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Dementia and continence

Many people living with dementia experience bladder and/or bowel incontinence which can be distressing for the person with dementia and those who care for them.
When caring for someone with dementia, incontinence may seem like the last straw, but there are measures that can be taken either to resolve the problem or to make it less stressful.
Key points
After considering the health and social challenges around continence Lorraine Haining, a specialist practitioner with Dementia Carers Count, has developed the following strategies to help carers manage potentially difficult situations:
Respect, empathy and trust
- Acknowledge the impact of the stigma, validate the person’s feelings.
- Develop a trusting relationship: it helps if you know how the person is feeling.
- Understand the person’s values, beliefs and behaviour and the impact of any previous experiences or traumas.
- Focus on offering reassurance, compassion and kindness.
- Be aware of your wellbeing as a carer and seek support when possible.
Communication
- Remain calm and positive to provide a sense of security.
- Ask for help: Request a continence assessment. This will provide you with specialist support.
- Be aware of your body language and facial expressions.
- Consider your tone. Say “would you mind…” rather than “you need to…”.
- Be mindful of the use of touch.
Environment
- Always ensure privacy when necessary (close doors/curtains, put products away in cupboards).
- Align your support to the person’s pace.
- Make necessary adaptations to the environment (contrasting toilet seat, claw handle taps).
- Ask for advice regarding products and equipment: this can help the person remain independent for as long as possible.
Independence
- Give the person the opportunity to make their own decisions (gender of carers, products).
- Respond promptly to the person’s needs to prevent accidents or cause anxiety and/or embarrassment.

Lorraine Haining is a specialist practitioner who’s background is in mental health nursing. She has specialised in dementia care for over twenty years and holds the title of Queens Nurse Scotland, a social movement of nurses, selected by their local Health & Social Care Boards who are catalysts for change in their community.