Is your PWD aware they are incontinent
I know that incontinence is something that eventually occurs with dementia. I fear it is beginning for my husband. He has experienced small amounts of leakage for about a year, but it has been something small that he seemed to notice and take care of. He is on 2 different meds for an enlarged prostate. I thought that was the issue. But recently he got up from a chair and was completely wet and surprised. He had no idea he had urinated all over himself and the chair. Is that how this works? The PWD doesn't realize when they are urinating?
My husband has Alzheimer's, and at his last neurologist appointment (June 2025) they believed it had just progressed from MCI to mild dementia. I have believed for some time that we are a little further along, but not quite this far. He is still handling all ADL's, but now I fear he may be skipping steps and I am just not aware. He insists he can handle his personal care himself. He has a lot of cognitive reserves, which makes me doubt he is as far along as some of the physical symptoms suggest.
Is the incontinence piece just something that will happen without his being aware that it is happening?
Comments
-
Hello CMC62, that’s a really good question, are PWD aware they are incontinent. I often wonder about that. My DH will occasionally tell me he has to go to the bathroom. He’s been incontinent for 18 months, double incontinent off and on for the past three months. He is immobile so I need a heads up if he needs a bathroom break. Sometimes he tells me just as he’s doing it, then there’s a huge mess to clean up. He was always so clean and discreet, I’m sure if he knew what was going on it would embarrass him. I never make a big deal about it if he has a BM. I just get busy cleaning it up. This happened yesterday and he fought and fussed at me for 15 minutes resisting while I tried to hook him up to the lift. Poor guy, my heart just aches for him and what he’s dealing with. I hate that it’s so hard to remember him not in this condition.
6 -
So sorry this is starting. It started out as leaks for my DH, so I used padded underwear and placed bed pad liners where he sat/slept. Yet, he kept saying there's nothing wrong with him. Then it was more and more and had to go to diapers. This was when things got very rough. He denied his diaper was wet, and the stench, when it was soaked to the gill and had leaked onto pants, socks. It became WWIII morning, day, and night to change him, clean him. I don't mean to scare you, but this is what happened to us. I finally had to place him in MCF.
4 -
Incontinence began this way for my DH. He has always been very conscientious about bathroom issues since he has Celiac and gluten can wreak havoc on his digestive system. It causes periodic urgent need to go…which has resulted in some unfortunate situations over the years. But with Alzheimer’s he now has both bowel and urinary incontinence, initially urinary and then bowel as well. He will sometimes say he needs to have a bowel movement but it is not always a reliable indicator.
3 -
yes, this is how it usually begins. Their brain doesn’t receive the message that they have to go. They can’t stop it. Try to get on a schedule taking him often to try and go. Get the men’s depends that look like men’s underwear. They also make liners for them for overnight. If he doesn’t want to wear them just switch all his underwear with them and tell him they are the newest thing. Cover your mattress with a cover that the entire mattress fits inside and get pads for the bed and chairs. Get a urinal for bedside. I got a bright red one that was spill proof. That will probably be temporary. They make disposable pads that go around the bottom of the toilet that help cleanup if there are accidents.
3 -
@CMC62
That's a pretty typically experience for the onset of incontinence. I'm sorry you are entering this phase.
Now is the time to protect your mattress and boxspring with 6-sided waterproof protectors and cover the chairs he uses with washable/disposable pads. The pet ones are useful for sofas and recliners. Since this was more than a didn't-make-it-there-in-time situation, now's the time to swap out his underwear for a pull-on incontinence product. Getting compliance might be easier if you frame this as a consequence of his prostate enlargement (physical) rather than dementia.
IME Dad had a lot of cognitive reserve; his language skills remained freakishly intact up until he died from aspiration pneumonia. This misled my mom (who struggled with denial and saw her role as protecting his dignity) and the doctors for whom he showtimed mightily into thinking he had mild/moderate dementia when I thought he was late stage. To be fair to his geripsych and neurologist were basing their assessments on his MMSE/MoCA results which were better than I would have expected given his poor memory and confusion IRL.I was basing my view on the fact that I'd noticed the first subtle personality and memory issues a decade earlier and was told by a clinical psychologist friend to consider him in the latest stage for which he had any behaviors/symptoms.
