Toileting Tips and Tricks
The idea of losing independence, especially when it comes to using the toilet, is troubling. Issues include finding the bathroom, missing the toilet bowl, and incontinence. Anything we can do to support the independence of a loved one living with Alzheimer’s is helpful, so here are some simple tools and ideas that can make life a bit easier for everyone.
Setting Up the Home Bathroom
To help maintain independence, set up the bathroom for success. The first step is to remove all bathroom locks, to avoid the person with dementia inadvertently locking themselves in. Or, if you want to keep the lock, keep the key hanging outside the door nearby.. Next, install handrails around the bathroom — near the toilet and in the shower at a minimum. Consider purchasing a “3-in-1” commode, which raises the toilet seat to a level that’s more accessible, and provides handrails on the side that can be used to aid sitting and standing. The 3-in-1 seats are adjustable — and savvy caregivers know to raise the back legs one notch higher than the front legs to make standing up a tad easier.
Men with dementia may have poor vision and trouble aiming their urine stream. It doesn’t help that the toilet is white, the bowl is white, and the water appears white. One way to increase the chances of success is to dye the water blue, with toilet cleaner. Some people have gone as far as painting the toilet seat to emphasize the target area. Another approach is to clip a small LED motion sensor light to the toilet bowl. This turns out to be the most effective way to improve aim!
Issues with Wiping
At some point, the process of wiping can become confusing for someone living with dementia. They may wipe themselves just fine, but be confused about where to put the paper. If your loved one hands you toilet paper, offer them the trash can. If they insist on giving it to you, have a plastic bag handy to put over your hand. Then turn the bag inside out and put it in the trash can.
Other Things to Think About
Be sure to leave the bathroom door open so the person can see the toilet and know it’s the right room. You can even paint the door jamb a contrasting color, offering a visual cue. People with dementia gravitate towards light, so leaving a light on in the bathroom will help them locate the right room. You can also consider installing motion sensor lighting. Help your loved one choose clothing that is easy to get on and off. Zippers, buttons, and belts will all impair successful toileting. If they are having accidents, remind them every two hours to use the restroom, and try to limit liquids two hours before bedtime.
When Accidents Happen
When accidents do happen, it’s important to change a wet brief as soon as possible. Otherwise, urinary tract infections and skin breakdown can develop, which can lead to other problems like increased antibiotic usage and increased dementia. If your loved one is starting to become incontinent, disposable briefs will become a necessity. Resistance to disposable briefs is common, but you can help by placing the briefs in your loved one’s usual underwear drawer, instead of next to the toilet. Remove their regular underwear and make the disposable briefs the only option. Solutions that feel more natural and normal tend to be more tolerable. Making a few adjustments to the physical space, offering visual cues, and going with the flow will go a long way towards toileting success and maintaining independence.
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