Caring Confidently: Expert Advice on Managing Dementia and Incontinence at Home
Over the past 15 years as a Nurse Practitioner, and even earlier as a nurse, I’ve cared for many patients with dementia, many of whom had the additional diagnosis of incontinence. I have also cared for my dad, who has both dementia and incontinence. Being a caregiver for a person with memory impairment is challenging but it can become significantly harder should that person become incontinent. Yet, there are strategies that I have discovered throughout my clinical practice, and as a caregiver, that have made the situation easier to manage, improving quality of life for my dad, my patients and the primary caregivers taking care of these people.
I’ve found that both dementia and incontinence provide a certain number of limitations, perceived or actual, to my patients and/or their caregivers. Memory impairment is tough. Its unpredictability is unsettling; the progression of decline is rarely linear. Incontinence frequently occurs with dementia due to the alteration in executive functioning that accompanies cognitive decline. Meaning that, individuals with dementia may not be able to effectively anticipate their need to use the bathroom, may not take the correct steps to complete that task, and may not be able to communicate what their needs are. All of the above can result in accidents. Having access to premium adult diapers that offer extended leak protection is crucial in facing this challenge. The extensive selection of premium products offered by NorthShore do just that, bringing much needed peace of mind to caregivers and loved ones alike.
If you are feeling trapped as the caregiver, take heart — you are not alone. Isolation and frustration are common sentiments. Both in my professional role and as a support caregiver for my own father, I have found strategies to allow for more independence and security in managing both dementia and incontinence. In planning for a vague sense of normalcy, we have employed these strategies with my dad, and they have worked!
Understanding Dementia-Related Incontinence Behaviors
My dad was an independent guy. He ran his own dental practice for over 35 years. He was funny and smart and loved learning. His cognition began to decline about 10 years ago, and when he retired from dentistry, the decline sped up significantly. As often is the case, incontinence became part of the picture in the last several years and my mom (his primary caregiver) was having a very difficult time managing. Her biggest challenge was helping him help himself. She wanted to allow him to maintain his independence but at the same time, she didn’t want him walking around in soiled clothes.
There came a time when we decided he probably shouldn’t be wearing regular underwear anymore and that we needed to start considering our adult diaper options. The need was evident as his accidents had become more frequent. It became a very big worry for my mom, but my dad wasn’t too bothered by it. He would just say, “whoops!” and then move on swiftly. My mother, on the other hand, was mortified and saddened by this new stage of his cognitive decline. As her confidant and support, I provided her some reassurance that we could figure this out.
She wanted to be able to continue to go to social events and interact with their friends. We discussed options to continue these activities. Below are some practical tips that she and I constructed that have worked for us so far, yet our process of management is constantly evolving. The trick is to adopt a flexible mindset, knowing that something that works today may need to be tweaked tomorrow. Because everyone is different, your care plan may look different than mine; just because a person has dementia, does not mean they don’t have a preference or opinion. Work with your loved one to create a personalized care plan just for them.
6 Tips for Managing Incontinence in Someone with Dementia
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Find the right incontinence products. Figuring out which type of incontinence product works best can take a little trial and error. Everyone’s needs are different, and getting the right fit really does make a difference when it comes to comfort and consistency. Be patient with the process. Fortunately, NorthShore offers a product sample program where you can try up to six premium products for free — just cover the cost of shipping!
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Start slow. Slowly start replacing the regular underwear with incontinence underwear in their underwear drawer. We found doing a rapid switch was not the right move for my dad and was met with much resistance. So, we started slowly replacing his regular underwear with diaper style briefs, just a few at a time until the only options in the drawer were briefs.
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Create comforting routines. Get in a schedule of giving gentle toileting reminders. We set up reminders on my mom’s phone to remind my dad to make a bathroom trip. This was especially important when out on social visits; being out of his home environment threw him off a little so he needed the extra support and reminders.
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Use different products for different scenarios. For longer outings or lengthy social gatherings, we employed a different product with higher absorbency. Our family throws a large holiday party every year and it goes on for the entire day and night. We needed something that would go the distance! We found that GoSupreme Incontinence Underwear did the trick.
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Bring backup.We always made sure to have extra supplies with us. The products from NorthShore provide excellent leak protection, however, it's always good to be prepared. We found having Supreme Cleansing Wipes available to be helpful as well. Clean and dry skin is happy skin!
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Take a breath. Give yourself grace. Caregiving is incredibly demanding, and it’s normal to feel overwhelmed at times. What you’re doing matters, and you don’t have to have it all figured out. There’s support out there, and even small wins each day can make a big difference.
Caring with Confidence: What Matters Most
Managing a loved one with dementia is hard and the challenges that come with incontinence are equally, if not more, challenging. The importance of patience and flexibility cannot be overstated throughout the process of determining the best product for your loved one. Thankfully, the premium products offered by NorthShore provide a reliable solution for managing incontinence, allowing you and your loved one to feel confident knowing that you have extended leak protection when heavy incontinence occurs.
Instead of focusing on what’s difficult, focus on what’s possible. With the right support, thoughtful strategies, and dependable products, it is possible to bring comfort, confidence, and even joy to everyday life—for both you and your loved one. If you need help getting started, NorthShore’s Customer Care team is available to answer questions and offer expert, personalized guidance.
Katie Pescatello, RN, MSN, FNP-C – Bio
About the Author: Katie Pescatello earned a Master of Science in Nursing from Simmons University, where she also taught pharmacology in the Master's program for several years. She has worked as a nurse practitioner in skilled nursing facilities, outpatient clinics, and hospitals. She is passionate about providing individuals with the tools to make informed decisions. While working as a Hospitalist in several Boston area hospitals, she enjoys writing health content for several online publications, focusing on aging in place and preserving dignity at the end of life.
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