Elimination Problems for the Alzheimer Patient

September 26, 2007

Disorientation, impaired neurological functioning, and inability to locate the bathroom may create elimination problems for the Alzheimer patient. It is important to note changes in bowel habits, such as constipation or diarrhea, dribbling, or incontinence. It is also advisable to monitor fluid intake very carefully because of its effect on elimination.

Methods used to facilitate Mr. Jones’s elimination included identifying the bathroom with a sign or a picture and providing adequate lighting at night to assist him in locating it. Mr. Jones was observed for restlessness and for other cues that indicate he might need to go to the bathroom; he was urged to go at frequent intervals (i.e., every four hours). He was encouraged to drink at least eight glasses of fluid during the daytime, but his fluid intake was limited before bedtime to reduce incontinence. Ms. C. was asked to look for swelling in his hands and feet. She was told to consult his doctor should this occur because it might mean he was retaining fluid.

To avoid constipation, laxatives or stool softeners were provided as needed. Since Mr. Jones wore adult diapers, because of urinary incontinence, the need to change them often was stressed, as was the need to apply lotion or powder to prevent skin breakdown.

Methods Of Improving Elimination

• Identify the bathroom with a sign or a picture.
• Provide adequate lighting, especially at night, to assist in locating the bathroom.
• Encourage the person to go to the bathroom at frequent intervals (i.e., every four hours).
• Encourage drinking at least eight glasses of fluid during the daytime, but limit fluids before bedtime to prevent incontinence. Consult a doctor if swelling of feet and/or hands is noticed.
• Observe the patient for restlessness and other cues that he or she may need to go to the bathroom.
• Provide laxatives or stool softeners as appropriate to avoid constipation.
• If adult diapers are worn, they should be changed often and lotion or powder applied to prevent skin breakdown.

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