Alzheimer’s Disease alone is a hard diagnosis to manage, and it has been known to be very burdensome for family members and friends to help the patient. This alone has been cited by researchers in recent months to be the main factor influencing families to take a patient to a nursing home. Managing incontinence for an Alzheimer’s Disease sufferer might prolong the decision for a family to admit their loved ones to a home.
A study conducted by Robert L. Grant and his team from Kingston University and St. George’s University of London took a look at rates of diagnosis in primary care of incontinence, both fecal and urinary. Patients observed were between the ages of 60 and 89. Over 54,000 records of people in this population were extracted for the study.
Their findings showed that dementia patients in primary care in the United Kingdom were associated with a higher rate of urinary incontinence, but a four-fold higher rate of fecal incontinence. Authors of this study claim their findings suggest that policymakers and insurers involved in providing services to patients with dementia should provide higher levels of help with incontinence.
The organization known as the Alzheimer’s Society, which main focus is disease management, describes the issue of incontinence in detail. It is commonly known that the use of toilets is a challenge for Alzheimer patients and it is also fairly common that there will be many accidents. This specific problem has been known to get worse as the dementia progresses. However, this condition is manageable as long as those around the patient are willing to help.
Urinary incontinence can be mild to severe with the total loss of bladder control. People with dementia are known to have overactive bladders and frequent urination. Fecal incontinence can range in severity just like urinary incontinence. Medical causes of incontinence in older adults (with or without dementia) can be a urinary tract infections, prostate gland problems, constipation, medication side effects, and irritable bowel syndrome.
The actual mechanisms behind incontinence can be difficult to understand and detect, but the causes of accidents can be for a number of reasons. Patients might not be able to react quick enough to the signal of a full bladder. Mobility troubles can also hinder the ability to make it to the toilet in time. Many patients with Alzheimer’s Disease or dementia have trouble speaking and communicating, so if they are reliant upon others to help them to the bathroom, timing could be an issue if the helper does not notice the patient signaling to them.
The Alzheimer’s Society advises caregivers that a patient should be given six to eight glasses of fluids every day, more if they have hard stools. Lower fluid intake is associated with urinary tract infections. A balanced diet with at least five daily portions of fruit, vegetables, and plenty of fiber is recommended to guarantee regular bowel movements. The person with dementia should also be accommodated for mobility and communication to make managing their condition as effective as possible.
There is also a regimen of pelvic exercises, especially for women with mild dementia, which with the help of a specialist or physiotherapists, can assist in managing some forms of incontinence. Medscape lists other forms of treatment:
- catheterization or another form of diversion should be in place for overflow incontinence
- mixed incontinence can be treated with anti-cholinergic drugs or surgery
- urge incontinence can be reduced with behavioral modification, pelvic floor exercises, medications, surgery, and alteration of diet
- stress incontinence can be relieved through surgery, physiotherapy, anti-incontinence devices, and medication.
The Cleveland Clinic describes the role of a caregiver to include the responsibility of providing and maintaining the quality of life for the person with dementia. It is also important to become educated about the condition, and to stay up-to-date on current literature. Signs of progression should not go unnoticed. It is also advised to show love and support to those who are suffering from this disease. Managing incontinence effectively in Alzheimer’s Disease sufferers has the potential of making the transition less cumbersome.
By Lindsey Alexander