Alzheimer’s Dementia Toileting Concerns

Managing Alzheimer’s Dementia toileting Issues in your home can be very difficult. For most people, Alzheimer’s toileting problems usually begin in the middle stage. But, soon, the “accidents” will start. 

The first rule is always to stay calm when this happens. Next, remember they will be embarrassed. 

Incontinence

Bladder control will go first, and bowel control loss is usually much later. In the medical world, we refer to this as incontinence. Incontinence is the term used to describe the inability to control the bowel or bladder.

As they progress through this illness, their needs will change. Alzheimer’s toileting issues appear when they begin having the occasional bladder accident. Next, they begin to have trouble finding the bathroom. Third, they begin to have problems removing their clothes to go to the toilet. 

Eventually, they will fail to recognize the need for toilets. At some point in the late stage, they fail to realize when their bowels or bladder move.

An Alzheimer’s Dementia Toileting routine will help

Beginning an Alzheimer’s toileting routine should be started early on in the disease. Toileting the first thing in the morning, every two hours during the day, and at bedtime is a regular Alzheimer’s toileting routine. Later, they will reach a point when they don’t realize they need to go to the bathroom. Often, a schedule will help you get them to the toilet before they have an incontinent episode. 

It is essential to remember keeping to a toileting routine helps prevent accidents!

Watch for signs they need to go to the toilet because they won’t be able to interpret the bladder/bowel signals correctly. For example, pulling at their clothing, wandering around the room, or becoming fidgety may signal they feel the need to void. They are uncomfortable, but they don’t know why they are feeling uncomfortable or what to do to fix it.

Plan for accidents

Understanding how the disease progresses and knowing what to expect next will help. Also, recognizing that incontinence is part of the Alzheimer’s dementia toileting process will help with the frustration of cleaning up an incontinence mess. 

Planning for accidents can also help prevent some of the embarrassment that goes along with it. Especially in the middle stage while you are still getting out and going places with your loved one. 

Having an extra pair of pants on hand when you go out is an excellent way to prepare for those unexpected accidents. I recommend a bag with pants, underwear or pull-ups, and wipes for the cleanup. Please keep it in your car for emergencies. 

Male Urine Guard

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Women’s Bladder Pad

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Pull-up

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Alzheimer’s Dementia Toileting & Cleanliness Concerns

When the loss of bladder begins, you will need to take extra measures to keep the private area clean. It is essential to help maintain cleanliness during this part of the Alzheimers toileting process. 

Keeping this area clean will help prevent odors and skin irritation. Also, disposable wipes are the easiest to use.

Watch out for reddened areas. Skin can become irritated, and the skin can break down. Frequently the skin breakdown leads to pressure injuries, also known as bed sores. If you find a reddened area, you can treat it before it becomes an open area.

Assisting with toileting care can be awkward for both of you.

Everyone does this in private, and as your loved one progress in the disease, they will begin to resist toileting more. Gentler reminders are often the easiest once the incontinence stage begins.

Resisting Toileting

Towards the late stage, you will need to change your tactics as they begin to resist toileting. Toileting and bathing become dreaded tasks. Eventually, those become words they don’t like to hear. I share a few tips to help with that in my Approach Blog. 

I recommend investing in a waterproof mattress cover. It is rare for a person with middle or Late-stage Alzheimer’s Disease to make it through the night without wetting.

Alzheimer’s Dementia Toileting and Fluid Intake

Cutting back on fluids later in the evening can decrease urine output at night. However, if you cut back on liquids during the evening, ensure they still get plenty of fluids during the day. Lack of fluids can lead to dehydration, which can lead to serious medical problems. 

All kinds of products are on the market to help you manage incontinence products at home. For example, cloth and disposable bed pads fit in the middle of the bed to catch urine, which can be used along with pull-ups or Depends to make cleanup easier.

The 5th type of incontinent products are the under-pads to be used on the bed or in chairs when they are up. 

Incontinence Pads

Incontinence Pads are a necessity for late-stage Alzheimers toileting issues. Creating a waterproof moisture barrier between any liquid and furniture is essential. They can be placed on a chair or bed to prevent leaks from ruining the furniture. They have disposable and cloth pads available.

Paper pads such as the hospital’s use can be disposed of when they get soiled. Unfortunately, both types of padding tend to roll up or wrinkle easily.  

Remember to check for wrinkles. A wrinkle left under someone can cause their skin to break down.

Disposable pads for chairs or beds

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Make sure the toilet is accessible and safe

As the disease progresses, they will have trouble finding the bathroom. Therefore, keeping the path to the bathroom clear and well-lit is best. Some people have found that placing a picture of a toilet on the door will help serve as a reminder. 

Make sure it is easy for them to get on and off the toilet. Grab bars on the wall to help can make a big difference. So can a raised seat. My preference has always been a bedside commode with arms. Removing the commode bucket, allowing the commode to fit right over the toilet. The commode is taller than the toilet and raises the seat, giving them handrails to hold onto, and it can be used at night by the bed if needed. The bedside commode is also the safest to use.

Bowel Issues and Alzheimer’s Dementia Toileting 

Taking care of toileting needs is crucial in dementia care. Tracking bowel movements using an app like Alzlog can be a real game-changer, especially in the middle to late stages. This helps in preventing problems like constipation and impactions.

It’s generally recommended that bowels should move at least every three days to steer clear of complications. Having a chat with your doctor about bowel protocol and preferred interventions is a smart move.

Make sure to have a well-thought-out bowel plan in place. And for more detailed insights into managing poop issues related to dementia, head over to my page specifically dedicated to that topic.

Remember: for all of Alzheimer’s Dementia toileting issues, it’s always good to stay proactive and informed!