Dementia and Bladder and Bowel Control in Maltese

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.

Għaliex nies bid-dimenzja jbatu minn problemi ta’ kontroll tal-bużieqa ta’ l-awrina u tal-imsaren?

Nies bid-dimenzja jbatu minn telf tal-memorja u jistgħu jkunu konfużi u jista’ jkun li lanqas ikunu jafu fejn huma. Dan jista’ jikkaġuna jew jiggrava l-problemi tal-kontroll tal-bużżieqa tal-awrina u l-imsaren.

Persuni bid-dimenzja jistgħu jsibuha bi tqila:

• “Iżommu” sa ma jaslu fit-tojlit.
• Jsibu t-tojlit.
• Ikunu jafu li jridu jniżżlu Ż-żipp jew jniżżlu l-qalziet tagħhom meta jmorru t-tojlit.
• Meta jkunu ‘l bogħod mid-dar f’postijiet fejn ma jafux fejn hu t-tojlit.
• Li jkunu jafu meta l-bużżieqa tal-awrina u msarinhom ikunu vojta.
• Li jkunu jafu li għandhom bżonn jgħaddu l-awrina jew ibattlu msarinhom.
• Jagħmlu l-awrina jew ibattlu msarinhom f’postijiet fejn mhux suppost.
• Minћabba dipressjoni, ansjetà jew stress, jew mard li jistgħu jiggravaw il-problemi tal-kontroll tal-bużżieqa tal-awrina u l-imsaren.

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.

Tista’ ssir xi ħaġa għal dawk li jbatu bid-dimenzja li jsibuha bi tqila jikkontrollaw il-bużżieqa tal-awrina u l-imsaren.

Iva!

Għalkemm id-dimenzja żżommhom milli jipparteçipaw f’xi trattamenti ta’ kura, hemm modi kif jistgħu jingħataw komfort u dinjità.

Hemm xi regoli ġenerali/wiesgħa ta’ ћidma li tkun tista’ toffri għajnuna lil persuni bid-dimenzja:

• Oqgħod ismagħhom b’attenzjoni u ћu interess fihom.
• Armi l-imbarazz. Żomm l-ispazju madwarhom sempliċi u familjari għalihom.
• Urihom rispett u ħu ħsiebhom b’mod sinċier.

Iċċekkja l-kontroll tal-bużżieqa tal-awrina u tal-imsaren

Itlob l-għajnuna tat-tabib, fiżjoterapista, jew in-ners tal-kontinenza tagħhom.

Eżami mediku tal-kontroll tal-bużżieqa tal-awrina u tal-imsaren ser jinkludi eżami fiżiku u mistoqsijiet dwar meta, fejn u għala jiġru l-problemi.

Il-kerer hu spiss l-aħjar persuna biex tagħti d-dettalji meħtieġa biex tiċċekkja l-kontroll tal-bużżieqa tal-awrina u tal-imsaren, bħal ngħidu aħna:

• il-ħin meta l-persuna tmur it-tojlit u/jew ikunx hemm taqtir tal-awrina;
• kemm tkun imxarrba l-persuna:
  ftit = il-qalziet ta’ taħt jkun niedi;
  moderat= id-dublett jew il-qalziet huma mxarrbin; jew
  severahemm għadira fuq is-siġġu, fl-art jew fis-sodda; u
• meta u kemm-il darba jbattlu msarinhom.

Immaniġġja l-kontroll dgħajjef tal-bużżieqa tal-awrina u tal-imsaren

• Ikkura l-kawża tal-problema. It-tabib, il-fiżjoterapista jew in-ners tal-kontinenza tagħhom jistgħu jgħinu biex jinstabu l-kawżi u jissuġġerixxu kif tikkurahom.
• Irrevedi l-mediċini. Il-mediċina tista’ tgħin, imma tista’ wkoll tagħmel lill-persuni aktar konfużi, u tagћmel agħar il-problema tal-kontroll tal-bużżieqa tal-awrina u l-imsaren.
• Kun ċert/a li l-persuna bid-dimenzja tixrob 1.5 – 2 litru ilma kuljum (sakemm tabib jgħid li dan mhux tajjeb). Ix-xorb tal-ilma jista’ jgħin fil-kura tal-infezzjonijet tal-bużżieqa tal-awrina, jagħmel l-imsaren jaħdmu aħjar u jżomm il-bużżieqa tal-awrina b’saħħitha. Il-kafè, it-te u l-kola fihom ħafna kafeina, li tista’ tirrita l-bużżieqa tal-awrina u jwassal biex ikun aktar diffiċli tikkontrolla l-bużżieqa tal-awrina. Ipprova naqqas l-ammont li jixorbu dan it-tip ta’ xorb.
• Ikkura l-kostipazzjoni Ara li jieklu ħafna frott u ħaxix u jixorbu ħafna ilma matul il-ġurnata u jżommu ruħhom attivi.
• Oqgħod attent għal sinjali li juruk li jridu jmorru t-tojlit. Itlobhom jużaw it-tojlit meta taħseb li jmorru l-aktar jew jkunu l-aktar ta’ spiss imxarrbin. Jekk tinnota l-ħin meta jiġri dan int tkun tista’ tara jekk l-affarijiet humiex qegħdin imorru għall-aħjar.
• Jekk isibuha bi tqila jniżllu ż- żippijiet u buttuni, ibda uża track suits, qliezet bil-lastku jew uża l-Velcro.
• Żomm il-passaġġ lejn it-tojlit mingħajr imbarazz. Tħallix affarijiet fin-nofs li jistgħu jagħmluha aktar diffiċli biex jaslu sat-tojlit. Dawl billejl jista’ jkun ta’ gћajnuna. Agħmel il-bieb tat- tojlit faċli biex tarah.
• Ara tkunx tista’ tuża r-riżorsi tal-komunità biex jgħinu fix-xogħol tal-kura ta’ persuna bid-dimenzja - bħal ngħidu aħna fil-ħasil tal-ħwejjeġ, xiri u kura ta’ respajt.

