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Managing incontinence in people with dementia

02 September 2020
Volume 25 · Issue 9


It is estimated that there are 850 000 people with dementia in the UK, and 53% of them have incontinence. Dementia adds an extra challenge to managing a patient's continence. This article discusses that challenge, looking at the nature and causes of incontinence, the effects that ageing has on continence and the associated complications. It then examines the nature of dementia and some of its causes and goes on to show how the symptoms of dementia can impact on a person's continence. The article highlights the important of conducting a thorough assessment of a person with dementia who experiences incontinence, including medical history, medications and symptom profile. Using a bladder diary, the importance of involving relatives and carers, physical examination and ‘red-flag’ symptoms to be aware of are also discussed. Lastly, this article talks about creating a strategy to manage a patient's incontinence, including prompted toileting, medication, using incontinence pads, catheterisation, care planning and supporting relatives and carers.

It is estimated that there are 850 000 people living with dementia in the UK (Royal College of Nursing (RCN), 2015), and one in every six people over the age of 80 years have dementia (RCN, 2015). It is important to view these numbers in context, because, overall, the UK population is ageing: one in five people in the UK are over the age of 65 years, and, by 2050, this number is projected to increase to one in four (Office for National Statistics (ONS), 2019). Dementia is often a condition of old age, and, with the change in the make-up of the UK population, its incidence is bound to increase.

Some 53% of people with dementia have incontinence, whereas only 13% of those without dementia experience this problem (Price, 2011). This is a large variance, especially as the prevalence of urinary and faecal incontinence is 1% in the general population (Price and Bradley, 2013; Bardsley, 2016). The nature of dementia makes assessing a patient's incontinence needs far more challenging, as the causes of incontience in this patient group are multifactorial.

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