Incontinence and toilet problems in people with dementia For some people, incontinence develops because messages between the brain and the bladder or bowel don't work properly.
As Alzheimer's disease progresses, it is common for incontinence of the bladder and bowels to occur, particularly in the middle and late stages. There are many causes, as well as ways to help manage incontinence.
Generally, urinary incontinence occurs first (stage 6d), then fecal incontinence occurs (stage 6e).
Tips to manage incontinence
Reduce the person's fluid intake before bedtime. Consider reducing the person's caffeine intake by providing decaffeinated coffee and tea. Reduce the person's intake of alcohol and carbonated drinks, which can irritate the bladder.
These include problems with memory, thinking, problem-solving or language, and often changes in emotions, perception or behaviour. As dementia progresses, a person will need more help and, at some point, will need a lot of support with daily living.
Incontinence can occur in the middle and late stages of dementia. Doctors generally define incontinence as the inability or limited ability to control when the body releases urine or stool. It can range in severity from occasional leakage to the full loss of control of these functions.
One of the most common causes of death for people with dementia is pneumonia caused by an infection. A person in the later stages of dementia may have symptoms that suggest that they are close to death, but can sometimes live with these symptoms for many months.
The room and the route to the toilet should be well lit, especially at night. Help the person to identify the toilet. A contrasting colour (for example, a black seat on a white base) can make it easier to see. Make sure the person has privacy in the toilet, but check that they don't have difficulty managing locks.
Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years. Vascular dementia – around five years.
According to researchers, life expectancy for those 65 and older with Alzheimer's disease varies between four to eight years after diagnosis but some live as long as 20 years. The main predictor is age, as those diagnosed at a younger age tend to live longer.
Introduction: The five-word test (5WT) is a serial verbal memory test with semantic cuing. It is proposed to rapidly evaluate memory of aging people and has previously shown its sensitivity and its specificity in identifying patients with AD.
An early indicator is forgetting recent events, even though memories from long ago are often crystal clear. There's an expression for that: “First in, last out.” It means that the first memories you make — long-term memories from childhood or young adulthood — are the last to fade.
Don't correct, contradict, blame or insist. Reminders are rarely kind. They tell a person how disabled they are – over and over again. People living with dementia say and do normal things for someone with memory impairment.
This can be exhausting and often leaves the person feeling like they haven't slept at all, so they are very tired and sleepy during the day. It can be hard to stay awake during the day after a poor night's sleep but, if possible, it's best to try to limit sleep during the day to small bursts or 'catnaps'.
Dementia lowers a person's life expectancy, but most dementia-related deaths are due to the underlying cause or complications resulting from dementia. Dementia complications that may increase the risk of death include malnourishment, infection, and serious injuries from falls and other accidents.
Stage 4: Moderate cognitive decline
Short-term memory begins to be more affected, and the person may entirely forget recent events. A person with moderate cognitive decline cannot navigate to new places, and they have significant difficulty completing complex tasks such as managing finances.
In the late stages of Alzheimer's, individuals lose their ability to communicate and respond to the environment. The brain damage leads to the failure of body systems including the lungs, heart and digestion.
Stage seven is the final stage of the dementia progression. At this stage, most people will have no ability to speak or communicate. They will require assistance with most daily activities including walking, dressing, bathing, and toileting. This stage requires 24-hour care and assistance.
Middle-stage Alzheimer's (moderate)
Middle-stage Alzheimer's is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer's will require a greater level of care. During the middle stage of Alzheimer's, the dementia symptoms are more pronounced.
The Mini-Cog test.
A third test, known as the Mini-Cog, takes 2 to 4 minutes to administer and involves asking patients to recall three words after drawing a picture of a clock. If a patient shows no difficulties recalling the words, it is inferred that he or she does not have dementia.
Creutzfeldt-Jakob disease causes a type of dementia that gets worse unusually fast. More common causes of dementia, such as Alzheimer's, dementia with Lewy bodies and frontotemporal dementia, typically progress more slowly. Through a process scientists don't yet understand, misfolded prion protein destroys brain cells.