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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.

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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.

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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.

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Seek help

Qualified 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.

* Calls from mobile telephones are charged at applicable rates.

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Last Updated: Fri 30, Jul 2021
Last Reviewed: Tue 17, Mar 2020