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Incontinence cognitive impairment — DGM MCQ

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ModerateContinenceIncontinence cognitive impairmentDGM

An 87-year-old woman with dementia has urinary accidents mainly when staff are busy. She can void if prompted and has no dysuria, retention or constipation. Her care home asks for medication to stop accidents. Current medicines include donepezil. What is the most appropriate management?

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Correct answer: A — Prompted voiding and toileting schedule

Prompted voiding is appropriate when cognitive impairment and care routines contribute to incontinence without infection or retention. Antimuscarinics may worsen cognition, catheters and fluid restriction cause harm, and antibiotics are not indicated. Behavioural continence support often works better than adding medicines.

Reference: NICE NG123; NICE NG97