This ElderCare Skill Builder™ is intended to give the eldercaregiver
background information on special skills that caregivers may need on a daily basis. While
these guides are primarily intended for caregivers of people with Alzheimer’s
Disease, they can be used for any frail or dependent elderly person. When caring for an
elderly loved one, always treat them as an adult, with dignity and respect.
You should use this guide for educational purposes and as a
supplement to any professional training, guidance from a home care provider, or
instructions from a qualified health care professional. As a caregiver, you will likely be
the first to notice any important changes in physical attributes, eating habits or health
status. Please notify a qualified health professional immediately if you notice any
changes.
Things That May Cause Problems With Toileting/Continence
Tips and Techniques
Urinary Incontinence
Constipation
Bowel Incontinence
Things That May Cause Problems With
Toileting/Continence
- Insufficient intake of fluids/dehydration.
- Intake of diuretic-containing fluids such as coffee, tea, cocoa, beer
or colas.
- Infections.
- Side effects of medications.
- Chronic illness.
- Inability to recognize the sensation of needing to go to the toilet.
- In men – prostate problems.
- In women – constipation or weak pelvic muscles.
- Inability to find the bathroom or having too far to go.
- Trouble undressing.
- A bed that is too high or chairs that are too soft to get out of in
time.
- Lack of privacy.
- Poor lighting.
- Inability to find the toilet (i.e., white toilet, white floor, white
walls.)
- Restraints.
- The task is too difficult or has too many steps.
- Need for assistance with clothing.
- Unfamiliar caregivers may cause anxiety or fear.
- Inability to remember what to do once in the bathroom.
- Feeling rushed.
- Inability to express the need to go.
Tips and Techniques
Learn to recognize the nonverbal cues a person gives about needing
to go to the toilet, and respond to them quickly. Other tips include:
Urinary Incontinence
- Schedule frequent visits to the toilet.
- Recognize that when a person starts to fidget or pick at his or her
clothing near the groin, it may signal a need to urinate.
- Urinary incontinence can be coped with by using adult absorbency
pads. Covering the pads with regular underwear helps a person feel less childlike.
- Change incontinence underwear often, keep skin clean and use lotions
and powders (or cornstarch) to protect the skin.
- Look for a pattern of where/when accidents happen.
- Make sure the person has adequate fluid intake.
- Have signs with words and pictures to identify the bathroom.
- Make sure clothes are easy to get on and off.
- Put a commode next to the bed at night.
- Provide adequate lighting to and in the bathroom.
- Nighttime incontinence can be lessened by withholding fluids at night
and by using a pad.
- Sometimes medication can help – talk to your elder’s
doctor.
Constipation
- Make sure a person with Alzheimer’s Disease drinks plenty of
liquids. This is important to maintain adequate hydration and help prevent constipation.
- Make sure the person in your care drinks five to eight glasses of
water, tea, mineral water or juice every day.
- Regular activity, such as a daily walk, can help.
Bowel Incontinence
- Make sure the bowel incontinence is not due to fecal impaction or
drug side effects.
- It is possible to manage bowel incontinence by monitoring diet. Learn
a person’s bowel regimen and lengthen toileting at that time.
- Cleanliness is the goal. To avoid serious skin problems, daily
bathing and a regular change of clothes are essential.