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How to Manage Urinary Incontinence in Dementia

Urinary incontinence can become more common as dementia progresses. A person may have difficulty recognizing a full bladder, remembering where the bathroom is, communicating the need to go, getting there quickly enough, or managing clothing independently.

Written and medically reviewed by Amarish Dave, DO, board-certified neurologist. This page is educational and does not replace an individual medical evaluation.

Video with Amarish Dave, DO, Board-Certified Neurologist

One of the most useful strategies is not to wait for the person with dementia to ask to use the bathroom. A predictable routine can reduce the memory, communication, and planning demands involved in toileting.

Use scheduled bathroom visits

Caregivers can establish regular, predictable bathroom trips throughout the day. Rather than asking, “Do you need to go to the bathroom?” consider making toileting part of the routine: “It's time to use the bathroom.”

Depending on the individual, scheduled or prompted toileting at regular intervals may reduce accidents. Consider bathroom visits:

  • After waking
  • Before leaving the house
  • Around meals
  • At regular intervals during the day
  • Before bedtime

The schedule should be individualized based on the person's usual pattern and needs.

Make the bathroom easier to find

Dementia can make navigation and recognition more difficult. Practical changes may include:

  • Keeping the path to the bathroom clear
  • Leaving the bathroom door visible
  • Using a simple bathroom sign
  • Providing adequate lighting, particularly at night
  • Using night-lights between the bedroom and bathroom
  • Making the toilet easy to recognize

Make clothing easier to manage

Complicated buttons, belts, and fasteners can make it harder for someone with dementia to use the bathroom independently. Simple, easy-to-remove clothing may reduce accidents and preserve independence longer.

A new change should not automatically be blamed on dementia

If urinary incontinence suddenly appears or becomes significantly worse, consider medical evaluation. A sudden change accompanied by new confusion or other symptoms deserves medical attention.

A new change in bladder control may have another cause

Potential contributors can include:

  • Urinary tract or other illness
  • Constipation
  • Medication effects
  • Mobility problems
  • Prostate or other urinary conditions
  • Diabetes or increased urine production
  • Other neurological or medical problems

Dementia, walking problems, and urinary incontinence

Urinary problems occurring together with significant walking difficulty and cognitive decline can sometimes be seen with normal pressure hydrocephalus, or NPH. This does not mean that everyone with dementia and incontinence has NPH, but the combination can be important during a neurological evaluation.

Learn more in What Is Normal Pressure Hydrocephalus? A Treatable Cause of Dementia Symptoms.

Preserving dignity

Accidents should be handled calmly and without criticism or embarrassment. The goal is to preserve dignity and independence while creating routines that make toileting easier for both the person with dementia and the caregiver.

Key takeaways

  • Do not rely on the person to recognize or communicate the need to use the bathroom.
  • Build scheduled bathroom visits around the person's routine and usual pattern.
  • Clear paths, visible signs, good lighting, and simpler clothing may support independence.
  • New or suddenly worse incontinence can have medical causes and deserves evaluation.
  • Walking difficulty, cognitive decline, and urinary symptoms together can raise concern for NPH.
  • Respond to accidents calmly and protect the person's dignity.

Continue learning about dementia care

Continue with memory loss and dementia evaluation, how dementia is treated, why people with dementia may have hallucinations, and Lewy body dementia. Caregivers can also review how to manage agitation in dementia. Browse more answers in the Neurology Video Library.

The Illinois Dementia Guide also offers a practical guide to treating agitation in Alzheimer's disease without medication and additional dementia caregiver resources.

Supporting someone with memory loss?

The Illinois Dementia Guide provides free, practical guidance for Illinois families navigating memory concerns, dementia evaluation, caregiving and planning.

Explore the Illinois Dementia Guide →

Frequently asked questions

Why do people with dementia become incontinent?
As dementia progresses, a person may have difficulty recognizing a full bladder, remembering where the bathroom is, communicating the need to go, reaching the bathroom in time, or managing clothing independently. Mobility problems and medical conditions can also contribute.
How often should someone with dementia be taken to the bathroom?
There is no single schedule for everyone. Caregivers can start with predictable visits after waking, around meals, before leaving home, at regular intervals during the day, and before bed, then adjust the timing to the person's usual pattern and needs.
Does scheduled toileting help dementia-related incontinence?
Scheduled or prompted toileting may reduce accidents for some people because it does not depend on the person recognizing, remembering, or communicating the need to use the bathroom. The schedule should be individualized and adjusted based on results.
Why doesn't someone with dementia tell me they need the bathroom?
Dementia may affect awareness of bladder signals, memory, language, planning, navigation, or the ability to act quickly. A calm prompt such as ‘It's time to use the bathroom’ may work better than waiting for the person to ask.
Can a sudden increase in incontinence mean something else is wrong?
Yes. A urinary or other illness, constipation, medication effects, mobility problems, diabetes, prostate or urinary conditions, and other neurological or medical problems can cause a new or sudden change. Medical evaluation is important, especially when new confusion or other symptoms are present.
Can normal pressure hydrocephalus cause dementia and urinary incontinence?
Normal pressure hydrocephalus can cause a combination of walking difficulty, cognitive change, and urinary symptoms. Most people with dementia and incontinence do not have NPH, but this pattern can be important during a neurological evaluation.
How can caregivers reduce nighttime bathroom accidents?
A bedtime bathroom visit, adequate lighting, night-lights along a clear path, easy-to-remove clothing, and a predictable routine may help. New nighttime symptoms, pain, increased thirst, or a sudden change should be discussed with a healthcare professional.

Related dementia and caregiver videos

More medically reviewed memory and caregiving videos appear here automatically as they are published.

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Memory & Dementia

How to Manage Agitation in Dementia

Amarish Dave, DO shares practical ways caregivers can look for triggers, reduce distress, redirect calmly, create predictable routines, and recognize sudden changes that need medical evaluation.

Watch Video
View all Memory & Dementia videos →

Subscribe to the NeurologistCare YouTube channel for additional short videos answering common questions about dementia, caregiving, and neurological health.

Caring for someone experiencing memory loss or dementia?

Learn more about dementia evaluation, treatment, and practical caregiver strategies at NeurologistCare.com. In-person neurological and memory evaluations are available in Crystal Lake and Woodstock, Illinois, and Lake Geneva, Wisconsin, with telehealth available when appropriate for patients physically located anywhere in Illinois or Wisconsin at appointment time.

Medical disclaimer

This information is for general educational purposes and is not individualized medical advice. New urinary symptoms, sudden worsening of bladder control, confusion, or neurological symptoms should be discussed with an appropriate healthcare professional.

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