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Managing urinary incontinence in persons with Alzheimer's disease

Linda M. Duffy, RNC, MS, is Clinical Nurse Specialist, Geriatric Research, Education and Clinical Center (GRECC), Veterans Administration Medical Center, Minneapolis, Minnesota. their caregivers makes the lack of information specific to their needs more obvious. Historically, urinary incontinence was viewed as a natural outcome of dementia. Recently this view has been questioned as efforts continue to clarify and classify the Alzheimer's disease process. Reisberg1 has developed the Functional Assessment Staging of Alzheimer's Disease (FAST) scale that describes seven levels of increasing severity of symptoms and loss of function, and differentiates treatable complications from the natural progression of the disease. This scale indicates that urinary incontinence develops in an advanced stage at which the person also has difficulty with dressing and bathing. Based upon Reisberg's Functional Assessment Staging of Alzheimer's Disease, appropriate interventions for managing urinary incontinence can be anticipated and initiated in a logical and progressive manner. These interventions do not differ significantly from those proven effective in other situations. However, our ability to provide caregivers with specific and workable techniques in a timely manner has the potential for increasing coping skills, reducing burden, and lengthening the time a patient may be cared for at home.