Caring for your loved one with Alzheimer's disease is a huge commitment and a loving responsibility. You will face many challenges along the way. One of them is bowel incontinence, or what we medically call bowel incontinence. This means passing stool without realizing it, or before you have time to go to the toilet. This can be very uncomfortable and distressing for you and your loved one. But don't worry, this is a common condition associated with Alzheimer's disease. Let's learn more about it and how to best manage it.
What are the situations when you should seek emergency medical advice?
Usually, bowel problems are not an emergency. However, sometimes they can be a sign of a serious problem. If your loved one has any of the following symptoms, see a doctor immediately or take them to the nearest hospital's emergency department (ETU).
| Dangerous symptoms to watch out for |
|---|
| ⚫ Stools that are black or dark red (cranberry) in color, like tar. |
| 🩸 Profuse bleeding with stool. |
| 🌡️ A high fever is a body temperature of more than 101 Fahrenheit (101 F). |
| 🤢 Severe stomach pain with nausea and vomiting. |
| New or worsening bowel problems with diarrhea (especially if you have recently been hospitalized or have used antibiotics). |
If your loved one is taking blood thinners, don't ignore even a small amount of blood in the stool. Call your doctor immediately.
Inform your doctor in such cases as well.
Even if some symptoms are not urgent, it is important to inform your family doctor about them so that he or she can perform the necessary tests to see if there is a problem.
| Symptom | Description |
|---|---|
| New problems | If you have a new or increasing low-grade fever along with bowel movement problems. |
| Change caused by medication | If this problem started or worsened after starting a new medication. |
| Diarrhea | If you have more than six loose stools in 24 hours. |
| After constipation... | If you have been constipated for a few days and suddenly start passing stool uncontrollably. |
| Changes in stool | If the stool is oily, clay-like, pale in color, or has a strong odor. |
| Skin problems | If the skin around the buttocks or genitals is red, sore, or painful. |
Be careful about dehydration!
Dehydration can also cause problems. Also look for these symptoms:
- Feeling like your mouth, nose, or eyes are dry
- Very low urine output (not urinating for 8 hours or more)
- Having a dry, cracked tongue
- The eyes look sunken.
- Heart rate exceeding 100 beats per minute
- Less alert than usual
- Extreme fatigue and difficulty speaking
- Urine turning dark yellow
Why does this happen to Alzheimer's patients?
There is not one reason for this, but several reasons may influence it.
- Disease-related effects: When Alzheimer's disease impairs brain function, the brain can't understand signals from the body. This means that they may not feel the urge to go to the bathroom. Or, they may forget to find the bathroom or take off their clothes.
- Other reasons:
- Lack of a healthy diet (especially low in fiber).
- Side effects of some medications.
- Severe constipation.
- Other medical conditions. For example, things like diabetes, Parkinson's disease, or urinary tract infections.
- Weakness in the body after surgery.
- Diarrhea caused by a viral or bacterial infection.
How to maintain care and cleanliness at home?
When something like this happens to your loved one, the most important thing is to not panic, but to be patient and loving. Remember, this is not something they do on purpose .
1. Calm down: They may be embarrassed and anxious about this incident. You should calm them down. Play a soft song, distract them, and start cleaning.
2. Clean quickly: Remove soiled clothing as soon as possible. Don't forget to wear gloves. Clean their skin with a soft cloth and soap. You can also use adult wipes that are alcohol-free and fragrance-free. When cleaning a woman, always wipe the vagina from front to back . This will help prevent infection.
3. Keep the skin dry: After cleaning, dry the skin thoroughly. Then put on a new set of clothes. If you have frequent accidents like this, using absorbent briefs for adults can make cleaning easier. Apply something like petroleum jelly to protect the skin.
4. Keep the environment clean: Wash soiled clothes, bedding, etc. in hot water with a disinfectant. Clean the bathroom and any areas that have come into contact with feces with a disinfectant solution.
How can you avoid accidents and make everyday life easier?
Making a few small changes can reduce the frequency of these accidents and make their lives easier.
- Make the path to the toilet easier: Make sure the path to the bathroom is clear and well-lit. If they have trouble finding the toilet, leave the bathroom door open. You can also put brightly colored tape on the door.
- Be patient and help: Some people want to be alone in the toilet. Some people like to have someone around. Watch their behavior and act accordingly. Give them as much time as they need.
- Establish a toilet routine: Get in the habit of taking them to the toilet at the same time of day (for example, after breakfast). When they become restless, pull on their clothes, or pace around, these may be signs that they need to go to the toilet. Help them at such times.
- Wear comfortable clothes: Wear clothes that have elastic instead of buttons and zips, and that are easy to take off.
- Prevent constipation: Drink at least 4-6 glasses of water a day. Eat a high-fiber diet, such as fruits, vegetables, and legumes. Ask your doctor about taking a fiber supplement if necessary. Encourage simple exercises, such as walking daily.
Constipation and Fecal Impaction
Sometimes, they try to avoid eating or drinking because they are afraid of danger. This can lead to severe constipation. If you have not had a bowel movement for several days and suddenly have a liquid stool, it could be a condition called fecal impaction . This is when a hard, stone-like mass of stool gets stuck in the intestines, causing liquid stool to leak out. In this case, do not give your child diarrhea medication. Call your doctor right away.
Take-Home Message
- Bowel incontinence is common with Alzheimer's disease. Understand that this is not something the patient does intentionally .
- Help your loved one deal with this with love, patience, and calmness.
- If you have dangerous symptoms such as blood in your stool, high fever, or severe stomach pain, seek medical advice immediately.
- It is very important to prevent constipation through a good diet, drinking enough water, and simple exercise.
- If you have any doubts or concerns, talk to your family doctor. You don't have to face this challenge alone.
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