continence
They are having accidents. How do I handle the toilet?
5 min read
Most continence problems in dementia are about finding, recognising and reaching the toilet in time, not about bladder control. Prompt every two hours, make the toilet visible and reachable, and change the clothing before you reach for pads.
What to try
- 1Prompt every two hours rather than waiting to be asked. Most accidents are timing, not capability.
- 2Make the toilet findable: door open, light on, a clear sign, and a contrasting toilet seat.
- 3Clear the route — no rugs, no closed doors, a night light along the whole path.
- 4Choose clothing that comes down in one movement.
- 5Use waterproof mattress and chair protectors so an accident costs a wash rather than a crisis.
What to avoid
- Cutting back on drinks to reduce accidents. It is a common instinct and it makes other things harder — raise it with the continence service instead.
- Reacting with dismay or disgust in the moment. How you handle the first accident decides whether they hide the next one.
- Moving straight to pads. Assess first — pads used too early can end continence that could have been kept.
What is usually going wrong
- They cannot find the toilet, especially in an unfamiliar or rearranged home.
- They no longer notice the bladder signal until it is urgent.
- They cannot manage the clothing in time.
- A white toilet in a white bathroom is close to invisible.
- Bins and plant pots that resemble a toilet get used as one.
Dignity
Keep your voice level, close the door, and never discuss it in front of visitors. Losing continence is felt keenly even when it cannot be explained.
How this guide was made
Written by
Written independently for Riparo. It is not copied or adapted from any organisation’s material.
Evidence checked
Some key points have been checked against published national dementia guidance; others have not been.
Reviewed by
Not clinically reviewed. No clinician has checked this guide.