Dementia & Incontinence: Practical Strategies

Incontinence is common in dementia—and it’s manageable. With a simple daily plan, the right tools, and a respectful approach, you can protect skin, dignity, and independence while reducing stress for everyone involved.

Why Incontinence Happens with Dementia

Brain changes: Trouble recognizing the urge, remembering where the bathroom is, or sequencing steps (stand → undress → sit).
Mobility barriers: Slow walking, obstacles, tight clothing, or distance to the toilet.
Medical factors: Constipation, urinary tract infection (UTI), prostate or pelvic floor issues, diuretics, caffeine, dehydration.
Routines: Irregular toileting and fluid patterns can worsen leaks and accidents. dementia incontinence

Types You May See

Urge incontinence: Sudden strong need to go, little warning.
Stress incontinence: Leaks with cough, laugh, lifting.
Overflow/retention: Dribbling, weak stream, frequent small voids.
Functional incontinence: Can’t reach/recognize the toilet in time due to thinking, vision, or mobility challenges.
Fecal incontinence: Often linked to constipation, diarrhea, or medications. dementia incontinence

Fast Medical Check (Do This Early)

Rule out UTI: Sudden worsening, burning, foul odor, fever, or abrupt confusion—call the clinician.
Check constipation: Hard stools, abdominal discomfort, fewer than 3 stools/week.
Medication review: Ask the prescriber about diuretics, sedatives, anticholinergics, or new meds.
Hydration check: Dark urine, dry mouth, dizziness = not enough fluids. dementia incontinence

Build a Simple Daily Plan

1) Timed Toileting & Habit Training

Offer the bathroom every 2–3 hours and at key times: on waking, before/after meals, before bed, and before outings.
Use gentle prompts and short cues (“Let’s use the bathroom now.”).
Watch non-verbal cues: pacing, pulling at clothing, sudden agitation. dementia incontinence

2) Make Bathrooms Easy to Find & Use

Clear path, nightlights, and door signage with words + picture.
Contrasting toilet seat color for visibility; add grab bars and a raised seat if needed.
Offer adaptive clothing (elastic waist, Velcro) and keep tissues/wipes within reach.
If distance is a problem, use a bedside commode or urinal. dementia incontinence

3) Fluids & Food

Encourage steady fluids through the day (small sips often).
Limit caffeine/alcohol and heavy fluids 2 hours before bed, but avoid daytime dehydration.
Prevent constipation with fiber-rich foods, gentle activity, and fluids; discuss laxatives with a clinician first. dementia incontinence

4) Skin Care & Comfort

Clean promptly with pH-balanced wipes or lukewarm water; pat dry.
Apply barrier cream (e.g., zinc oxide) to protect against moisture.
Use breathable pads/briefs that fit well; change on a schedule (not just when wet).
Inspect skin daily for redness, rash, or breakdown. dementia incontinence

5) Nighttime Strategies

Toilet right before bed and at the first sign of restlessness.
Consider absorbent night products, waterproof mattress covers, and a bedside commode.
Keep the path lit and clear; put a bell or motion sensor if wandering is a concern. dementia incontinence

6) Dignity, Communication, and Choice

Knock, explain each step, and offer privacy.
Use calm tone, validate feelings, and never shame accidents.
Offer choices: “Now or in five minutes?” “This brief or these soft pants?”
Celebrate wins—small improvements build confidence. dementia incontinence

Tools That Help

Absorbent products: Pads/briefs sized correctly, booster pads for nighttime.
Protective linens: Washable/waterproof bed and chair covers.
Mobility aids: Grab bars, raised seats, walkers.
Travel kit: Wipes, spare clothing, disposal bags, portable urinal/commode, hand sanitizer. dementia incontinence

Keep a Simple Continence Log

Track for 3–7 days: times offered, times voided, leaks (how much), fluids, foods, bowel movements, and cues. Share patterns with the clinician to fine-tune the plan and product choices. dementia incontinence

Starter schedule:

7:00 am (wake), 9:30 am, 12:00 pm, 2:30 pm, 5:00 pm, 7:30 pm, bedtime, and once overnight if awake.

When to Call the Clinician

Sudden change in continence, pain with urination, blood, fever, or strong odor.
New confusion, falls, dehydration signs, or skin breakdown.
No improvement after trying a timed toileting plan and environmental changes. dementia incontinence

Compassion First

Routine, respect, and the right equipment make a big difference. Aim for comfort and dignity, not perfection—and keep adjusting the plan as dementia changes over time. dementia incontinence

Source

Adapted from the user-provided handout on Incontinence and Dementia. dementia incontinence

Disclaimer

This article is for education only and does not replace personalized medical advice. Always follow your clinician’s guidance for continence care and skin protection.

Daily Living Tips, Senior Education

Dementia & Incontinence: A Kind, Practical Guide for Families & Care Teams