It is vital to establish an accurate continence assessment. This will identify what type of incontinence the individual is suffering from and initiate an appropriate treatment plan. Patients who have dementia may also have a continence issue that is not related to their dementia but simply to another disease or part of the ageing process.
As part of the continence assessment, an accurate fluid input/output chart should be obtained. From this chart, a Healthcare Professional will be able to advise whether the patient’s fluid intake is adequate for their body weight. They will also be able to interpret the urinary output by noting what time a patient empties their bladder which may help to determine any pattern to their output. From this, a Healthcare Professional will introduce an individual toileting programme. It is normal to empty your bladder every 3-4 hours and to go to the toilet 4 – 7 times within a 24 hour period, however, people with dementia can pass urine more often than normal. Also, check what type of fluid they are drinking as consuming drinks with caffeine can cause urgency and irritate the bladder.
People with dementia can find it difficult to remember where the toilet is, so a picture of a toilet on the toilet doors, as opposed to a written word e.g. toilet or ladies can be useful to help the individual remember where the toilet is.
Having a brightly coloured toilet seat in a contrast colour to the bathroom suite or floor is preferable so the patient can easily identify the actual toilet.
As well as having an individual toileting programme, it is advisable to look for signs that the patient needs or is looking for a toilet. They may appear anxious or be fidgeting with clothing or have a change in facial expressions. If there is a specific sign this should be documented in the patient's notes so all care staff are aware that this could mean they are looking for a toilet.
To aid a patient’s independence and dignity it is important they are wearing appropriate clothing, for example, no buttons or complicated zips or clips. If necessary clothing can be adapted.