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Why Do People With Dementia Have Trouble With Bladder And Bowel Control?

People with dementia have memory loss and may be confused and not know where they are. This can cause or make bladder and bowel control problems worse.

People with dementia may have trouble with:

  • “Holding on” until they get to the toilet.
  • Finding the toilet.
  • Knowing they need to unzip or pull down their pants when going to the toilet.
  • Being away from home at places where they don’t know where the toilet is.
  • Knowing when their bladder or bowel is empty.
  • Being aware of the need to pass urine or empty their bowels.
  • Urinating or opening their bowels in places they should not.
  • Depression, anxiety or stress, or illness, which may make bladder and bowel control problems worse.

为什么患痴呆症的人难以控制大小便?

患痴呆症的人丧失了记忆力并可能因迷惑而不知道自己身在何处。这会导致大小便控制失常,或令其更加严重。

患有痴呆症的人士可能:

  • 无法“忍住”大小便,直至去到厕所。
  • 找不到厕所。
  • 不知道上厕所时要开拉链或脱裤子。
  • 离开家到他们不知道厕所在哪里的地方。
  • 不知道大小便何时排完。
  • 不知道自己需要排尿或排便。
  • 会随地大小便。
  • 可能会因为沮丧、焦虑或压力令大小便控制失常更严重。

Can Anything Be Done For People With Dementia Who Have Trouble With Bladder And Bowel Control?

Yes!

While dementia may rule out some treatments, there are ways to provide comfort and dignity.

There are some broad rules for working in a helpful way with people with dementia:

  • Listen with care and respond to the person.
  • Get rid of clutter. Keep the space around them simple and well known to them.
  • Show respect and sincere care.

Check bladder and bowel control

Seek help from their doctor, physiotherapist, or continence nurse.

A bladder and bowel control check up will include a physical check and questions about when, where and why problems happen.

The carer is often the best person to give the details needed to check bladder and bowel control, such as:

  • the time the person goes to the toilet and/or leaks;
  • how wet the person is:
    minor = underwear is damp;
    moderate = skirt or trousers are wet; or
    severe = chair, floor or bed is flooded; and
  • when and how often they open their bowels.

Manage poor bladder and bowel control

  • Treat the cause of the problem. Their doctor, physiotherapist or continence nurse can help find the causes and suggest how to treat them.
  • Review medicines. Medicines may help, but they can also make people more confused, and make bladder and bowel control problems worse.
  • Make sure the person with dementia drinks 1.5 - 2 litres of fluid per day (unless a doctor says this is not okay). Drinking water can help treat bladder infections, make the bowels work better and keep the bladder healthy. Coffee, tea and cola have a lot of caffeine, which can upset the bladder and make the bladder harder to control. Try to cut down on how many of these drinks they have.
  • Treat constipation. Make sure they eat lots of fruits and vegetables, drink lots of water through the day, and stay active.
  • Watch for signs they want to go to the toilet. Ask them to use the toilet at the times you think they most often go or are most often wet. If you note the time this happens you will be able to see if it gets better.
  • If they have trouble with zips and buttons, change to track suits, trousers with elastic waists, or use Velcro.
  • Keep the way to the toilet clear. Don’t leave things in the way that might make it hard to get to the toilet. A night light may help. Make the toilet door easy to see.
  • Think about using community resources to help with the load of caring for a person with dementia – such as laundry, shopping and respite care.

Bladder management products such as pads and pants may improve quality of life. You may be able to get some help to cover the cost of these products. Advice on whether you are able to receive this help and the types of products you can get can be found on the National Continence Helpline (Free call* 1800 33 00 66). These things may reduce how often bladder and bowel mishaps occur and how bad they are.

可以为难以控制大小便的痴呆症患者做些什么吗?

可以!

虽然某些治疗可能不适合痴呆症患者,但有一些方法可以给他们安慰及尊严。

在有效地帮助痴呆症患者方面,存在一些广泛适用的规则:

  • 仔细聆听并作出回应。
  • 清理杂物。保持他们的周围环境简单整洁,让他们感到非常熟悉。
  • 表现出尊重及真诚的关心。

检查大小便控制情况

向他们的医生、理疗师或排便科护士寻求帮助。

大小便控制检查包括身体检查,以及询问大小便失控发生的时间、地点和原因。

照顾人是提供大小便控制检查所需详情的最合适人选,所需情况包括:

  • 去厕所及/或失禁的时间;
  • 尿湿的程度:
    轻度 = 尿湿内裤;
    中度= 尿湿裙子或裤子;或者
    严重= 椅子、地下或床上湿透;以及
  • 他们的排便时间及间隔。

