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Dementia – Managing incontinence and toileting difficulties.

Dementia – Managing incontinence and toileting difficulties. Maria Moor. What is dementia. Broad term used to describe the symptoms of a large group of illnesses that cause a progressive decline in a person’s mental functioning:

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Dementia – Managing incontinence and toileting difficulties.

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  1. Dementia – Managing incontinence and toileting difficulties. Maria Moor

  2. What is dementia • Broad term used to describe the symptoms of a large group of illnesses that cause a progressive decline in a person’s mental functioning: • It is a permanent and progressive disease that eventually renders people incapable of looking after themselves. • It is not a normal part of aging (common after age of 65.

  3. Symptoms • Begins with forgetfulness • Progresses to confusion and disorientation • Effects problem solving • Effects decision making • Personality changes, irritable , agitated , depressed

  4. Types Of Dementia • Alzheimer's disease - this causes up to 60% of cases of dementia. It is characterised by memory loss and difficulties with language in its early stages, • Vascular dementia - this is the consequence of strokes and/or insufficient blood flow to the brain and causes up to 20% of cases of dementia. • Dementia with Lewy bodies - this causes up to 15% of dementia cases and is characterised by symptoms similar to Parkinson's Disease as well as hallucinations, and a tendency to fall.

  5. Other types of dementia Fronto temperal dementia ( group of dementias) Creutzfeldt Jakob disease occurs in 1 in 1 million. A rare and fatal brain disease Aids related dementia Huntingtons Disease Alcohol related dementia

  6. Dementia Incidence • Approximately 600,000 people in the UK have dementia. 5% of the total population aged 65 and over, rising to 20% of the population aged 80 and over. • Dementia can also occur before the age of 65; there are about 17,000 people with dementia in younger age groups in the UK.

  7. Incidence • Of the people with dementia, 154,000 live alone . It is estimated that by 2026 there will be 840,000 people with dementia in the UK, rising to 1.2 million by 2050. (Alzheimers Society 2011)

  8. Treatment • There are no cures as yet • A group of drugs called acetyl cholinesterase inhibitors may slow the progression of Alzheimer’s dementia and Lewy Body dementia • Memantine, a glutamate blocker, may protect brain cells against damage. • In Vascular dementia drugs may be of use in slowing the damage to brain cells • Aspirin • Medication to control high blood pressure

  9. Dementia and Incontinence • Incontinence is the loss of control of bladder and bowel • Incontinence occurs in people with dementia for many reasons • A decline in intellect and memory as a result of dementia can result in incontinence

  10. Causes of Incontinence • Infection • Constipation • Medication • Physiological bladder and bowel problems • Prostate enlargement • Vaginal Prolapse

  11. Other causes due to changes in person’s ability • Inability to recognise toilet • Inability to find the toilet • Inability to recognise the need to go • Inability to use the toilet • Inability to communicate needs • Inability to formulate words • Mobility and Dexterity

  12. Common occurring actions. • Parcelling (eg wrapping and concealing the evidence in drawers etc • Wetting or soiling clothes • Wetting or soiling the bed • Using an inappropriate receptacle • Smearing

  13. Other causes • Depression • Fear • Embarrassment

  14. Suggestions for managing toilet problems • Ensure the floor and toilet are of sharply contrasting colours. • Coax forward, help to aim. Sit down • Shiny floor can be perceived as wet • Use reflective tape to direct to the toilet • Night lights • Use pictures where possible • Personalised toilet routine,music,raised seat, grab rails

  15. Use a raised Loo

  16. Location of Toilets

  17. Inconsiderate siting of commodes

  18. Continued • Clothing. Simplify clothing. Elastic waistbands, Velcro. • Toilet. Music to calm them. Make sure toilet securely fastened. Raised loo seat. Grab bars. Toilet routine. • Skin care. Prevent soreness

  19. Continued • Intake. Adequate fluids. Reduce caffeine • High fibre diet • Prevent constipation • Exercise • Effective Communication

  20. Changes in Communication • May have difficulty finding a word • They may not make sense • Can’t understand what you are saying • May ignore you • Difficulty expressing emotion

  21. Communication is key • Communication is made up of three parts:- • 55% is body language • 38% is tone and pitch • 7% is the words we use

  22. How we can help. • Use short simple words • Remain calm • Non verbal clues. • Do not rush them. • Give them plenty of time • Avoid competing noises • Consistent approach

  23. Respect the patient • Losing control can be humiliating and embarrassing and care givers need to be sensitive to these feelings

  24. Thank you • Any Questions?

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