Caregiver.com

For About and By Caregivers


Subscribe to our bi-monthly publication Today's Caregiver magazine

  + Larger Font | - Smaller Font



ARTICLES / Incontinence / Dementia & Incontinence Treatment | Other Articles

Share This Article

Dementia and Incontinence Treatment

by Sandra Ray, Staff Writer

(Page 3 of 4)

Treatment Options

If the incontinence is due to an underlying medical condition, such as a urinary tract infection or a bowel obstruction, treatment can range from antibiotics to surgical intervention. The decision, of course, will be based on the severity of the condition and the best course of action for the patient. It is important to remember that incontinence is not a disease, but rather a symptom of an underlying issue that has developed with the patient.

If a medical condition is readily ruled out, the doctor may move on to other options like medications that treat the bladder’s urge to urinate or the frequency with which the bladder sends the “alarm” to the body that urination is about to occur. These medications are generally anticholinergics and have the effect of reducing frequent urges to urinate when the patient is unable to make it to a toilet fast enough. These urges may be made worse by the dementia since the signal that urination is about to occur may be misunderstood or misinterpreted by the patient.

Recently, however, researchers with the Wake Forest University School of Medicine uncovered a serious problem with older anticholinergic medications and medicines that are used to lessen the mental decline in cognitive functioning in some dementia patients. In many patients, the anticholinergic medications that treat incontinence interfere or counteract the medications that are also treating dementia. In other words, patients with dementia may experience a more rapid decline in mental functioning while taking anticholinergic medications. For these patients, treating the incontinence with medication is worse than finding alternative solutions for working with the issue. There are newer anticholinergic medications that were developed since the study’s original test results in 2003 and 2004 which may or may not have this effect. This is perhaps the best reason to discuss any medications that a dementia patient takes with their primary doctor before starting a new treatment course.

There are other non-medication or surgical methods that can be used to treat incontinence at home. Adaptive clothing may be able to help if functional incontinence is an issue. Replacing hard-to-manipulate buttons and snaps with Velcro and zippers may be a quick fix if it appears that the patient is aware of the incontinence and wants to correct it without too much intervention on the part of the caregiver. This approach gives the patient more control over their environment and encourages independence. It also affords the patient the most privacy which is often a serious source of angst for many patients. There are also incontinence products for all ages and sizes that may be helpful, although the patient may have difficulty understanding their use and disposal. Communicating the need for these products may be a challenge, and the caregiver may need to explain their use more than one time in order for the patient to understand.

Other methods may be home modifications or adding a portable toilet chair to the room(s) where the patient spends most of his or her time. This method is relatively easy to implement, although it may need some additional explanation since patients with dementia wonder why the caregiver is altering the living situation or the layout of a particular room. Any approach that changes the daily routine of a dementia patient drastically should be undertaken thoughtfully and with as much input from the patient as possible.

  1 2 3 4


Printable Version Printable Version

 

 

Related Articles

Urinary Incontinence Treatments for Women

Tips for Managing Incontinence with Frontotemporal Dementia

Embarrassed About Incontinence? Don’t Be