Stages of Dementia and Diapers: Part One

Stages of Dementia

Funny how times change. Remember when we were younger and something funny would happen and when we retold the story we added, “I almost pissed my pants!” and everyone laughed? Flash-forward to caring for a person with dementia and peeing your pants is no longer a laughing matter.

One of my biggest caregiver challenges through Mom’s middle stages of dementia was that she was peeing everywhere except in the bathroom. Dining room chairs, living room couch, my car, closet, garage, outside…didn’t matter where. When Mom had to go, she went.

When my three year-old son peed outside by a tree, the neighbors would laugh. When my eighty year-old mother did the same thing, the neighbors freaked out! It was like having a puppy in the house. But Mom was not going to grow out of this phase. As time wore on it only got worse.

As I mention in “Alzheimer’s Disease and Other Dementias: The Caregivers Complete Survival Guide,” “Incontinence will be your biggest challenge…and cause the greatest caregiver distress”.

I should have seen this coming. Had I not been in denial for so many years it would have been obvious. Looking back now, the signs were all there. When mom was in the early stages of dementia she became obsessed with napkins and paper towels. At first, I thought she was being thrifty.

There wasn’t a restaurant, gas station or supermarket bathroom that she went into without stuffing her purse with paper towels. Once she was home, she would proudly show off her newfound contraband.

It was during this stage of dementia that she also started buying and wearing large boys’ underwear. According to Mom, they were “much more comfortable,” so I never questioned her choice. Looking back, everything adds up. The underwear provided extra room, making it much easier to stuff with toilet paper, paper towels, and napkins.


Back in the days when my always-frugal mother was growing up during the depression, there were sanitary products on the market that were expensive and uncomfortable. But lets face it – for my mom, household paper products were cheap, absorbent and could be discreetly thrown away. Especially since she visited so many restrooms!

As Mom’s stages of dementia progressed, the only product that would have worked for her back in the 90’s was a Kotex feminine pad. But who would have thought back then to use those for urinary incontinence?

Today, the grocery and drug store shelves are stocked with incontinence products. But as a caregiver, the vast amount of products and styles available now is confusing.

Small, medium, large, or extra-large. Daytime or nighttime. Pull on, tabs, disposable, or cloth. Light, moderate or heavy absorbency. Full diapers vs. pads. Male or female… the list is never ending. Choosing a product that works for your loved one is a battle in itself.

As a successful caregiver you need to be prepared that incontinence can strike during any stage of dementia. And this is an embarrassing issue for your loved one to talk about with you, and probably vice-versa. Next to taking away their car keys, this may be the hardest discussion you’ll have to have with your loved one. But it needs to be done.

The first step in feeling comfortable enough to approach this topic of conversation is becoming familiar with the various types of products on the market. I often advise my clients to take a trip through this aisle at their local drug store. If they get confused or overwhelmed, imagine how someone struggling with dementia would feel.

In this series of posts, I will help you through the difficult process of overcoming diaper resistance and choosing the right product as your loved one moves through their different stages of dementia.

If you liked this article and know someone it will help, please share. If you have a specific question regarding the different stages of dementia or dementia care – ask away!

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Photo courtesy of David Shankbone

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