Why does someone who is dying become incontinent?
Incontinence near death can happen because the person is weak, sleepy, less aware and losing muscle control.
Incontinence near death can happen because the person is weak, sleepy, less aware and losing muscle control. They may not know they need the toilet, may not be able to get there, or may pass urine or faeces without control.
This is common near the end of life. It can feel upsetting or undignified, but careful practical care can protect comfort and dignity.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why it happens
As the body shuts down, muscles relax and awareness reduces. The person may be too sleepy or weak to call for help. They may no longer feel bladder or bowel signals clearly.
CarerHelp lists being unable to tell you when they need to go to the toilet as one common sign that death may be near.
Incontinence can also happen after death as muscles relax.
Check for discomfort
Incontinence is not always painful. But bladder or bowel problems can cause distress.
Tell the care team if the person seems restless, has lower belly swelling, keeps trying to pass urine, has diarrhoea, constipation, blood, pain, fever, or a blocked catheter.
A full bladder can make a dying person very uncomfortable and may look like agitation.
Practical care
Ask the nurse what supplies and care are best. Options may include continence pads, absorbent bed sheets, a commode, urinal bottle, bedpan, catheter, barrier cream, or a planned toileting routine.
Keep the person clean and dry, but avoid unnecessary movement if turning causes pain or distress. The team can show you how to roll the person gently and change sheets with less strain.
Speak respectfully. Tell the person what you are doing, even if they cannot answer. Use towels or sheets to protect privacy.
Catheters and bowel care
A catheter may help if urine needs to drain, if the person cannot get to the toilet, or if bladder fullness is causing discomfort. It is not right for everyone.
Bowel care also matters. Constipation can cause pain, nausea, agitation and overflow soiling. Ask whether regular bowel medicines should continue, change or stop.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff if the person has pain, agitation, lower belly swelling, no urine with discomfort, diarrhoea, bleeding, fever, a blocked catheter, or skin breakdown.
Call 000 if there is sudden severe illness or another life-threatening emergency and no end-of-life plan telling you what to do.
You may also want to read
- How do I manage toileting when someone can no longer get out of bed?
- Why has a dying person stopped passing much urine?
- How do I change sheets when someone cannot get out of bed?
- Is what I'm seeing normal dying, or are they suffering?