Alzheimer's And Incontinence: A Puzzling Combination

Daniel L. Paris, MSW

Just when you thought it couldn’t get any worse, your loved one with Alzheimer’s develops incontinence.  What do you do now?  The following letter and its answer may help with this puzzling combination.

Q)  My mother has had Alzheimer's for probably 8 years. She has just begun having accidents in her bed and clothes. My father has briefs for her, but we are wondering about a simple way to get her to wear them. Perhaps you have some suggestions. Also if she wet them and changed clothes she might to put the briefs in the toilet. Should we put a diaper pail in the bathroom? Any ideas you have would be very helpful and much appreciated. Mother is 78, as is my father.

Elizabeth Smith-Boivin of Mills View Adult Home in New York and Gladys Bunker of the Alzheimer's Association of the Greater Palm Beach Area in Florida, provided the following answer:

A)  If it is environmental incontinence, related to Alzheimer's Disease she simply may be forgetting how to find the bathroom in a timely way. In that case, you may want to keep

the bathroom door open and the light on, so the toilet is visible. Treat the protective     undergarments as part of normal dressing and don't make a big deal over it. The more you make an issue of it, the more it becomes a battle. Your mother may be unwilling to wear adult protective undergarments because she finds them uncomfortable. There are a number of products available, from simple, thin undergarment liners that enable a person to continue wearing their own underpants to the full, protective undergarments that feel like underpants. There are disposable as well as reusable and washable products on the market today. Find the most comfortable and reasonable product for your mother and your situation. Protective bed sheets are also available. To the degree it is possible, involve your mother in the decision of which product to use, showing her all the available options. This will contribute to her sense of independence, which is very important to an individual with Alzheimer's Disease.

Using a diaper pail in the bathroom is an excellent idea. But remember, it will be    difficult for your mother to learn a new task. It would be a good idea for someone to   assist her so they can remind her not to throw the undergarments in the toilet. You could    also try securing a plastic garbage bag around the toilet bowl and dispose of it later.  

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