HB3 -
Thank you all for your responses and great suggestions. I had purchased a couple of the washable pads from the Alzheimer's store to have ready when this became an issue. I guess it has started. We are going out of town in a couple of days on a trip to the beach. I will get the depends today and pack those instead of underwear. This suggests that my husband is in stage 5, and not 3 as the doctors suggest, or 4 as I suspected.
1 -
It was good to read what others have experienced when first dealing with incontinence. My mom has had bladder leaks for some time. It is now to a point that she needs a night time depends during the day. She describes it as not being able to get to the bathroom in time. She still uses the toilet, but often times don’t make it. Lately she has started having the same trouble with her bowels. She said when she needs to go she needs to go now, with little or no warning. There is no loose stool. She believes it is something she ate or medication she is taking. She is upset with the doctor and me because we are doing nothing about it. I feel helpless anyway, but I now have her blaming me for not taking this more seriously and trying to figure out what is going on. The doctor believes this is the beginning of bowel incontinence. She has managed her personal hygiene well so far, but cleaning up after bowel incontinence is going to be way more challenging that just bladder.
2 -
Everyone is different. My DH gradually became incontinent with small amounts of leakage and then puddles on the floor. At first I was cleaning up a lot of messes as he refused the disposable pull ups. I finanaly insisted on the pull-ups and he often fights me on it. He forgets he is incontinent which is to be expected as he forgets much these days. I have learned to make things easier for myself by having him wear eleastic waist pants and most days slippers without socks. It is very hard for me to get wet socks off of him and I struggled with blue jeans and belts. He forgot how to get dressed and undressed.
2 -
Can you begin putting your mom on a regular schedule of toileting assistance to maybe stop the accidents ahead of time. We are not far behind you in this part of the journey and I am going to try it especially for the mornings.
0 -
She is in a nursing home. So far she recognizes when she is wet and changes her own depends. She also has very bad anosognosia. She thinks nothing is wrong with her. Someone telling her when to use the toilet would probably not go over very well. They go into the bathroom occasionally to see how she is managing on her own, but this has made her so mad that she put a sign on her bathroom door tell nurses to knock before entering. She complains every visit about the lack of privacy.
3 -
My DM had 1 accident on the floor of her ILF's bathroom. She did not make it to the stall in time.
Subsequently, she has had increased urgency, not affiliated with a UTI. She went to see her urologist who ruled out any anatomical or physiological issues.
As I've had to do bladder training with my patients, I have tried the same with her. I encourage her to go to the bathroom every 2 hours while awake, before leaving her apartment for a function, and before bed.
This group was able to help me recognize that my mom was slowly but surely transitioning to stage 6. I was shattered.💔
3
Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
Read more
Categories
- All Categories
- 634 Living With Alzheimer's or Dementia
- 350 I Am Living With Alzheimer's or Other Dementia
- 284 I Am Living With Younger Onset Alzheimer's
- 17.7K Supporting Someone Living with Dementia
- 5.7K I Am a Caregiver (General Topics)
- 8.7K Caring For a Spouse or Partner
- 2.9K Caring for a Parent
- 227 Caring Long Distance
- 180 Supporting Those Who Have Lost Someone
- 12 Discusiones en Español
- 1 Vivir con Alzheimer u Otra Demencia
- 1 Vivo con Alzheimer u Otra Demencia
- Vivo con Alzheimer de Inicio Más Joven
- 11 Prestación de Cuidado
- 2 Soy Cuidador (Temas Generales)
- 8 Cuidar de un Padre
- 23 ALZConnected Resources
- View Discussions For People Living with Dementia
- View Discussions for Caregivers
- Discusiones en Español
- Browse All Discussions
- Dementia Resources
- 8 Account Assistance
- 15 Help