascular dementia, dementia with Lewy bodies (DLB), Parkinson's disease dementia, and frontotemporal dementia. Old age, diabetes, heart disease and genes can all be contributing risk factors. Women are also more likely to experience dementia than men.

The three stages of dementia

Dementia symptoms vary between the different types, which part of the brain is affected, and the individual. These can include problems with cognitive functions, orientation, comprehension, calculation, learning capacity, language and judgement. Dementia develops over time and is categorized in the following three stages.

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Early-stage

Mood, small behavior changes and forgetfulness. Often the symptoms aren't clear, so they're confused with 'old age'.

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Middle-stage

Very forgetful, impaired communication abilities, difficulties with everyday tasks.

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Late-stage

Dependent on others for care, unaware of time and place and, unable to recognize relatives and familiar objects.

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Behavioral and Psychological Symptoms of Dementia (BPSD)

Individuals with dementia find it increasingly more difficult to communicate their needs and understand the world. This can result in a resistance to care. In fact, 90% of people with dementia will experienced BPSD, which can include anxiety, apathy, restlessness, paranoia, hallucinations, and reactive behavior. 

Many things can trigger BPSD, such as pain, constipation, itching, sleep deprivation, lack of privacy, and a stressful environment. 

Since BPSD greatly affects quality of life, it’s important to identify and minimize these triggers through person-centered care.

What is person-centered care?

Person-centered care means to treat the resident as an equal partner, helping them help themselves to improve their own independence, quality of life, and well-being and giving them the knowledge, assistance, and confidence to do so. 

When caring for people with dementia, it’s important to treat them with dignity, compassion, and respect to help them develop their strengths and abilities to live an independent life and preserve their identity for as long as possible. 

So, get to know the resident, talk to their relatives, and involve the individual in their own care. Participation in activities can help to prevent frustration and challenging behavior for residents. Manage any symptoms through music, massage, an active lifestyle, and spending time outdoors. It also helps to say and do one thing at a time, be patient, and wait for answers.

How can person-centered care improve symptoms of dementia?

Encouraging residents to enjoy a healthy and active lifestyle, maintaining social interactions and a good, consistent sleeping routine, can improve symptoms of dementia.

Person-centered care improves symptoms of dementia

Person-centered incontinence care supports residents’ independence as much as possible. Here are some ways to achieve this, ensuring residents’ dignity, comfort, and safety. 

  • Assess the resident’s needs and set personalized times for toileting (TENA Identifi or a bladder diary are helpful tools). 
  • Observe signs of needing to go to the bathroom and help as needed 
  • Maintain independence by ensuring clothes and incontinence products are easy to put on and remove, like TENA Incontinence Underwear. 
  • Ensure residents know the way to the bathroom – clearly label the bathroom, light switch, and toilet seat. 
  • Leave the bathroom door open and the light on at night to make it easy to find. You could also put a commode next to the bed at night. 
  • Have easily accessible personal hygiene products so residents can maintain hygiene and skin health. 
  • Use mobility aids like a raised toilet seat and handrails.
Product image of TENA ProSkin Underwear

Products for continence care

TENA offers a great range of incontinence products and aids. From TENA Underwear that encourage independence and self-toileting, to products with wetness indicators to help ensure individuals are changed only when needed. Some people who experience dementia can be afraid of water, so rinse-free products like TENA Wash Gloves and shampoo caps can help maintain skin health and independence, while TENA’s Skin Cream can help sooth dry skin and prevent it.

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Audited by Josefine Grandin, District nurse, urotherapist, 2023-06-08

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