Caregiving and night incontinence: how to improve your loved one’s sleep, and your own

Sleep is incredibly important to our health. Every bit as important as diet and exercise. But when you're caring for someone who has incontinence, or needs support to remain continent, ensuring they get a good night's sleep can be a challenge. Fortunately, there are strategies available to make both of your lives easier. Here are a few steps you can take to minimize sleep interruptions and make your nighttime caregiving routine more efficient. 

As we grow older, our bodies change in numerous ways that can result in needing to empty our bladder more frequently at night. Our sleep becomes shallower, our kidney function declines, and our bladder grows less elastic. Still, a treatable ailment can sometimes be at fault. If you suspect this may be the case, consult your family doctor to rule out a urinary tract infection or some other condition that may respond to treatment.  

Seemingly obvious measures like avoiding caffeine and excessive fluid intake before bed, and being sure to empty the bowel and bladder, can make a big difference. If your loved one takes a nap during the day, make sure they don't sleep for so long that it keeps them awake at night. Also, try to keep their sleep cycle consistent and encourage them to go to bed every night at the same time. Medications such as diuretics can also increase thirst and fluid intake. If this is leading to frequent night toileting episodes, ask a doctor about replacing these medications, or administering them earlier in the day.  

Take a look at patterns that may be interfering with a good night's rest. Does your family member's daily regimen include enough exercise and fresh air? Are there nagging sources of pain or irritation that may be contributing to insomnia? If so, it may be time to re-examine the analgesic regime. Evening activities can be worth considering too. Is TV before bed too stimulating? Maybe that late glass of wine could be replaced with gentle stretching, reading, or listening to calm music, to promote a restful frame of mind. 

A groggy trip to the bathroom in the dark can easily result in an accident. Installing a chair-style commode next to the bed in the evening can enhance safety and simplify the whole process. Alternatively, installing motion sensor lights can help your senior relative see where they're going when heading to the restroom in the wee hours. Be sure to clear the path to the destination and get rid of loose rugs and other hazards.  

Remember that your own sleep matters too. Sleep in a separate room from your loved one, if needed. Make it a sanctum that elicits a natural sleep response, free from stimuli that prompt anxiety or stress. If needed, invest in a baby monitor to keep in close touch during the night. If advanced dementia is present and night wandering is a concern, consider a bed alarm to alert you if they get up and wander off. 

Knowing it's pointless to spend sleepless hours fretting over your relative's care doesn't make it any easier to shut down your anxieties and go to sleep. A trick for switching off can be to set aside a designated time during the day for pondering and planning. Write a to-do list, and put it away until the next day. Knowing you've done this might just make it possible for you to let go, and drift off. 

Fecal leakages during the night can be frustrating and embarrassing. In elderly people, damage to skin in contact with feces occurs quickly. Emptying the bowel during the day will help minimize the risk of interference during the night. If diarrhea is the issue, your doctor may prescribe medications to promote more solid stool. On the other hand, constipation may respond to dietary changes such as increased fluid intake and fiber-rich foods. Exercise activities aimed at strengthening the pelvic floor muscles can also help maintain healthy bowel movements.