A Story from the Heart: A Difficult Day at the Restaurant

Let me share a moment you might relate to.

I remember sitting in a restaurant with my loved one who had dementia. We were enjoying a nice meal when suddenly I noticed that familiar smell… their bowels had moved while we were sitting there eating.

I felt the heat of embarrassment rising up my neck. I glanced around, hoping no one else had noticed. But I couldn’t just sit there. I had to act—quickly and calmly.

Getting them up and to the restroom wasn’t easy, especially since they didn’t fully understand what was happening. Once we made it there, the cleanup began. It was messy and stressful. I was fumbling through my bag for wipes and a new brief, all while trying to comfort them as they became confused and upset.

After what felt like forever, I finally got them cleaned up and back to the table. But by then, I was frazzled, and the meal had lost its charm.

What I learned from that experience is something I carry with me to this day.

Preparation matters.

I started carrying a small “care kit” everywhere—wipes, gloves, extra clothes, and disposable bags. But even more importantly, I learned this:

These moments, as hard and embarrassing as they are, are part of the dementia journey.

We can’t always prevent them—but we can be prepared, stay calm, and respond with patience and kindness.

If you’ve experienced something like this, you’re not alone—and you’re not doing anything wrong. Let’s walk through why these problems happen and what you can do to make them a little easier to manage.

Dementia poop problems can be one of the hardest and most upsetting parts of caregiving. Many families are caught off guard by how much dementia can affect bowel habits, bathroom behavior, and personal hygiene.

Here are a few important things to know:

• Dementia can affect bathroom awareness and bowel habits
• Constipation and bowel incontinence are common
• Bathroom accidents may happen because of confusion, not choice
• Some people may smear or play with poop because of brain changes
• A regular bathroom routine can help reduce accidents
• Sudden bowel changes should always be reported to the doctor

Why Dementia Causes Bathroom Problems

Dementia poop problems can include constipation, bowel incontinence, diarrhea, bathroom accidents, poop smearing, and even going in unusual places. These changes can feel overwhelming, but they are more common than many caregivers realize.

As dementia progresses, everyday tasks become more complex for your loved one. Even something as simple as using the bathroom becomes a multi-step process that can be difficult or impossible to complete.

Constipation in Dementia

Constipation is very common in people with dementia and can quickly turn into a bigger problem if it is not recognized early.

It may happen because of:

• low fluid intake
• less movement
• medications
• poor diet
• forgetting to use the bathroom
• trouble communicating discomfort

Constipation can lead to:

• pain
• restlessness
• reduced appetite
• sleep problems
• bowel obstruction
• worsening confusion

Some caregivers notice that constipation shows up first as a behavior change before obvious stomach symptoms appear.

Diarrhea in Dementia

Diarrhea can also happen in dementia and may come on suddenly.

Common causes may include:

• medications
• stool softeners or laxatives
• infections
• food intolerance
• antibiotics
• overflow around constipation

Diarrhea can lead to:

• dehydration
• weakness
• skin irritation
• increased accidents
• confusion or delirium

If diarrhea is new, severe, or keeps happening, it is important to contact the doctor.

When to Call the Doctor

Call the doctor if you notice:

• Sudden diarrhea
• New constipation
• Blood in the stool
• Belly pain
• Fever
• Vomiting
• A major change in bowel habits

If a hospital visit becomes necessary due to dehydration, infection, or sudden decline, this guide explains what to expect during a dementia hospital stay and how to prepare.

Why Dementia Patients Poop on the Floor

One of the more upsetting situations caregivers face is when a loved one begins pooping on the floor or in the wrong place. This is usually not done on purpose.

It often happens because the person:

• Cannot find the bathroom in time
• Does not recognize the toilet
• Gets confused about where to go
• Cannot remove clothing quickly enough
• Mistakes another object (like a garbage can) for the toilet

Many caregivers have seen their loved one use a small garbage can instead of the toilet—even when it is right next to them.

Helpful things that may reduce this:

• Keep the bathroom door open and easy to see
• Add a sign or picture to the bathroom door
• Keep the bathroom well-lit, especially at night
• Remove confusing items like small trash cans
• Use a different-colored toilet seat to help it stand out

Sometimes accidents happen more often during periods of confusion or restlessness. If your loved one is also becoming more upset or hard to redirect, you may want to read more about dementia agitation.

Bowel Incontinence in Alzheimer’s Disease

Bowel incontinence in Alzheimer’s disease becomes more common as dementia progresses. It can be one of the most difficult parts of caregiving.

This may happen because the person:

• Does not realize they need to go
• Cannot get to the bathroom in time
• Cannot find the bathroom
• Has trouble removing clothing
• Is constipated and leaking stool
• Has diarrhea due to food, illness, or medications
• Has reduced awareness of hygiene

In many cases, this is not a behavior problem—it is a progression or physical issue.

👉 You can learn more about why incontinence happens in dementia, along with practical caregiver tips, in my article Alzheimer’s & Bowel Incontinence: Why It Happens and What Caregivers Can Do.

