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Additional Issues in Toileting Toileting behavior may require special considerations.
In some cases, patients may experience obsessions with toilet paper use. Caregivers may limit some access to toilet paper, if needed, to reduce problems, such as toilets backing up that may create a hazard and hygiene risk. Caregivers should also pay attention to their own personal hygiene, including washing their hands thoroughly before and after helping patients with toileting and handling of their clothing and any products. Waterproofing bedding and furniture might also be a good idea. Incontinence pads may be laid out on furniture to help protect it. If going out of the home or facility with a person with dementia and incontinence, it will be important to plan for toilet stops. Remember, they may not be able to tell you when they should start looking for a bathroom so that they make it in time. In addition, you should be prepared for accidents by bringing pads and extra clothes.
Patient Care Note
Caregivers should recognize that each patient may react differently to incontinence. While some find it upsetting, others may see it as an integrated part of their situation. It will require some education, training, patience, and commitment by caregivers to support the patient through the sometimes frustrating process of toileting and personal hygiene. As dementia progresses to dependency for care it’s important to have respect for the patient, while providing as much privacy as possible and addressing issues in a calm and matter-of-fact manner. This will help the patient to not feel guilty or embarrassed, while the avoidance of scolding or being upset with the patient, and showing understanding with kind and respectful care, will remain important to the patient’s dignity.
Resources Patients and caregivers can engage the support they may need with several resources. The Family Caregiver Alliance (https://www.caregiver.org) connects caregivers with information, support, and resources/tools to help in managing through a listing of service organizations and resources. In addition, there is a database for information on dementia caregiving programs. The Alzheimer’s Foundation of America (https://alzfdn.org) also provides a toll-free helpline manned by social workers to provide information along with text and online webchat communication options for educational and other resources for patients and caregivers. Also listed are good sources of information and education regarding dementia conditions that include care recommendations. There are a number of organizations that are dementia-type specific, such as the Lewy Body Dementia Association and the Association for Frontotemporal Lobe Degeneration, that can easily be located through an internet search.
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