Why we should promote continence in people living with dementia

Ageism plays a part in why the effects of incontinence for older people are considered so differently and nurses should continue to provide dignified care

A hand pushes open the door of a male toilet which has dementia signage affixed to it
Dementia signage Picture: David Mitchell

Ageism is widespread, including in institutions providing health and social care, and in workplaces, the media and elsewhere, according to the World Health Organization.

Such ageism can convey a narrative that incontinence is a normal or inevitable part of ageing – and that nothing can be done to change the outcome either for those affected or across healthcare services.

Yet incontinence has significant emotional, psychological, relational and social effects on older people’s dignity and quality of life, including for those living with dementia.

Why is ‘containment’ seen as the priority?

Why are the effects of incontinence for older people considered so differently? Would we neglect to consider the wider effects of incontinence on younger people?

Why should an older person living with dementia be offered only containment products that are difficult to negotiate, bulky and may also require the support of their partner or another family member or carer to administer? Especially considering there may be alternative products or interventions that could help them to remain independent and protect their dignity for as long as possible.

Why would an older person not want to share a bed with their partner and be enabled to enjoy moments of closeness and intimacy that can mean so much when words might be challenging to find?

Stop this inequity in care and advocate for change

I suggest that such questions are rarely asked.

This inequity needs to stop, and we must continue to highlight that older people and their families may have complex needs and emotions relating to continence, which need to be addressed.

We must advocate for change. While our bodies and minds may age, core values and beliefs – like the need to be treated as individuals with dignity and respect – do not.

Further information