The Problem of Incontinence in the Elderly
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Many treatment strategies either need modification or are not appropriate for patients with dementia. Treatment options will often depend on the setting of care and the availability of carers and need to be individualized.
Much of the assessment may need to be discussed with carers, and it is important to recognize that family members may feel uncomfortable discussing and being involved in this intimate area of care with their loved ones and vice versa.
Continence aids are often a mainstay of treatment. Options of modifying the environment to improve access and reduce the risk of falls and incontinence include decluttering, ensuring adequate lighting and highlighting the toilet.
Ensuring bowels are regular has a greater emphasis in dementia patients to avoid incontinence both of bowel and bladder.
Patients with Alzheimer’s disease may be managed with cholinesterase inhibitors that can cause or exacerbate urinary frequency and incontinence.
Medications used for urge incontinence should not be completely dismissed in patients with dementia despite their potential side effects.
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