👉 For a list of different products that can make this part of caregiving a little easier, visit the Incontinence Products Page.

Why Dementia Patients Play With Poop

This is one of the most upsetting situations for caregivers, but it is more common than people talk about.

A person with dementia may:

• Remove their brief or clothing
• Have a bowel movement outside the bathroom
• Touch or smear poop

This is usually not intentional.

It may happen because:

• They feel discomfort and try to “fix” it
• They do not understand what is happening
• They are constipated or irritated
• Their judgment and impulse control have changed
• They are confused about what to do next

What can help:

• Stay calm
• Clean gently without scolding
• Check for constipation or skin irritation
• Keep nails trimmed,
• Soaking hands in warm, soapy water can help get rid of the mess
• Keep a manicure kit handy for cleaning under fingernails. You can find them HERE.
• Keep cleanup supplies nearby
• Consider clothing that limits access if needed – Find Adult Onesie on Amazon HERE.

Some caregivers notice this happens more during times of confusion or when their loved one is reacting to things that are not there. If that sounds familiar, you may want to read more about dementia hallucinations.

How Caregivers Can Prevent Bathroom Accidents

Not all accidents can be prevented, but many can be reduced with a few simple changes.

Too Many Steps?

As dementia progresses, everyday tasks become more complex for your loved one. In the middle stage, the steps involved in using the bathroom become difficult or even impossible to coordinate.

1. Find the bathroom
2. Recognize the toilet
3. Pull down pants,
4. Sit on toilet
5. Poop
6. Wipe
7. Pull up pants
8. Flush the toilet
9. Wash hands

For someone with dementia, that is a lot of steps to remember!

So, if you are having problems in these areas, try to figure out which step is causing the issue and adjust your assistance accordingly.

Toileting Schedules

Taking your loved one to the bathroom on a regular schedule can help.

A common routine:

• Every 2 hours
• After meals
• Before bed

This has been used in nursing care for many years.

You can also support bowel movement timing by offering things like coffee or prune juice in the morning.

Also, take a look at their diet. Giving them coffee or prune juice at breakfast can help wake up the bowels and get them moving soon after. These are natural laxatives and will help you keep them on a routine.

Helpful Bathroom Setup Tips

• Keep the path to the bathroom clear
• Use simple, easy-to-remove clothing
• Keep lighting bright in the bathroom
• Limit clutter and distractions
• Keep supplies nearby

Toileting struggles often overlap with other care challenges. If you are also having trouble with hygiene or resistance, you may find helpful tips in my article on bathing problems in dementia.

Common Over-the-Counter Bowel Medications

When bowel problems begin, it can help to understand the basic types of medications:

• Fiber: Adds bulk to stool (Metamucil, Citrucel)
• Stool softeners: Help soften stool (Colace)
• Stimulants: Help move the bowels (Dulcolax, Senna)
• Osmotics: Draw water into the bowel (Milk of Magnesia)
• Suppositories & enemas: Used when needed for more direct relief

Always check with the doctor before starting anything new.

Why You Need to Track the Bowels

Tracking bowel movements is one of the most important things you can do as a caregiver.

Many people with dementia cannot tell you when something is wrong. That means you have to watch for changes.

Tracking helps you notice:

• Constipation
• Diarrhea
• Incontinence patterns
• Changes linked to food or medication

It also helps prevent bigger problems like:

• dehydration
• infections
• bowel obstruction

Frequently Asked Questions About Dementia Poop Problems

Why do dementia patients poop in strange places?

They may be confused, unable to find the bathroom, or not recognize what to do.

Is bowel incontinence common in Alzheimer’s?

Yes, it becomes more common as the disease progresses.

Why do they play with poop?

This can happen due to confusion, discomfort, or loss of judgment.

What should I do about repeated accidents?

Try a toileting schedule, simplify clothing, and talk to the doctor if it worsens.

When should I be concerned?

Sudden changes like diarrhea, constipation, or pain should be checked by a doctor.

Can constipation affect behavior?

Yes, it can cause agitation, confusion, and discomfort.

Need More Dementia Caregiver Help?

If you’re dealing with difficult behaviors at home, you are not alone.

I’ve created tools and resources to help make caregiving easier and less overwhelming.

👉 Visit the Caregiver Support Toolbox
👉 Learn more in the Understanding Dementia Course
👉 Track changes easily with Alzlog: The Caregiver’s Notebook

Conclusion: Navigating Dementia Poop Challenges with Care and Practical Solutions

Managing bowel issues in dementia is hard—there’s no way around that.

But when you understand why these problems happen and have simple routines in place, it becomes more manageable.

Small steps—like a toileting schedule, tracking changes, and having supplies ready—can make a big difference.

Most importantly, please remember this:

You are not alone in this.

Every caregiver faces messy, overwhelming moments. What you are doing matters more than you realize.

You are showing up with patience, love, and strength—and that makes all the difference.