30 August 2018

21 September is World Alzheimer’s Day

Dementia and incontinence: what you need to know

Alzheimer’s disease is the most common cause of dementia – a condition that affects over 47 million people worldwide. Yet it is often hidden away, not spoken about, or ignored at a time when the person living with dementia and their family are most in need of support.

What is dementia?

Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly. Although each person will experience dementia in their own way, eventually those affected are unable to care for themselves and will need help with all aspects of daily life as the brain is permanently damaged.

It is not, however, a normal part of ageing.

The most common symptoms include loss of memory, mood changes, problems with thinking, orientation, understanding, calculation, learning capacity, language, and judgement.

Dementia can be confused with depression; the effects of some medications; acute confusional states most commonly caused by infection (urinary, chest or kidney); dehydration; or constipation. So, it’s important to get a proper diagnosis from a qualified healthcare professional.

What are the statistics?

Worldwide, 47.5 million people have dementia, with 9.9 million new cases every year, which is one new case every three seconds. 

What are the common types of dementia?

There are over 100 types of dementia but the most common forms are:

  • Alzheimer's disease
  • Vascular dementia
  • Dementia with Lewy Bodies
  • Fronto-temporal dementia

Alzheimer's disease and vascular dementia are responsible for up to 90% of cases of dementia.

What does it mean to be continent?

Going to the toilet is a complex series of processes that the brain needs to help with and is something that we tend to take for granted.

We need to:

  •  Know we need to go to toilet
  •  Locate the toilet
  •  Hold on until we get there
  •  Reach the toilet
  •  Recognise the place and equipment
  •  Manage to undo any clothing
  •  Use the toilet
  •  Then be able to wipe, flush and wash ourselves

Having dementia does not automatically mean that someone will be incontinent, but if they struggle with any of the above, then they may be. 

It may be useful to get a full continence assessment which can help:

  • To identify potentially reversible causes and contributing or aggravating factors; for example, the individual may be constipated, which will have a big impact on their urine output and may cause urinary incontinence.
  • To determine the need for further investigation or specialist referral; a man might have an enlarged prostate which causes symptoms of passing urine frequently.

Some easy to make lifestyle and environmental changes:

  • Ensure that there are no obstacles which might make it difficult to reach the toilet in time such as furniture blocking the way, chairs which are difficult to get up from, poor lighting and doors which are hard to open.
  • If the bathroom is too far away, consider reorganising the living areas within the home so that the distance is reduced.
  • Are there are mirrors in the bathroom? Check that they are not contributing towards the person with dementia thinking that someone else is there.
  • They may need a sign on the front and back of the toilet door to remind the person where they are and why they are there.

It is important to keep the person mobile for as long as possible to help maintain their independence. If they need to use an incontinence product, TENA has a range to help with from light leaks to heavier incontinence problems.

The TENA Lady and Men’s ranges include “pull up” pants that feel like you are wearing your own underwear to retain a sense of normality and are easy to put on and take off. 

TENA Flex is a unique belted product that is designed to minimise the need for lifting and has been proven to reduce the risk of back strain on carers, whilst also making changing less intrusive for the wearer.

For advice on bladder weakness products, please call us on 087 359 1079. Visit TENA for more information on our product range. You can also buy TENA products online at TENA Shop


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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