People with dementia often need help with daily tasks and the amount of assistance they need will change over time. They may feel upset about losing their independence and be resistant to accepting help. However by involving them in the process, you can overcome some of these challenges.  Here are strategies to support you in providing the best care for your loved one.

Remember:

• Be patient and take your time.  Don’t rush your loved one to complete a task. 

• Try to maintain a routine so that it becomes familiar and comfortable for your loved one. However, recognize when it is not working and adapt the process. 

• Provide simple, step-by-step instructions so as not to overwhelm them with information, and provide reassurance throughout the process. 

• Encourage your loved one to do as much as possible and include them in the task. 

  • Try to move slowly and remain in your loved one’s field of vision.

  • Stand at eye level and make eye contact when speaking with them.

  • Engage your loved one and work the task into a conversation instead of saying it as a command.

  • Use gestures to accompany your words.

  • Respect your loved one’s opinions and desires. Don’t argue or talk down to them. 

• Create the right environment and plan your approach. Identify obstacles and health considerations

• If the person is upset or does not want your help, try again later as if it were the first time.

Watch for cues and maintain routines

• Notice when your loved one gives a sign about needing to use the toilet such as becoming restless, making unusual sounds or faces, tugging on clothing, touching their genitals, or pacing around the room.

• Have a routine and take the person to the bathroom or remind them on a regular schedule, e.g. every two hours. 

• Notice if they have specific times they use the toilet and remind or direct them at those times. 

Make the bathroom and toilet easy to find

• Clearly mark the path on walls and/or floors; ensuring that there are no obstacles and the way is well-lit. 

• Label bathroom doors with words or a picture of a toilet.

• Keep the door to the bathroom open so they can see the toilet.

• Paint the bathroom door with a color in contrast to the wall.

• Use a contrasting colored toilet seat. 

• Put lids on waste paper baskets and remove containers and plants that may be mistaken for the toilet.

Make it easier to use the toilet

• Use a commode or a urinal in the bathroom.

• Install hand rails beside the toilet, and a raised toilet seat to make sitting down and getting up easier.

• For men, try putting a decal inside the toilet bowl to have something to “aim at.”

• Choose easy-to-remove clothing, such as Velcro closings and elastic waists.

Provide clear, simple instructions

• Direct your loved one to the front of the toilet before removing clothes and face them.

• Give a cue to get started, such as running water, prompting, or demonstrating what to do.

• If they need help removing clothes, help by moving slowly and encouraging them to help. 

• Remind them to push down their pants before sitting down. 

• Hand them toilet paper or wipes to use as needed. You may need to help the person get started with wiping. 

• If staying seated is a problem, play music or provide a favorite item to look at or hold.

Provide privacy and ensure safety

• Provide privacy, but stay nearby. 

• Explain that you are “just outside the door if anything is needed.”

• If they are alone, make sure that no medications or dangerous objects are accessible.

• Consider removing any door locks to avoid your loved one from locking themselves inside the bathroom. If they insist on a lock, use a “fake” lock or one you can unlock from the outside. 

• Don’t rush them.  It may take time.

Follow up

• Check the toilet to see if it was used

• Flush the toilet if needed.

• Watch for redness or skin breakdown, and contact a nurse or doctor for treatment. 

Monitor fluids

• Encourage overall fluid intake, but limit fluid intake before bedtime.

• Cut down on drinks that stimulate urination, like cola, coffee or tea.

Accidents happen

• Stay calm and try to ease any embarrassment your loved one might be feeling. For example, say, “Anyone can have an accident” instead of saying, “You wet yourself.”

• Be matter-of-fact; don’t scold or make the person feel guilty.

• If accidents happen during the night, consider having a commode in the bedroom. 

• Keep the person dry and clean. If necessary, use briefs, disposable underwear, or protective bedding.

• If you are going out, consider using padded undergarments or adult briefs. They can be helpful when you’re in a place where getting to a toilet might be difficult.