I read a lot of threads on here about incontinence. Is it inevitable that incontinence occurs? As yet there is no evidence of it and I feel that we are quite some way down the path with Lex's Alzheimers.
Is it inevitable??
- Thread starter di65
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Like everything else, there is no set timetable for when a person starts losing abilities. I think my mother had been diagnosed for about 4 years before she started having 'accidents'.
She could tell time for far longer than most people with AD though.
She could tell time for far longer than most people with AD though.
My husband would have been about 8 years post diagnosis when he started to have accidents. Complete incontinence would have been about a year later.
Hello Di65 my hubby has had AD for 7yrs l would say he is middle stages, he does wet himself sometimes but only if he leaves it too long before going to a toilet, if we are out and there is no toilet he can't hold it, it never happens at home. It will probably happen in the last stages, hopefully we will have a few yrs yet before that happens, everyone is different. ♡♡♡
I would guess that on average men have a stronger pelvic floor and larger bladder capacity, so a man might be urinary continent for longer provided he is prompted to go regularly throughout the day?
Incontinence has many causes. Some are mechanical (e.g. prolapse, small bladder, enlarged prostate, sluggish bowel). UTIs and other illnesses can cause temporary incontinence. With dementia, eventually people lose their sense of time so it is much harder to manage your bodily needs without someone to prompt these as part of daily routine.
The progression seems to be that people lose the awareness of sensation as the bladder fills and only realise that they need to go when the bladder is quite full. A sudden sense of bladder urgency then occurs with little time to get to the toilet and manage to undress before they have to let go.
My mum no longer has any awareness of her bladder so is completely incontinent of urine. She can be sat on the toilet by her carer, have a wee, get washed and dried, but frequently still lets go a flood of urine when she stands upright.
She also has no awareness of her bowels but will 'perform' when sat on the toilet after a meal, so at present we don't have the dirty nappy problem very often. Occasionally she is out of sorts and sad, which usually means her bowel is full, but she couldn't explain what the physical sensation is that is making her uncomfortable. It's like with a toddler. You can often tell that they need toileting by their behaviour but they haven't got the awareness of "I feel like this so what must happen next is..."
Not everyone with dementia becomes incontinent before they die. However, IMO they would have done if they had lived longer. I would say Yes it will happen in a long term progression scenario. When it will happen is extremely variable, as others have said.
My MIL has had dementia for probably as long as 15 years (maybe even longer because it takes a while before symptoms are obvious to other people). She isn't incontinent, but needs regular prompting or she will have accidents. Going to the toilet only occurs to her when she is suddenly busting to go. She either doesn't feel, or ignores, the sensation of a partly full bladder.
Incontinence has many causes. Some are mechanical (e.g. prolapse, small bladder, enlarged prostate, sluggish bowel). UTIs and other illnesses can cause temporary incontinence. With dementia, eventually people lose their sense of time so it is much harder to manage your bodily needs without someone to prompt these as part of daily routine.
The progression seems to be that people lose the awareness of sensation as the bladder fills and only realise that they need to go when the bladder is quite full. A sudden sense of bladder urgency then occurs with little time to get to the toilet and manage to undress before they have to let go.
My mum no longer has any awareness of her bladder so is completely incontinent of urine. She can be sat on the toilet by her carer, have a wee, get washed and dried, but frequently still lets go a flood of urine when she stands upright.
She also has no awareness of her bowels but will 'perform' when sat on the toilet after a meal, so at present we don't have the dirty nappy problem very often. Occasionally she is out of sorts and sad, which usually means her bowel is full, but she couldn't explain what the physical sensation is that is making her uncomfortable. It's like with a toddler. You can often tell that they need toileting by their behaviour but they haven't got the awareness of "I feel like this so what must happen next is..."
Not everyone with dementia becomes incontinent before they die. However, IMO they would have done if they had lived longer. I would say Yes it will happen in a long term progression scenario. When it will happen is extremely variable, as others have said.
My MIL has had dementia for probably as long as 15 years (maybe even longer because it takes a while before symptoms are obvious to other people). She isn't incontinent, but needs regular prompting or she will have accidents. Going to the toilet only occurs to her when she is suddenly busting to go. She either doesn't feel, or ignores, the sensation of a partly full bladder.
My mam has started to have accidents more often - she has been diagnosed with Alzheimer's for 5 or 6 years now, but symptoms started a couple of years before that.
Dad has been told our doctor can refer them to the incontinence nurse - who will contact them around April time
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Meanwhile he's just struggling on, getting up at 4am to wash mam, the sheets, the mattress ... he has now reluctantly put her into pads and will be looking for mattress protection.
It's very sad. I hope your husband continues to be continent for a long time to come. I'm afraid I can't answer whether it's inevitable, but it certainly is common, I'm afraid.
Dad has been told our doctor can refer them to the incontinence nurse - who will contact them around April time
.Meanwhile he's just struggling on, getting up at 4am to wash mam, the sheets, the mattress ... he has now reluctantly put her into pads and will be looking for mattress protection.
It's very sad. I hope your husband continues to be continent for a long time to come. I'm afraid I can't answer whether it's inevitable, but it certainly is common, I'm afraid.
It is a very common symptom, my husband started with urgency and didn't know where to go, now he is incontinent but I do regular toileting which helps,a bit hit and miss but at least I can wash and change him. He was diagnosed 7yrs ago.
I don't want to tempt fate, but my husband has no underlying health problems, so hopefully this symptom is quite a way down the track, as it seems from the posts that most people who have incontinence problems have other health issues along with their AD.
Thanks everyone for your comments
Thanks everyone for your comments
Had a very few accidents over the last few months, but certainly, as yet, nothing to worry about. The worst time was when hubby had his last stroke. He can still manage going to the toilet himself, which is quite amazing, seeing that he's really poorly, now. As yet, there's nothing problematic.
I think Mum had tiny bit of urine leakage about 2 years before she died but tbh it wouldn't have been a major issue if the whole washing and wearing clean clothes every day hadn't also cropped up. Mum never had faecal incontinence but she was on a very heavily staffed rehab cottage hospital ward for the last seven months of her life and being taken to the loo was done on a very regular basis. Sadly that hospital is no longer under NHS remit but I can sort of see why, it was top loaded with Matron, Senior Nurses etc etc, whilst most of the care was done by Junior or trainee nurses or health care assistants. I think the demographic of patients had changed hugely in the last ten years or so. What was once a small hospital for people recovering from dramatic injuries which needed months and months of rehab turned into a sort of waiting room for the elderly with Dementia or other elderly problems.
Dad was urinary continent till very recently but I think that is slipping now, partly due to his mobility declining.
Dad was urinary continent till very recently but I think that is slipping now, partly due to his mobility declining.
