What is dementia?
Dementia isn’t a specific disease, but a term used to describe a group of symptoms that are caused by brain function issues. These affect thinking, memory and behaviour, often impacting a person’s ability to manage everyday tasks and social situations, including incontinence issues.
Other symptoms include:
- Personality change
- A reduction in mobility and muscle function
- Difficulty communicating, finding the right words and following the conversation
- Rapid, unexplainable mood swings
- Disorientation about time and place
- Risky behaviour and poor judgement
- Social inappropriateness
- Inability to take any initiative or perform simple, abstract thinking tasks such as adding up numbers
- Misplacing items, putting things in inappropriate places, like the kettle in the fridge
- Memory loss
Of course, many people experience some of these symptoms without having dementia, so it needs to be thoroughly investigated and properly diagnosed. Some treatable conditions can also produce these symptoms - vitamin and hormone deficiencies, medication, depression, infection and brain tumours – so it may not be dementia.
A correct diagnosis can involve:
- A review of the person’s medical records, including family history
- A physical and neurological examination
- Pathology tests
- Brain imaging
- A neuropsychology assessment
- A psychiatric assessment
The emotional toll of dementia can be enormous. People with the condition often feel confused, anxious and disconnected, and those who care for them experience grief and loss. If you or someone you love does receive a diagnosis of dementia, seek support from a specialised organisation like Dementia Australia or Dementia New Zealand
Who gets dementia?
Although anyone can develop dementia, age is the most defining factor. In fact, according to the Dementia Australia website, three in 10 people over the age of 85 and almost one in 10 people over 65 have the condition. It should be noted, however, that it should not be considered an inevitable or a regular part of ageing. If you notice symptoms, don’t ignore them – make an appointment with your doctor.
‘Early onset’ or ‘younger onset’ dementia refers to cases where people under 65 have been diagnosed. This is far less common, with less than 6% of all people living with the condition aged in their 50s, 40s and even 30s.
Those more likely to acquire dementia have:
- Cardiovascular disease, which can restrict the oxygen-rich blood flow to the brain and is exacerbated by smoking
- High cholesterol
- High levels of homocysteine
- A family history of dementia, although the exact genealogy is yet to be discovered
- Suffered a moderate to a severe head injury at some stage in their life
Causes of dementia
Over 100 diseases can cause dementia, with the most common being Alzheimer’s. In fact, it’s believed that 50-70% of people with dementia have this condition.
Other causes are:
- Vascular disease, which impairs the flow of blood to the brain, which over time, induces dementia
- Lewy Body Disease, a condition that is very similar to Alzheimer’s but more rapid in progress
- Frontotemporal dementia. This disease leaves the memory intact, but the damage to the front and temporal lobes of the brain affect emotion, personality and behaviour
- Alcohol-related dementia, caused by long-term, excessive alcohol consumption
Dementia and Incontinence
There are many reasons why dementia can cause incontinence. Memory loss can reduce a person’s ability to remember where the toilet is and what to do when they get there. Managing to unfasten and adjust clothing can become equally challenging.
For others, the messages between the bladder and bowel and the brain become unclear and muddled, so recognising when there’s a need to pass urine or faeces is lost.
Treatment medication can cause diarrhoea or constipation, both of which can impact continence.
Ways to manage incontinence
Bladder retraining and pelvic floor exercises are effective ways of improving continence. Read more about them on the links provided to determine if they might be suitable. In many cases, however, reduced cognitive function will make those options impractical, but there are still many things you can do to manage incontinence.
- If you’re a carer, you may wish to discuss any continence issues with the person you’re caring for. This can seem very daunting as many people feel embarrassed. This article, Tips for Carers: Discussing Incontinence may help get you started
- Make getting to the toilet as easy as possible. Ensure the path is clear, the door open and the lid of the toilet is up
- Think about clothing that’s easier to remove, avoiding buttons, zips and clasps and instead, choosing elastic waists
- Develop a toileting routine. Reminding the person with dementia to go to the toilet at the same times throughout the day can be effective
- Ask your doctor for a review of all medication to see if they are contributing to continence issues. They can often be substituted or adjusted to ease the problem
- Manage constipation, which can contribute to urinary and faecal incontinence. A high fibre diet and good hydration will help. You can read more about that here
- Don’t underestimate the psychological toll of incontinence on you as a carer or as a person with dementia. Try not to let things get on top of you. Seek professional help if you suspect you or the person you care for, could be suffering anxiety or depression.
Using TENA absorbent products
It’s likely that a person with dementia will eventually be unable to self-manage and incontinence products will be required. These days, they’re super absorbent, breathable and discreet, as well as being soft, flexible and comfortable. They all contain Super Absorbent Polymer, or SAP, which is a fine, sand-like product that can absorb many times its weight in liquid, transforming it into a gel. This stops any wetness from being pressed back out of the pad, even when sitting, keeping the wearer dry and comfortable.
SAP also prevents urine from being exposed to the air, which is how it prevents odours from developing. You can read more about Odour Control Technology here
Using purpose-made products to manage incontinence can make a world of difference. They reduce laundry, can save furniture and bedding from soiling, control odour and provide confidence for any outings.
It’s also true that if you are using disposable incontinence products all the time, the cost can add up. Australia and New Zealand both have several funding schemes to help families with this expense. You can find out more about those, including useful links here, and discover more about the Australian schemes, including eligibility, here
Best incontinence products for dementia
The TENA Pants range can be a great choice for people in the earlier stages of dementia. That’s because they look and feel like regular underwear, which will be familiar to the wearer. Similarly, they pull up and down, enabling regular toileting but with the protection of high absorbency should the wearer not make it. Tear-away sides make for easy removal should the pants become soiled.
Faecal incontinence needs special management as it shouldn’t be left in contact with the skin for any length of time. If the person with dementia has faecal and urinary incontinence, consider TENA Duo. These are a protective layer inserted into urinary products and, if soiled, can be easily removed without having to discard the more expensive, high absorbency product.
An uninterrupted night’s sleep is ideal for everyone’s wellbeing, and while that may not always be possible, there are products that can help. Check out the range of TENA Specialist Products https://www.tena.com.au/products/specialist/ for high absorbent, overnight protection, including the Bariatric Range https://www.tena.com.au/products/specialist/bariatric-range/ for people who are overweight or obese. There’s even a range of flat, disposable pads, called TENA Bed https://www.tena.com.au/products/specialist/bed-range/ that provide an additional layer of protection for mattresses and furniture.
Finding the right product to suit your circumstances can be tricky. If changing the person with dementia is stressful for one or both of you, choose a more absorbent product that can hold several voids, reducing the frequency of changes. Others may feel more comfortable with a lighter product and more frequent changing. To help make the right choice, take advantage of the TENA Product Finder Tool https://www.tena.com.au/find-your-product/. This steps you through some questions about your situation, then suggests some products. You can even order free samples. If they don’t turn out to be just right, jump back online and try some other options.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.