Memory Digest

Incontinence

Bladder and bowel accidents are common as dementia progresses; learn the treatable causes to check first, toileting schedules and bathroom set-ups that help, product tips, skin care, and how to protect dignity.

Last reviewed: October 2026

Few caregiving topics are harder to talk about than incontinence—losing control of the bladder or bowels. It can be embarrassing for the person with dementia and exhausting for the people who care for them. It's also one of the most common reasons families start thinking about outside help.

You're not alone. A 2026 review of studies including more than 286,000 people with dementia estimated that about 4 in 10 have urinary incontinence, with higher rates in hospitals and care settings. And there is a lot you can do to reduce accidents and keep the person comfortable.

Why it happens

The Alzheimer's Association notes that incontinence becomes common in the middle and late stages of Alzheimer's. Dementia-related causes include:

• Not recognizing the body's signal that it's time to go
• Forgetting where the bathroom is, or not finding it in time
• Trouble with clothing—zippers, buttons, belts
• Not recognizing the toilet, or having trouble sitting down on it
• Medicine side effects

The National Institute on Aging (NIA) notes that people in the later stages of Alzheimer's often have urinary incontinence because they don't realize they need to go, forget to go, or can't find the toilet. Many older people also have functional incontinence: normal bladder control, but trouble getting to the toilet in time because of arthritis or other conditions that make moving quickly hard.

First: check for treatable causes

The Alzheimer's Association says that if a person has recently started having accidents, the most important first step is to find out why. Call the doctor to look for:

• Urinary tract infection (UTI)—which in older adults with dementia can also cause sudden confusion or agitation (see Delirium vs. Dementia)
• Constipation, which can press on the bladder and cause both urine and stool leakage
• Prostate problems in men
• Diabetes, stroke or Parkinson's disease
• Medicines, including diuretics ("water pills"), sleeping pills and anti-anxiety drugs that may relax the bladder
• Physical problems that make it hard to get to the bathroom quickly

Some causes can be treated, and the problem may improve.

Make the bathroom easy to find and use

The Alzheimer's Association recommends:

• Keep the bathroom door open so the toilet is visible.
• Put a picture of a toilet on the bathroom door.
• Paint the door a color that contrasts with the wall.
• Light the path from bedroom to bathroom with night lights; remove clutter and trip hazards.
• Raise the toilet seat and install grab bars on both sides.
• Consider a portable commode or urinal near the bed at night.
• Remove wastebaskets, plants and other objects that might be mistaken for a toilet.

See Home Safety.

Use a toileting routine

Regular, planned bathroom trips are one of the most effective tools:

• Watch for the person's natural pattern and remind them just before their usual times.
• Try a schedule: first thing in the morning, every two hours during the day, right after meals, and just before bed.
• If accidents happen at predictable times, plan a bathroom trip just before.
• Give the person plenty of time to empty their bladder and bowels.
• If they have trouble starting, the Association suggests running water in the sink or offering a drink.

Learn their signals

The person may not be able to say, "I need the bathroom." Watch for nonverbal cues the Alzheimer's Association lists: restlessness, pacing, unusual sounds or faces, sudden silence, tugging at clothes, or hiding in corners. Some people use their own words or phrases that mean "I need to go," even if they seem unrelated.

Fluids: don't cut back

It may seem logical to limit drinks, but the Alzheimer's Association warns this can cause dehydration, which raises the risk of UTIs and can make incontinence worse. Instead:

• Encourage plenty of fluids during the day
• Limit drinks in the evening, before bed
• Cut down on caffeine (coffee, tea, cola), which increases urination

Clothing and products

• Choose clothes that are easy to remove and wash: elastic waistbands, no complicated buttons or belts.
• Absorbent underwear or adult briefs can help, especially for outings or at night. Try different brands and sizes for comfort and fit.
• Waterproof mattress pads and washable chair pads protect furniture.
• Pack a "just in case" bag for outings: a change of clothes, wipes, a plastic bag and gloves.

Protect skin

Moisture and friction can quickly cause rashes and sores.

• Clean gently after each accident and pat dry.
• Use a protective barrier cream, as the NIA suggests in its bathing advice.
• Change wet products promptly.
• Check the skin daily, and tell the doctor about redness or sores that don't heal.

See Bathing, Dressing and Grooming.

Protect dignity

How you respond matters as much as any product. The Alzheimer's Association advises:

• Be matter-of-fact. Don't scold or show frustration.
• Use reassuring words, such as "Anyone can have an accident," instead of "You wet yourself."
• Use adult words, not baby talk, and call products "underwear" rather than "diapers."
• Respect privacy as much as possible.

Nighttime accidents

• A bedside commode and good night lighting
• Fewer drinks in the last two hours before bed
• A bathroom trip right before sleep
• Overnight-strength absorbent products and a waterproof mattress cover

Caring for yourself

Managing incontinence is physically demanding and can disrupt your sleep. It's okay to ask for help—a home health aide, adult day program or Respite Care can give you breaks. If incontinence becomes too much to manage at home, it may be part of a discussion about other care options (see Choosing Memory Care or a Nursing Home).

Where to get help

• Alzheimer's Association 24/7 Helpline: 800-272-3900 (they hear about incontinence every day)
• NIA ADEAR Center: 800-438-4380

See also Daily Care and Routines and Caregiver Stress and Burnout.

Sources

1. Alzheimer's Association: Incontinence
2. National Institute on Aging: Urinary Incontinence in Older Adults
3. Global Prevalence of Urinary Incontinence in Individuals With Dementia: A Systematic Review and Meta-Analysis. Neurourology and Urodynamics, 2026

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

Related articles

• Bathing, Dressing and Grooming
• Daily Care and Routines
• Middle-Stage Dementia
• Late-Stage Dementia
• Home Safety