Prodotti tal-immaniġġjar tal-bużżieqa tal-awrina bħal ngħidu aħna pads u qliezet jistgħu jtejbu l-kwalità tal-ħajja. Gћandek mnejn tkun tista’ tikseb għajnuna biex tkopri l-ispejjeż ta’ dawn il-prodotti. Pariri dwar jekk tistax tirċievi din l-għajnuna u t-tipi tal-prodotti li tista’ tirċievi jistgħu jinkisbu fuq il-Linja Nazzjonali tal-Għajnuna bit-Telefown dwar il-Kontinenza (Telefonata bla ħlas* 1800 33 00 66). Dawn l-affarijiet jistgħu jnaqqsu l-frekwenza ta’ nuqqas ta’ kontroll tal-bużżieqa tal-awrina u l-imsaren u kemm ikunu serji.

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.

Il-mediċina tista’ tgħin fil-kontroll tal-bużżieqa tal-awrina u tal-imsaren?

Iva!

• Jistgħu jingħataw antibijoteċi biex jikkuraw l-infezzjoni tal-bużżieqa tal-awrina.
• Terapija tal-bdil tal-ormoni (pilloli, paċis jew kremi) jistgħu jagħmluha eħfef biex nisa ‘ jkunu jistgħu jikkontrollaw il-bużżieqa tal-awrina tagħhom wara l-menopawsa.
• Pilloli biex iserrħu l-bużżieqa tal-awrina jistgħu jingħataw biex jgħinu meta l-bużżieqa tal-awrina tkun irritata, biex tkun tista’ taħżen aktar awrina. Dan jista’ jnaqqas in-numru ta’ drabi li l-persuna jkollha bżonn tmur it-tojlit.
• Xi mediċini jistgħu jikkawżaw problemi tal-kontroll tal-bużżieqa tal-awrina u tal-imsaren, jew jagħmluhom agħar. Il-mediċini jridu jiġu ċċekkjati mit-tabib, biex jara jekk għandhomx jinbidlu.
• Xi mediċini għall-problemi tal-kontroll tal-bużżieqa tal-awrina u tal-imsaren jistgħu jikkawżaw ċerti problemi bħal ħalq xott, kostipazzjoni, bilanċ dgћajjef u nuqqas ta’ enerġija. Fil-każ ta’ nies bid-dimenzja, hemm ukoll ir-riskju li jsiru aktar konfużi. L-użu tal-mediċini għandu jiġi ssorveljat bir-reqqa mit-tabib tagħhom. Għarraf lit-tabib tiegħek dwar kwalunkwe problema li l-mediċini jistgħu jikkawżaw.

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.

Itlob l-għajnuna

Hemm nersis ikkwalifikati jekk iċċempel lin-National Continence Helpline fuq 1800 33 00 66* (mit-Tnejn sal-Ġimgħa, bejn it-8.00am to 8.00pm AEST (Ħin Standard tal-Lvant tal-Awstralja)) mingħajr ħlas:

• Informazzjoni;
• Pariri; u
• Fuljetti.

Jekk ikollok diffikulta’ biex titkellem jew biex tifhem bl-Ingliż jista’ jkollok aċċess għall-Helpline permezz tat-Telephone Interpreter Service fuq 13 14 50 b’xejn. It-telefon ikun imwieġeb bl-Ingliż, għalhekk għid liema lingwa titkellem u stenna fuq it-telefon. Tkun ikkonnettjat/a ma’ interpretu li jitkellem il-lingwa tiegħek. Għid lill-interpretu li tixtieq li ċċempel lin-National Continence Helpline fuq 1800 33 00 66. Stenna fuq it-telefon biex tkun ikkonnettjat/a u l-interpretu jgħinek biex titkellem ma’ ners li tagħti pariri dwar il-kontinenza. It-telefonati kollha huma konfidenzjali.

* Telefonati minn fuq telefonijiet mowbajl ikunu ċċarġjati r-rati li japplikaw.