Incontinence: Toileting Behavior

Incontinence is an involuntary control of the bladder and/or bowel. People with dementing illness may begin to wet themselves or have bowel movements in their clothing or may urinate or defecate in inappropriate places. The ability to use the toilet properly is often affected in the middle or late stages of Alzheimer's Disease.

1. PERSON SOILS CLOTHING/FURNITURE:

Possible Underlying Causes:

Chronic or acute bladder infection; uncontrolled diabetes; weakening muscles; clumsiness or confusion on way to bathroom; awkward clothing; needs help in toileting but too embarrassed to ask; can't find bathroom in time; doesn't know what to do once in bathroom; difficulty in using equipment.

Possible Modifications: A portable commode

  • Use easy to remove clothing (e.g., pull-on elasticized pants, velcro closures, two-piece exercise suit).
  • Place plastic over chair/other furniture that is being used.
  • Provide sign or verbal reminder to use bathroom every two hours.
  • Place portable commode in room (if bathroom is too far away).
  • Use incontinence products (e.g., Depends).
2. TOILETING BEHAVIOR: ELDERLY PERSON HAS DIFFICULTY USING A TOILET:

Possible Underlying Causes:

Reduced motor skills; difficulty using equipment. Toilet with hand rails and grab bars

Possible Modifications:

  • Install handrails and grab bars next to the toilet. Make sure handrails are anchored into studs rather than drywall.
  • Provide toilet seat raiser with arms if person has difficulty getting on and off seat that is too low.
3. TOILETING BEHAVIOR. PERSON DOES NOT KNOW WHAT TO DO ONCE IN BATHROOM:

Possible Underlying Causes:

Confusion on sequence of toileting activity; needs help but too embarrassed to ask.

Possible Modifications:

  • Place simple sign with sequential instructions next to toilet (e.g., take off pants, sit down).
  • Try using colored, padded toilet seat that may call attention to toilet.
  • Remove toilet seat cover.

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