Why do people with dementia have trouble with bladder and bowel control?People with dementia have memory loss and may be confused and not know where they are. This can cause or make bladder and bowel control problems worse. People with dementia may have trouble with: - “Holding on” until they get to the toilet.
- Finding the toilet.
- Knowing they need to unzip or pull down their pants when going to the toilet.
- Being away from home at places where they don’t know where the toilet is.
- Knowing when their bladder or bowel is empty.
- Being aware of the need to pass urine or empty their bowels.
- Urinating or opening their bowels in places they should not.
- Depression, anxiety or stress, or illness, which may make bladder and bowel control problems worse.
| 為什麼患有癡呆症的人士難以控制大小便？患癡呆症的人喪失了記憶力並可能因迷惑而不知道自己身在何處。這會導致大小便控制失常，或令其更加嚴重。 患有癡呆症的人士可能： - 無法在去到廁所之前“忍住”大小便。
- 找不到廁所。
- 不知道上廁所時要開拉鏈或脫褲子。
- 離開家到他們不知道廁所在哪裡的地方。
- 不知道大小便何時排完。
- 不知道自己需要排尿或排便。
- 會在不適合的地方大小便（會隨地大小便）。
- 可能會因為沮喪、焦慮或壓力令大小便控制問題更嚴重。
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Can anything be done for people with dementia who have trouble with bladder and bowel control?Yes! While dementia may rule out some treatments, there are ways to provide comfort and dignity. There are some broad rules for working in a helpful way with people with dementia: - Listen with care and respond to the person.
- Get rid of clutter. Keep the space around them simple and well known to them.
- Show respect and sincere care.
Check bladder and bowel control Seek help from their doctor, physiotherapist, or continence nurse. A bladder and bowel control check up will include a physical check and questions about when, where and why problems happen. The carer is often the best person to give the details needed to check bladder and bowel control, such as: - the time the person goes to the toilet and/or leaks;
- how wet the person is:
minor = underwear is damp;
moderate = skirt or trousers are wet; or
severe = chair, floor or bed is flooded; and - when and how often they open their bowels.
Manage poor bladder and bowel control - Treat the cause of the problem. Their doctor, physiotherapist or continence nurse can help find the causes and suggest how to treat them.
- Review medicines. Medicines may help, but they can also make people more confused, and make bladder and bowel control problems worse.
- Make sure the person with dementia drinks 1.5 - 2 litres of fluid per day (unless a doctor says this is not okay). Drinking water can help treat bladder infections, make the bowels work better and keep the bladder healthy. Coffee, tea and cola have a lot of caffeine, which can upset the bladder and make the bladder harder to control. Try to cut down on how many of these drinks they have.
- Treat constipation. Make sure they eat lots of fruits and vegetables, drink lots of water through the day, and stay active.
- Watch for signs they want to go to the toilet. Ask them to use the toilet at the times you think they most often go or are most often wet. If you note the time this happens you will be able to see if it gets better.
- If they have trouble with zips and buttons, change to track suits, trousers with elastic waists, or use Velcro.
- Keep the way to the toilet clear. Don’t leave things in the way that might make it hard to get to the toilet. A night light may help. Make the toilet door easy to see.
- Think about using community resources to help with the load of caring for a person with dementia – such as laundry, shopping and respite care.
