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The toilet and incontinence

Alzheimer’s disease and related diseases affect all aspects of daily life and can also lead to loss of control of the bladder and intestines. Episodes of faecal or urinary incontinence may occur. When our bladder or our intestines have to be emptied, our brain sends us messages, but these messages are not always received, or we no longer have the ability to recognize the sensations.

For many, incontinence is experienced as cruel humiliation. Losing control of this bodily function, learned at a very young age, can deeply hurt self-esteem. It is therefore difficult to accept help in such an intimate area of a person’s life, especially from a loved one.

Why does a person become incontinent?

Start by examining the possible reasons for the accident. By clarifying the cause of the problem, you will find the solution and prevention strategies more easily. However, the reasons may vary from one accident to another. If you take note of what happens just before or at the time of the accident, some things may become more consistent. Remember that because of the evolution of the disease, accidents are always possible, whatever the strategies used.

Consider the person
  • Does it have a health problem that can be treated, bladder infection, constipation, reduced bladder tone, weakened muscle control, reduced bladder capacity or, for men, prostate problems?
  • Does she drink a lot of coffee, tea or soft drinks, or take medication that could contribute to the frequent need to go to the bathroom and, as a result, increase the risk of accidents?
  • Is there a loss of urine when the person sneezes, coughs or laughs?
Consider the disease
  • Is the person able to communicate his need to go to the bathroom?
  • Does she understand the messages that her body gives her?
  • Is she able to find the bathroom, recognize the toilet and not confuse it with another object? Does her confusion increase at night, which could require an adaptation of the places to her needs, a night light for example?
  • Is she able to undress in time?
  • Is the task too complicated? Can she go through all the necessary steps, find the toilet, lower her pants, etc.?
  • Are the toilets too far?
  • Does the person have difficulty getting up from the bed or a deep armchair?
  • Does she have her privacy in the bathroom?
  • Are the bathrooms and hallways well lit?
How does the person feel their incontinence?

Some people may be very embarrassed and upset by this problem, others may not. In the advanced stages of the disease, some will try to hide the damage, hiding the wet and soiled clothes, or trying to throw the excrement. If the problem persists, consult your doctor. There is a danger of infection.

What to do ?

If you find the cause of the accidents, you will find it easier to find a way to help solve the problem. If, despite your best efforts, you can not find the exact cause, try the following strategies:

At home
  • Make the toilets easy to find. Clearly identify the path to follow on walls and floors. Make sure there are no obstacles. Paste an image on the door, a description, or both.
  • Install a contrast color toilet seat. If the person has visual or perception problems, colored tape around the perimeter of the bowl or colored water may help to prevent damage.
  • Leave a night vase or a pierced chair near the bed.
  • Put lids on waste baskets or any other container that the person might confuse with a toilet.
  • The mirrors in the bathroom may give him the impression that someone else is there.
  • Remove all obstacles, plants, wastebaskets, that could hurt when she goes to the bathroom.
  • Leave the bathroom door open when it is free.
What you can do as a caregiver
  • Pay attention to the visual cues that tell you that the person needs to go to the bathroom. For example, she seems agitated, the expressions of her face are unusual, she paces the room.
  • Give him simple instructions.
  • Tell her often to go to the bathroom, for example every two hours, in the morning when getting up and in the evening at bedtime, and before going out.
  • Choose clothes that are easy to remove, such as Velcro closures or elastic belts.
  • Bring the person near the toilet before helping them to undress.
  • For men, put a sticker on the bottom of the bowl as a “target”.
  • Give him the signal that it is time to start, by running tap water for example, or by saying something to him. Try to make sure your bladder is completely empty.
  • Leave the person alone if she prefers it, but tell her that you are not far off if she needs something.
  • If the person has difficulty sitting, give them something to look at or hold in their hands.
  • If incontinence occurs at night, make sure she does not drink just before going to bed. However, do not stop him from drinking during the day.
  • Make sure she goes to the bathroom before going to bed.
For safety reasons
  • Make sure you have good lighting
  • To help them sit up and get up, install support bars near the toilet and a raised toilet seat.
If accidents persist

he ideas presented above may help you keep the person clean and dry if you have determined that they do not have other health problems, or that their medications are not the cause of their problems. ‘incontinence. If accidents persist, disposable undergarments, incontinence pads, pantiliners and protective sheets may be useful on certain occasions, or in specific situations. Use them only as needed. Even if the person wears protection, accompany them regularly to the bathroom.


Incontinence can cause skin irritation and be very unpleasant. If the person gets wet or dirty, help them get rid of their clothes immediately. Wash the person with mild soap and warm water. Dry it and give it clean clothes.

The daily

In case of an accident, it is important not to get angry or to draw attention to the event. That would only embarrass or upset her further. Of course, it is not nice to clean up the damage of a parent or spouse, but remember that the disease is the cause of these accidents. This is not the fault of your loved one. He is probably as distressed as you. Save your dignity with words of encouragement. Stay calm. Remember that you are doing your best.

In addition

Every day, we learn something new about Alzheimer’s disease and related diseases, often from caregivers like you who have found the solution to some problems and share it with others. Contact your regional Alzheimer Society for resources in your community. You can also share your ideas with others in the Forum section. The information exists. Help exists. You are not alone.