Caregiver’s corner: be gentle with incontinent people with Alzheimer’s

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Dear Mary,

I am so frustrated with my husband. I know he has Alzheimer’s disease, but it’s not that bad. He can still do a lot of things but no matter how much I tell him to go to the bathroom, he doesn’t and then I have to clean up the mess. I get so angry; how can he not know how to use the bathroom when he has done it all his life?

Dear reader,

Incontinence in people with Alzheimer’s disease is one of the most difficult aspects of caregiving that a family member has to deal with. It is important to keep in mind that your husband has no control over the condition causing the incontinence problem. Alzheimer’s disease, as well as other dementias, can limit a person’s ability to even recognize the need to go to the bathroom. That doesn’t mean they don’t feel like they have a full bladder, but it might limit their understanding of what that feeling means. Sometimes we may see a person with dementia rocking, pacing, or wandering in an effort to make the discomfort go away.

Others who can recognize the need to go to the bathroom might not be able to do so in time. Alzheimer’s disease can affect vision and it can affect mobility. It can affect a person’s ability to initiate an action and it can affect their ability to control muscle movement. Vision, mobility, muscle movement and cognitive abilities are all needed to get to the bathroom in time!

Sometimes people with Alzheimer’s disease can have trouble remembering the location of the bathroom. This may be difficult to understand when they have lived in the house for many years, but Alzheimer’s disease has a way of causing disorientation in the individual and they may not recognize where they are or do not know how to orient themselves in what we consider to be familiar surroundings. .

You may want to visit your husband’s doctor to check if there is a medical cause such as a urinary tract infection, prostate condition, diabetes, or even a side effect of medication causing frequent urination. . In the meantime, there are some things you can do that might improve the situation. Watch for signs that he should use the bathroom and guide him there. Better yet, make a toileting schedule where you guide him to the bathroom first thing in the morning, then every two hours throughout the day, and again before bedtime.

Eliminate or decrease caffeinated beverages (such as coffee, tea, and colas) which act as diuretics and can increase urination. However, do not limit the amount of liquids he consumes; limiting fluid causes dehydration, which could lead to urinary tract infection and increased urination.

Make sure the path to the bathroom is free of obstacles; you may want to put a sign or picture on the bathroom door to identify it. Keep the door open to serve as a reminder.

Make sure her clothes are easy to take off and put back on, and don’t be afraid to replace her underwear with adult incontinence briefs (please don’t call them diapers!). Use disposable towels or liners to protect furniture and bedding.

Incontinence can be bothersome; Understanding that your husband cannot control his Alzheimer’s disease or his accidents can help you preserve his dignity. Try not to be mad at him.

Instead of saying, “You got wet,” try saying, “Anyone can have an accident. Let’s clean you up. Don’t scold him or make him feel guilty.

I hope you are also taking care of yourself. Talk to members of your support network about things you might find helpful. Can someone stay with your husband while you take breaks? Would you let someone do the laundry for you? Let others take over some of these tasks so you can spend time with your husband listening to music, taking walks, enjoying some of the things you’ve always done together.

Mary Chaput is the Director of Family Caregiver Support Programs in the Anne Arundel County Department of Aging and Disability.

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