Alzheimer's Foundation of America


Proper use of the toilet requires a complex mixture of motivation, internal cues, visual recognition and motor skills—all of which diminish with dementia. Therefore, as the disease progresses, many people develop incontinence, or loss of bladder or bowel control. Typically, an individual first develops episodic urinary incontinence that slowly progresses over a period of years to total loss of bladder control. A similar pattern is seen with bowel control, which becomes impaired in the latter stages of dementia. The rapid onset of incontinence suggests a behavioral or medical change, and should be evaluated by a physician.

Possible problems:

  • Medical problems, such as enlarged prostate glands and urinary tract infection, or medication side effects.
  • An individual cannot remember where or what the bathroom is.
  • Loss of verbal skills makes them unable to express their needs.
  • Clothing is hard to remove in time.
  • Individuals are not able to perceive internal signals for urination.


  • Treat the individual with respect and dignity.
  • Be understanding and reassuring when accidents occur.
  • Establish a routine; for example, take the person to the bathroom every two hours while they are awake.
  • Try to respond quickly to an individual's request for the bathroom.
  • Watch for non-verbal cues, such as facial expressions or tugging on clothing.
  • Put up signs (with illustrations) to indicate the bathroom door.
  • Use easy-to-remove clothing, such as those with elastic waistbands.
  • Avoid caffeine and other stimulants in the evening.
  • Continue to let ambulatory individuals use the bathroom, even if they are managed with adult continence products, until such efforts are counter-productive, e.g., the individual fights during attempts to place them on the toilet.
  • Do not give liquids a few hours before bedtime.
  • Place a commode in the bedroom at night for easy access.

For more information, please go to the Alzheimer's Foundation of America website.

Q: My 78-year-old father is experiencing the early stages of dementia. What can I do to minimize his frustration?

A: First, be sure that your father has been thoroughly assessed by a physician and that he is properly diagnosed. In some cases, dementia symptoms are caused by a treatable medical condition. If your father has been diagnosed with a progressive (irreversible) dementia, continue to pay close attention to his behavior and his complaints—and report any changes to his doctor. The doctor may propose treatments that will have the effect of reducing feelings of frustration.

As a family caregiver, you will have many opportunities to manage his experience to help reduce frustration. It helps to stick to a daily schedule. Program...


Top Tip

Avoid caregiver burnout. Make time for yourself. Join caregiver support groups. Pursue interests beyond your caregiving role, such as exercise, hobbies, journaling and art.

Read More


of Events

Stay Tuned for Current Events