Coping With Urinary and Fecal Incontinence in Dementia

How to Prevent and Respond

One of the challenges as Alzheimer’s disease progresses is urinary and fecal incontinence. Incontinence can be a difficult topic to discuss with others, but it's an important aspect of caring for your loved one.

Incontinence is the loss of the ability to control urination or bowel movements. In a medical setting, this may be referred to as being incontinent of bowel or bladder, or fecal or urinary incontinence.

Incontinence Can Be a Challenge in Dementia
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Relationship to Dementia

As dementia progresses, a person’s ability to control his body diminishes. Often in the middle to later stages of Alzheimer’s, people may experience difficulty getting to the bathroom in time. They might not be able to locate it right away, be able to physically move fast enough, or recognize the need to urinate. This is complicated by the fact that as individuals age, some people also develop physical conditions or take medications that can cause incontinence.

Facts and Figures

According to the Bladder and Bowel Foundation Community in the United Kingdon, it's estimated that 60 percent to 70 percent of people with dementia develop incontinence. Typically, urinary incontinence develops first and then fecal incontinence follows as dementia progresses.

Urinary and fecal incontinence is one of the top reasons nursing home placement is chosen. Caring for someone who is incontinent can be physically tiring. This can be compounded at times since your loved one with dementia might not understand what you're doing and react with challenging behaviors, such as resistance or combativeness.

Addressing the Issue

Incontinence can affect your loved one’s skin, causing it to be prone to open areas and sores. Incontinence is also a dignity and emotional concern. It can contribute to feelings of depression and embarrassment, and if not handled appropriately, can cause others to react negatively due to odors.

Preventing and Reducing Incontinence

By being proactive, we can adjust some environmental aspects including commode placement and adequate lighting to assist in locating the toilet. We can also anticipate toileting needs by noting typical patterns of urination and bowel movements and bringing the person to the bathroom prior to those times of the day.

Reacting to Incontinence

If you walk into the room and discover that your loved one was incontinent, do you know what to do? Clearly, she will need some assistance in getting cleaned up, but your approach can sometimes make the difference between turning this into a very difficult part of the day or simply a few minutes of care.

Be sure to avoid blaming or embarrassing her. Be matter of fact about the need to change her clothes, and provide reassurance if she feels bad about being incontinent. Make sure you don't show frustration or anger, even if you're tired and discouraged. If you're struggling with signs of caregiver overload and your loved one is incontinent, it can be helpful to pause for a few minutes to be sure you're able to respond well.

A Word From Verywell

It's important to acknowledge that sometimes caring for someone who is living with dementia can be stressful. Remember that there are resources available to help you.

If the challenges of incontinence are too much for you or your loved one (for example, her skin is breaking down or you're hurting your back), you may need to enlist the help of home health care, the physician, or a nursing home. You might also benefit from a support group, either in person or online where you can exchange ideas and encouragement with others in similar situations. Finally, don't forget to ask your physician for suggestions to handle the challenge of incontinence.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Schüssler S, Lohrmann C. Change in care dependency and nursing care problems in nursing home residents with and without dementia: A 2-year panel study. PLoS ONE. 2015;10(10):e0141653. doi:10.1371/journal.pone.0141653

  2. Bladder and Bowel Community. Alzheimer's disease and incontinence. 2020.

Additional Reading

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.