Dementia and Incontinence

    Over 60% of care home residents have some level of dementia and while dementia is becoming increasingly common as the population ages, it’s not a normal part of aging.

    What is dementia?

    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.

    Types and causes of dementia

    Dementia is an umbrella term to describe different symptoms which occur when the brain is affected by disease. More than half of all people with dementia have Alzheimer’s disease, followed by 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. To reduce risks, encourage residents to enjoy a healthy and active lifestyle, social interactions and a good and consistent sleeping routine.

    The three stages of dementia

    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.


    Mood, small behaviour changes and forgetfulness. Often the symptoms aren’t clear, so they’re confused with ‘old age’.


    Very forgetful, impaired communication abilities, difficulties with everyday tasks.


    Dependent on others for care, unaware of time and place and, unable to recognise relatives and familiar objects.

    Behavioural and Psychological Symptoms of Dementia (BPSD)

    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 Behavioural and Psychological Symptoms of Dementia known as BPSD. These can include anxiety, apathy, restlessness, paranoia, hallucinations and reactional behaviour.

    There are many things that can cause BPSD, both physical and psychological. Pain, constipation, itching, sleep deprivation, lack of privacy, and a stressful environment, are all things that can trigger BPSD. Since BPSD greatly affects quality of life, it’s important to find the trigger. While there are no effective medical treatments for BPSD caused by psychological problems, you can prevent and manage symptoms through music, massage, an active lifestyle, and being outdoors. It also helps to optimise the environment and situations where the resident experiences well-being.

    Person-centred care

    Everyone is unique and should also be met as an individual when it comes to health care. 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. It also helps to say and do one thing at a time, be patient and wait for answers.

    Dementia and continence care

    Dementia can cause incontinence in different ways. In the early stages incontinence may be due to difficulties reaching the toilet in time for a variety of reasons. This can be prevented by employing strategies for example; easy to handle clothing, assisting with toileting, improving toilet door visibility and a coloured and contrasting toilet seat. Mobility aids, like a raised toilet chair or handrails, can also help.

    The prevalence of incontinence increases as dementia progresses. An effective care strategy requires a thorough continence assessment, followed by a person-centred care plan with objectives and activities that support their independence, dignity, comfort and safety.

    Incontinence can happen to anyone, you can read more on the types and causes on our page about incontinence.

    Products for continence care

    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 itching, a trigger for BPSD.

    You can find more information over on our products page.