Mood, small behaviour changes and forgetfulness. Often the symptoms aren't clear, so they're confused with 'old age'.
Over 60% of care home residents have some level of dementia, which is commonly caused by Alzheimer's Disease. Dementia can affect memory and other cognitive functions, and impacts mobility and dexterity. All these symptoms can contribute to incontinence. Residents may forget where they are and why they're there. They might not be able to ask to use the toilet, or even realise they need to go until after they've had an accident.
Let's see an overview of the condition, and look at some of the ways that person-centred care can help you manage incontinence in residents with dementia or Alzheimer's Disease.
Dementia is an umbrella term to describe different symptoms which occur when the brain is affected by disease.
The World Health Organisation defines dementia as an acquired permanent state of deterioration of memory and other cognitive features that has been there for at least six months and, affects work, social activity and eventually, the ability to lead an independent life.
More than half of all people with dementia have Alzheimer's disease, which affects the brain, causing memory loss and confusion, and slowing down or even stopping brain functions such as thinking, understanding, and interpretation.
These include vascular dementia, dementia with Lewy bodies (DLB), Parkinson's disease dementia, and frontotemporal dementia. Old age, diabetes, heart disease and genes can all be contributing risk factors. Women are also more likely to experience dementia than men.
Dementia symptoms vary between the different types, which part of the brain is affected, and the individual. These can include problems with cognitive functions, orientation, comprehension, calculation, learning capacity, language and judgement. Dementia develops over time and is categorised in the following three stages.
Individuals with dementia find it increasingly more difficult to communicate their needs and understand the world, this can result in a resistance of care. In fact, 90% of people with dementia will experienced BPSD, which can include anxiety, apathy, restlessness, paranoia, hallucinations and reactional behaviour.
Many things that can trigger BPSD, such as pain, constipation, itching, sleep deprivation, lack of privacy, and a stressful environment.
Since BPSD greatly affects quality of life, it’s important to identify and minimise these triggers through person-centred care.
Person-centred care means to treat the resident as an equal partner, helping them help themselves to improve their own independence, quality of life and wellbeing, and give them the knowledge, aids and confidence to do so.
When caring for people with dementia it’s important to treat them with dignity, compassion and respect, to support them developing their strengths and abilities, to live an independent life and preserve their identity for as long as possible.
So, get to know the resident, talk to their relatives and involve the individual in their own care. Participation in activities can help to prevent frustration and challenging behaviour for residents. Manage any symptoms through music, massage, an active lifestyle, and spending time outdoors. It also helps to say and do one thing at a time, be patient and wait for answers.
Encouraging residents to enjoy a healthy and active lifestyle, maintaining social interactions and a good, consistent sleeping routine can all improve symptoms of dementia.
Person-centred incontinence care supports residents’ independence as much as possible. Here are some ways to achieve this which ensuring residents’ dignity, comfort, and safety.
TENA offers a great range of incontinence products and aids. From TENA Pants that encourage independence and own toileting, to products with wetness indicators to help ensure individuals are changed only when needed. Some people who experience dementia can be afraid of water, so rinse-free products like TENA Wash Gloves and Shampoo Caps can help maintain skin health and independence, while TENA’s Skin Cream can help sooth dry skin and prevent it.
Audited by Josefine Grandin, District nurse, urotherapist, 2022-08-01