This Insidious Dementia
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Let’s talk about the toileting issues of your loved one with dementia.
Up this month is another of my 19 suggestions to do once you learn that your loved one has dementia and this one deals with toileting issues. As your loved one with dementia travels the dementia journey you may run into the issue of wetting the bed and/or peeing all over the place.
One of the first things I would do is go out and buy a waterproof mattress protector and put that on the mattress under the sheets. Even if your loved one isn’t at the bed wetting stage yet, it isn’t going to hurt and they can get used to how it feels and/or sounds.
You can get the rest of my suggestions by adding your email below.
why a person with dementia might wet the bed or pee on the floor
They might not remember where the toilet is
They might not recognize the toilet
They might not be able to tell you that they have to go
They might not be able to get there in time due to difficulties with clothing or mobility issues
Due to incontinence or some other medical reason such as a UTI or Prostate gland problem
They may not remember all the steps involved in going to the bathroom – find the bathroom, pull down the clothes or unzip, sit on the toilet or stand nearby, pee or poop, etc.
They may not understand the need to wait until they get to the proper place to go
Depression
Embarrassment
What helps dementia patients with toileting issues
Toilet picture on door
Paint the door a different color than the surrounding walls in the hallway
Leave the bathroom door open so the toilet is visible
Keep a light on in the bathroom
Have a light on in the hallway or motion sensor lights so your loved one can see to get to the toilet at night
Reflective tape is an option to highlight the path to the toilet
Make sure their path to the bathroom is free of any obstacles and anything that could be mistaken for a toilet
Install a seat riser so that the person doesn’t have to bend down so far to sit on the toilet (I appreciate the taller toilets!)
Install a black or red toilet seat so that it shows contrast with the floor and surrounding area and helps with depth perception. You could try a light green toilet seat as green is a calming color and it would provide contrast. You might have to try different colors (stay away from patterns) as a color may end up seeming like a hole and you don’t want that.
You could try coloring the water
Flooring should contrast with the toilet so that the toilet is visible
Avoid shiny bathroom floors. Dementia patients may think the floor is wet and will avoid it.
Putting a non-slip mat at the base of the toilet might help in distinguishing the floor from the toilet but that’s a potential trip hazard so that may depend on how mobile your loved one is.
Wear clothes that are easy to pull on/off however if your loved one is going to the bathroom everywhere (and not in the bathroom) then you might switch to adaptive clothing which would require someone’s assistance.
Remove any other objects that might be mistaken for a toilet such as a wastebasket, a plant or a hamper
If mobility is an issue in getting to the toilet in time, put a portable commode beside the bed
Reduce the amount of caffeine they consume
What are some toileting issue cues to watch for
Agitation
Anxiety
Moving around/fidgeting
Tugging/pulling on clothing
Hands around the privates
Flushed/red face, signs of strain
Listen for certain language or words that might be used in place of what we would normally expect to hear that would indicate they need to use the bathroom.
How to establish a toileting schedule
Take some time to observe when they go and how often
If they pee in the bed at night, can you tell when they pee – is it towards morning or earlier in the night
Some people are very regular in that shortly after drinking coffee, there is a need to poop. If this is your loved one, urge them to the toilet 20-30 minutes after that morning coffee.
Try getting them to the toilet every 2-3 hours
Before and after meals
Upon awakening in the morning
Before bed
Use language they grew up with and use – don’t ask “Do you have to go to the bathroom” when they’re used to the word “pee”
Reduce the amount of liquid consumed a couple hours before bedtime
Ways to protect the mattress
There are various ways to protect the mattress. You can check stores like Walmart, Lowes, Home Depot, Target for these items or look online.
Waterproof mattress cover
Plastic fitted sheet
Peel away fitted sheets
Adult diapers
Chux/Chucks
Heavy duty shower curtain
Puppy pads
Garbage bags
Large tarp
Mattress storage bags from u-haul or other moving company
I would add a note of caution – some plastic items may cause your loved one to get overheated while in bed so be careful about that. Or on the flip side, they may get cold. I had flannel sheets on the bed. Even in the summer, my mom said she still wanted those flannel sheets on. They kept her warm.
Luckily, I only had to deal with a wet area a few times. I had put a waterproof mattress protector on that I got from Walmart. I also used rectangular disposable pads that I placed under the fitted sheet in the area where Mom slept. One negative thing about those is that they tend to shift around as the body moves during sleep so you’ll have to straighten them out regularly.
If your loved one with dementia has had a few toileting issues, there are some things you can try. Start watching their behavior, listen for verbal cues, protect the bed, check the bathroom surroundings to see if that can be improved so it’s more likely they will go and try to establish a potty routine!
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