Dementia care: Problems with toileting

People with dementia often have problems with toileting. Carers can find this particularly distressing and difficult to manage.

Dementia and difficulty toileting 

People with dementia can lose their ability to find, recognise or use the toilet. They may also have difficulty undressing and undertaking personal hygiene. Carers can also find helping someone with such an intimate task very embarrassing.

In the later stages of dementia incontinence can become an issue. Some people develop behaviours that are distressing to deal with such as the smearing of faeces.

It is essential to seek professional help for incontinence issues early on. There are many things you can do to help a person with dementia and problems toileting. Carers often site incontinence as one of the main reasons for seeking residential aged care. 

Tips for dementia and problems toileting

•  Learn the person’s cues for toileting such as certain words, wandering up and down, holding onto clothes, and pulling off bed sheets
   
•  Prompt the person to the toilet and give instructions in simple sentences
   
•  Place signs on the toilet door with a symbol such as a toilet
   
•  A commode chair and grab rails can help a person feel more secure on the toilet
   
•  Identify a pattern in incontinence by noting when the incontinence occurs for 3 days
   
•  Toilet the person at theses times to avoid incontinence episodes
   
•  Consider the use of incontinence aids such as pads
   
•  Encourage fluids to avoid infection
   
•  Use a commode by the bed at night
   
•  Ensure adequate lighting in bathroom
   
•  Use a raised toilet seat to assist in getting on and off the toilet
   
•  Remove objects such as waste paper bins if they are mistaken for the toilet (some people replace the bin with a bucket and find this works)
   
•  Seek help from an incontinence adviser, doctor or community nurse
   
•  Problems with toileting or incontinence can be related to medical reasons such as a urinary tract infection, enlarged prostate gland, constipation or dehydration
   
•  If a person with dementia is incontinent do not restrict fluids. This could lead to a urinary tract infection or problems with constipation.

Helpful resources 

• Call the National Dementia Helpline on 1800 100 500, a free service for people living with dementia, their carers and family members.

Related articles

• Dementia care: Help with personal hygiene and dementia
  
• What home care aids can assist with personal hygiene?
• Bathroom safety: How to make the bathroom safe for showering