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Incontinence

After you have ascertained that there is no physical cause for the loss of bladder and/or bowel control, you should develop strategies to manage this behaviour.
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  Strategies for Managing Incontinence
(usually in later stages of dementia)

Try addressing the following factors:
  • Daily routine
  • Clothing
  • Environment


Step
Questions & Suggestions
Daily Routine
Set up a toileting routine, including toileting before and after meals and before bed.

Follow a prompted voiding routine as follows:

  • Gather baseline information about how often the individual is incontinent during a 12 hour day, by checking every hour.
  • Begin the intervention by asking the individual if he/she is wet or dry every hour.
  • Give the individual a prompt. For example, ask if a bathroom break is needed. If "Yes", take them to the bath- room, or accompany them to assist if they can manage on their own.
  • Provide them with social approval when they are dry, when they request to go to the bathroom, or when they respond "Yes", to a prompt.
  • Praise in an adult manner.
  • Do not reprimand or criticize when they are wet or do not ask for help. Change them. ·If an hourly schedule is successful, try a 2-hour voiding schedule.
Other provisions:
  • Provide plenty of fluids on a regular schedule (water, juices, jello, popsicles, ice cream).
  • Avoid too much caffeine or alcohol.
  • Set up a changing schedule. Try to change clothing and sheets as soon as they are soiled. Wash skin and apply ointments to prevent rashes immediately after accidents.Keep the bathroom routine consistent. Be calm, firm and supportive.


Step
Questions & Suggestions
Clothing
  • Provide the individual with elastic waistbands or velcro closures.
  • Use washable fabrics and shoes.
  • When necessary use disposable briefs, disposable pads rubberized sheets or mattress covers.


Step
Questions & Suggestions
Environment
  • Clearly identify the bathroom.
  • Place lids on wastebaskets.
  • Cover chairs with washable, plastic lined covers.
  • Use a raised toilet seat and grab bars in the bathroom.
  • Provide a urinal, bedpan or commode at night.
  • Keep commode chairs uncovered to identify them from other chairs.Brightly light pathways to the bathroom and remove any obstacles or clutter in the pathways.
  • Be calm, supportive and maintain the privacy and dignity of the individual.



 
 
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