Managing Incontinence in Alzheimer’s Patients – Best Practices for HCPs

Whether you work in the community or a hospital setting, managing incontinence in patients with Alzheimer's requires personalised care and sensitivity. This blog explains how healthcare professionals (HCPs) can promote best practices for incontinence management in Alzheimer's patients, who can feel anxious, frustrated and fearful without the correct support.

Understanding incontinence in Alzheimer's Individuals

Urinary, faecal or double incontinence are common as Alzheimer’s disease progresses, although it is not an inevitable part of the condition.

Communication between healthcare providers and the patient is one of the prime challenges in managing incontinence. The person living with Alzheimer’s may be unable to tell you they need the toilet, can’t reach it in time, or forget how to use it.

Best Practices for Incontinence Management

These evidence-based strategies can help you to manage incontinence in patients with Alzheimer’s.

Nutrition and fluids

A balanced diet and exercise help prevent constipation. Encourage fluids, as limiting fluids could cause dehydration, which could lead to a urinary tract infection and increased incontinence.

Keep to a routine

Maintaining a routine for toilet use can help to avoid accident.

Hygiene

Ensure the skin is kept clean and dry. Check skin regularly to ensure that there isn’t excessive exposure to urine and faeces, as this may cause skin damage.

Continence products

When selected/used appropriately, continence products can help maintain dignity and prevent the discomfort of fluid soaking into clothing or bedding.

Medications

Medications can affect incontinence — for example, diuretics or sleeping tablets and so on. It is important to review these.

Healthcare Professional Caring for Patient

Maintaining Patient Dignity and Comfort

Creating a supportive environment will help you to manage incontinence in Alzheimer’s patients, preserve their dignity and comfort, and reduce the likelihood of distress.

Simple design changes like these create a dementia-friendly environment:

Colours – Painting the bathroom in a contrasting colour helps people identify it.

Light – Adding a night light shows a clear path to the toilet. You can also keep the doors ajar for easy access.

Materials – Avoid busy patterns, which patients can misinterpret as a hole or someone jumping at them, making them feel agitated.

Signage – Putting a picture of a toilet on the bathroom door (at head height) will make it more visible.

Practical Adjustments – Handrails, raised toilets, and commodes make toilet use easier. Patients can recognise a lever more than a modern push button.

Avoid Mirrors – reflections can be distracting if a person does not recognise their reflection. They may think that there is a stranger in the bathroom.

Effective Communication

Healthcare providers and caregivers must adapt to patients’ loss of communication skills as Alzheimer’s disease progresses.

Look for nonverbal cues that show the patient needs to use the toilet, such as hiding, silence, fidgeting and pacing. Use matter-of-fact language (not baby talk) to alleviate embarrassment and prevent agitation from escalating.

Make a note of trigger phrases Alzheimer’s patients with incontinence use when wanting the bathroom, even if the words do not make sense to you, for example: ‘I need to go out’.

Personalised Care Plans

Respect the need for privacy as much as possible.

When managing incontinence in Alzheimer’s patients, HCPs should personalise care plans to consider the person’s needs.

It’s vital to be flexible and update the plan continually as the disease’s progression changes.

Ensure Alzheimer’s patients have a continence assessment, with referral to a Continence Specialist Nurse and Alzheimer’s specialist for additional support.

Hygiene and Skin Care

Keep wipes, sanitiser, continence products, disposable gloves and a disposal bin close to hand to maintain proper hygiene and skin care.

Learn how to prevent Moisture-Associated Skin Damage (MASD).

Continence Products

The type of continence products you need will depend on the individual’s type and level of incontinence, and the individual’s ability. For example, if the individual is passing small amounts of urine, or a dribble, a smaller product may be beneficial rather than a larger product which may cause distress to the individual.

When it comes to selecting an all-in-one product, it is important to select the correct size. Please measure the individual’s waist and hips and use the larger of the two sizes to select a product size. If a product is too large, it increases the risk of leakage.

You can use our product finder tool to find the most suitable type of product and absorbency level.

We have nine categories at Attends, providing all-round comfort, leakage protection and odour protection.

Shields for men – these incontinence pads protect against light to moderate urine leaks.
Pads for women and men - can be worn day or night for light to heavy urinary incontinence.
They are breathable and soft for sensitive skin. Night pads are also available for extra protection.
Shaped pads – these easy-to-fit anatomically shaped unisex products are for urine and faecal leaks.
Pull-up pants – our unisex Pull-Ons are disposable pants for light to moderate bladder weakness.
Belted briefs – we designed the Attends Flex range to manage heavy incontinence.
All-in-one – these briefs are for managing heavy incontinence in men and women.
Fixation pants – used with Attends shaped pads; the Fixation range includes 6 sizes from small to XXXL.
Underpads – the Cover-Dri range provides an extra layer of security and comes in different shapes/sizes to suit different needs.
Other products – we produce various products for HCPs and caregivers, including bibs, cleansing gloves and dry cleansing wipes.

Collaboration with Caregivers and Families

If an individual has Alzheimer’s, incontinence can have a profound impact on the person and their families who may be scared about someone else handling their care.

Involving the family carer in the management plan can help to alleviate their worries. It’s also an opportunity for the HCP to learn about the patient’s likes and dislikes, so they can personalise the care plan.

Education, resources and support for caregivers are available from the charity Social Care Institute for Excellence, the Alzheimer’s Society and Dementia UK.

Alzheimer’s patients require a comprehensive and compassionate approach from healthcare professionals when managing incontinence.

We can do this by listening to them and their families, maintaining patients’ dignity, tailoring strategies and approaches to individual needs, creating a safe environment, maintaining hygiene, and using the correct continence products.

Explore our complete range of continence products that promote patient comfort and dignity.