Fecal incontinence

yes - essentially there are a few things that can trigger this, but in general beyond the standard diet pieces (if anything changed in her diet) my understanding is they can lose muscle control or not communicate effectively that they need to use the restroom.

Unsure of what her routine looks like, I’d recommend using adult diapers and helping her clean thoroughly. Think of the diapers as an “in case” thing, even if she can successfully still make it to the bathroom sometimes.

The downside of diapers in my opinion is when they immediately replace all trips to the bathroom. My experience with my mom was that she wasn’t “entirely incontinent” like some people tried to tell me, but rather we couldn’t rely on making it to the bathroom 100% of the time.

Still worth trying, but with the added protection.

Mom has very little warning before a movement and I think there are occasional accidents. I think this is likely to be dementia related. She also has trouble with bladder leaks (I think it’s actually more than just leaks ). She used depends for the first year after diagnosis and for the last 2 years has use a heavy duty Tena diaper. She is stage 4 and has vascular dementia. I think I read somewhere that incontinence can show up earlier with vascular dementia, but I can’t remember where.

@lilacgirl

You're wise to investigate this further to see if there is a treatable cause rather than dementia progression.

That said, while most PWD person will progress through the symptoms in a manner outlined in the DBAT or FAST, there are some folks who might hold onto or lose a skill earlier or later than expected.

My dad seemed to develop bowel incontinence earlier than I would have expected. It preceded bladder incontinence and arrived when he presented as stage 4 for the most part. I suspected at the time that this might be related to damage from radiation to treat prostate cancer; FWIW the radiation was not successful despite considerable tissue damage. But as he progressed, he retained abilities that are normally lost in stages 4, 5 and 6. I held rigidly onto the idea that a PWD is in the latest stage for which they have any symptom/behavior and accepted that he was moving into stage 6. Mom did not; she lovingly focused on what he could do denying his incontinence as "accidents".

Six months before he died, he was able to do serial subtraction by 7s during a MoCA. And the very day he died, from aspiration pneumonia, we had an animated conversation about a visit from my sister that shocked the SLP who was there to evaluate his swallowing. Spoiler alert: my sister died in 1994. His speech was conversational, but his mouth and throat could no longer manage unprocessed food safely. He even excused himself to use the bathroom during the visit.

YMMV.
HB