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Let’s talk about the toileting issues of your loved one with dementia.

Photo of toilet and sink with the text dementia patients and toileting issues

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.

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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 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

Freebie offering downloads to help with the toileting issues of a person with dementia
CLICK ON THE LINKS BELOW TO GET A SET OF BATHROOM SIGNS

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.

Picture of a toilet and a woman sitting on a toilet with the words dementia patients and toileting issues over the photos

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. 

You can read about my Mom’s story here.

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!

Related information:

Incontinence

see these posts for other suggestions

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