大小便控制失常的管理

  • 针对问题的起因。他们的医生、理疗师或排泄科护士可以帮助找出原因及提出对策。
  • 考虑用药治疗。药物可能有帮助,但它们也可能令人更迷惑,并令大小便控制失常更加严重。
  • 保证患有痴呆症的人每天饮用1.5—2升液体(除非医生说不能这样做)。喝水有助于治疗膀胱感染,令肠道更通畅及保持膀胱健康。咖啡、茶及可乐含有大量咖啡因,会影响膀胱,令排尿更难控制。尽量减少他们喝这些饮品的量次。
  • 治疗便秘。确保他们吃大量水果及蔬菜,每天大量喝水,并经常活动。
  • 观察他们想去厕所的征象。在你认为他们最经常去厕所,或最经常尿湿的时侯叫他们去厕所。如果你能留意出现这些情况的时间,就可以知道是否有改善。
  • 如果他们开拉链,解钮扣有困难,就改穿运动服、有松紧腰带的裤子,或使用粘扣带(Velcro)。
  • 保持去厕所的路畅通。不要在路上放东西,以免去厕所更困难。夜间照明灯可能有帮助。令厕所门容易看得见。
  • 考虑利用社区资源减轻照顾痴呆症患者的负担—例如,提供洗衣,购物及暂休照顾。

控制尿失禁用品如垫子及裤子或可改善人们的生活质量。你也许能获得资助,支付这些用品的开支。关于你是否可以获得这项资助,以及你可以购买的产品类型的建议,请致电全国排便节制帮助热线(National Continence Helpline)(免费电话*1800 33 00 66)。 这些用品或可以降低大小便失禁发生的次数及严重程度。

Can Medicine Help With Bladder And Bowel Control?

Yes!

  • Antibiotics may be given to treat a bladder infection.
  • Hormone replacement therapy (tablets, patches or creams) may make it easier for post menopausal women to control their bladder.
  • Tablets to relax the bladder may be given to settle an upset bladder, so it can store more urine. This can cut down the number of times the person needs to go to the toilet.
  • Some medicines may cause bladder and bowel control problems, or make them worse. Medicines should be checked by a doctor, to see if any need to be changed.
  • Some medicines for bladder and bowel control problems may cause problems like dry mouth, constipation, poor balance and lack of energy. For people with dementia, there is also a risk they may get more confused. Use of medicines should be watched with care by their doctor. Tell the doctor about any problems the medicines cause.

药物可以帮助大小便控制吗?

可以!

  • 抗生素可用于治疗膀胱感染。
  • 荷尔蒙替代疗法(药片,贴片或乳膏)可令绝经后的女性较容易控制排尿。
  • 对受刺激的膀胱可用松弛膀胱的药片治疗,让膀胱可以储存较多尿液。这可以减少病人需要上厕所的次数。
  • 有些药物会引起大小便控制失常,或令失常更加严重。药物应该经医生检查,看看是否需要换药。
  • 一些用于大小便控制失常的药物可能引起如口干、便秘、平衡失调及乏力等问题。对于痴呆症患者来说,还有可能令他们更迷惑。医生应该在用药期间对他们进行仔细观察。要告诉医生任何由药物引起的问题。

Seek Help

Qualified nurses are available if you call the National Continence Helpline on 1800 33 00 66* (Monday to Friday, between 8.00am to 8.00pm Australian Eastern Standard Time) for free:

  • Information;
  • Advice; and
  • Leaflets.

If you have difficulty speaking or understanding English you can access the Helpline through the free Telephone Interpreter Service on 13 14 50. The phone will be answered in English, so please name the language you speak and wait on the phone. You will be connected to an interpreter who speaks your language. Tell the interpreter you wish to call the National Continence Helpline on 1800 33 00 66. Wait on the phone to be connected and the interpreter will assist you to speak with a continence nurse advisor. All calls are confidential.

Visit bladderbowel.gov.au or continence.org.au/other-languages

* Calls from mobile telephones are charged at applicable rates.

寻求帮助

如果你致电国家排便节制热线,有资质的护士会接听你的电话1800 33 00 66*(周一至周五,澳大利亚东部标准时间8:00am—8:00pm)。

  • 信息;
  • 建议;及
  • 资料册。

如果你在讲英语或者理解上有困难,你可以通过拨打13 14 50获取免费电话传译服务以接通国家排便节制热线。电话会用英语接通,因此请说明你要讲的语言并且不要挂机。你会被连接到一个讲你母语的传译员。告知传译员你想要致电国家排便节制热线,电话是1800 33 00 66。待电话接通后传译员会帮助你与排便节制护理顾问对话,所有的来电均保密。

请登陆:bladderbowel.gov.au 或者 continence.org.au/other-languages

* 用手机打出会收取相应费用。

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Last Updated: Fri 30, Jul 2021
Last Reviewed: Tue 17, Mar 2020