Bladder management products such as pads and pants may improve quality of life. You may be able to get some help to cover the cost of these products. Advice on whether you are able to receive this help and the types of products you can get can be found on the National Continence Helpline (Free call* 1800 33 00 66). These things may reduce how often bladder and bowel mishaps occur and how bad they are. | 可以為難以控制大小便的癡呆症患者做些甚麼嗎？可以！ 雖然某些治療可能不適合癡呆症患者，但有一些方法可以給他們安慰及尊嚴。 以有效方式幫助癡呆症人士有一些廣泛適用的規則： - 仔細聆聽及回應病人。
- 清理雜物。保持他們的周圍環境簡單整潔，讓他們感到非常熟悉。
- 表現出尊重及真誠的關心。
檢查大小便控制情況 向他們的醫生，理療師，或排便科護士尋求幫助。 大小便控制檢查包括身體檢查，以及詢問有關問題在何時、何地及為何發生。 照顧者是提供大小便控制檢查所需詳情的最合適人選，所需資料包括： - 病人上廁所及/或失禁的時間；
- 病人尿濕的程度：
輕度= 尿濕內褲；
中度= 尿濕裙子或褲子；或者
嚴重= 浸濕椅子，地或床；以及 - 他們何時及多久排一次大便。
大小便控制失常的管理 - 針對問題的起因。他們的醫生，理療師或排泄科護士可以幫助找出原因及提出對策。
- 考慮用藥治療。藥物可能有幫助，但它們亦可能令人更迷惑，並令大小便控制問題更加嚴重。
- 保證患有癡呆症的人每天飲用1.5—2升液體（除非醫生說不能這樣做）。喝水有助於治療膀胱感染，令腸道更通暢及保持膀胱健康。咖啡，茶及可樂含有大量咖啡因，會影響膀胱，令排尿更難控制。儘量減少他們喝這些飲品的量次。
- 治療便秘。確保他們吃大量水果及蔬菜，每天大量喝水，並經常活動。
- 觀察他們想上廁所的徵象。在你認為他們最經常上廁所，或最經常尿濕的時侯叫他們上廁所。如果你能留意出現這些情況的時間，就可以知道是否有改善。
- 如果他們開拉鏈，解紐扣有困難，就改穿運動服、有橡筋腰帶的褲子，或使用魔術貼（Velcro）。
- 保持去廁所的通道暢通。不要在通道上擺放可能阻礙上廁所的物品。夜間照明燈可能有幫助。令廁所門容易看得見。
- 考慮利用社區資源減輕照顧癡呆症患者的負擔—例如提供洗衣，購物及暫休照顧。
排尿管理產品如墊子及短褲或可改善人們的生活質素。你也許能獲得資助，支付這些用品的開支。關於你是否可以獲得這項資助，以及你可以購買的產品類型的建議，請致電全國排便節制幫助熱綫（National Continence Helpline）（免費電話*1800 33 00 66）。這些用品或可以降低大小便失禁發生的次數及嚴重程度。 |
Can medicine help with bladder and bowel control?Yes! - Antibiotics may be given to treat a bladder infection.
- Hormone replacement therapy (tablets, patches or creams) may make it easier for post menopausal women to control their bladder.
- Tablets to relax the bladder may be given to settle an upset bladder, so it can store more urine. This can cut down the number of times the person needs to go to the toilet.
- Some medicines may cause bladder and bowel control problems, or make them worse. Medicines should be checked by a doctor, to see if any need to be changed.
- Some medicines for bladder and bowel control problems may cause problems like dry mouth, constipation, poor balance and lack of energy. For people with dementia, there is also a risk they may get more confused. Use of medicines should be watched with care by their doctor. Tell the doctor about any problems the medicines cause.
| 藥物可以幫助大小便控制嗎？可以！ - 抗生素可用於治療膀胱感染。
- 荷爾蒙替代療法（藥片，貼片或乳膏）可令絕經後的女性較容易控制排尿。
- 對受刺激的膀胱可用鬆弛膀胱的藥片治療，讓膀胱可以儲存較多尿液。這可以減少病人需要上廁所的次數。
- 有些藥物會引起大小便控制失常，或令失常更加嚴重。藥物應該經醫生檢查，看看是否需要換藥。
- 一些用於大小便控制問題的藥物可能引起如口乾，便秘，平衡失調及乏力等問題。對於癡呆症患者來說，還有可能令他們更迷惑。藥物的使用應該由他們的醫生小心觀察。要告訴醫生任何由藥物引起的問題。
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Seek helpQualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free: - Information;
- Advice; and
- Leaflets.
If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential. Visit bladderbowel.gov.au or continence.org.au/other-languages * Calls from mobile telephones are charged at applicable rates. | 尋求幫助如果你致電國家排便節制熱線，有資質的護士會接聽你的電話1800 33 00 66* （週一至週五，澳大利亞東部標準時間8:00am—8:00pm）。 如果你在講英語或者理解上有困難，你可以透過撥打13 14 50獲取免費電話傳譯服務以接通國家排便節制熱線。電話會用英語接通，因此請說明你要講的語言並且不要掛機。你會被連接到一個講你母語的傳譯員。告知傳譯員你想要致電國家排便節制熱線，電話是1800 33 00 66。待電話接通後傳譯員會幫助你與排便節制護理顧問對話，所有的來電均保密。 請登陸：bladderbowel.gov.au或者continence.org.au/other-languages * 用手機打出會收取相應費用。 |
