Incontinence is something that can affect people from all walks of life, and of all ages. It is not uncommon for women to develop stress incontinence after pregnancy, and older adults of both genders are susceptible to incontinence. One in five adults over the age of 40 suffer from an overactive bladder, and some people find that their symptoms are so strong they experience a slight urine leak before they are able to get to a restroom.
As people get older, incontinence symptoms often get worse. While some seniors write it off as being a fact of aging, it is not something that needs to just be accepted. Many adults are embarrassed about their urinary incontinence and this can lead to them being reluctant to seek help. If you care for someone who is struggling with incontinence it is important to deal with the symptoms compassionately and discreetly.
Types of Incontinence
Not a lot of people know this, but incontinence has several different varieties. Yes, they are all equally annoying and frustrating! The most common kinds of incontinence are:
- Urge Incontinence: Where the involuntary contractions of the bladder cause urine to leak out. This can be made brought on by strokes, dementia, Alzheimer’s disease, pelvic floor atrophy in women, Parkinson’s disease, and prostate enlargement in men.
- Stress Incontinence: Yes, that ‘I leak a bit when I cough’ thing is a common medical phenomenon. Stress incontinence is something that happens more often in women than in men, but men who have an enlarged prostate are not immune to this trouble.
- Overflow Incontinence: This is less common than other kinds. People who have this find that they need the toilet often, and that they leak small amounts of urine. It can happen to people with diabetes, or who have had nerve damage from a stroke.
- Functional Incontinence: This condition isn’t strictly incontinence, but rather difficulty using the toilet. For example, someone with poor motor control might find it hard to unzip their pants, while someone with a bad hip might find small, cramped public restrooms hard to use so may avoid going to the toilet for so long that they end up with an urgent need to go, or have an “accident”.
Tips for Dealing With Incontinence
Many people with incontinence feel that they are still sharp, and that they are being let down by their bodies. The last thing they want is to be made to feel like a child. The idea of wearing ‘adult diapers’ might horrify them.
Be honest, as a caregiver, even though you know the person you care for is intelligent, kind and caring, and generally takes good care of themselves, and that you would never judge them for wearing incontinence pants, would you want to wear them yourself?
Compassion and understanding are key to dealing with incontinence. A lot of the time incontinence can be successfully managed through non-surgical, non-medicinal measures. Work with the person you care for to come up with simple ways to reduce the risk of accidents.
Bladder training involves the patient training themselves to go longer between trips to the bathroom. It is possible to delay urination slightly and go longer between bathroom trips. It is also possible to reduce the need to go to the toilet so often by ‘double voiding’. With this practice, a person can use the restroom, then wait for a few minutes and go to the toilet again. This helps them get used to fully emptying their bladder.
Pelvic Floor Exercises
Using pelvic floor exercises, it is possible to strengthen the muscles that help to hold the bladder. Kegel exercises should be done several times per day. Learning how to contract and relax the kegel muscles is important to ensure that the exercises are giving benefit.
Scheduled Bathroom Trips
Some people may benefit from scheduled trips to the bathroom. If you have someone in your care with mobility issues, then taking them to the bathroom at specific times of the day may help to reduce the risk of accidents. If you are caring for someone with memory issues, then reminding them that it is toilet time if done carefully and sensitively, may avoid issues where they put off or forget going to the restroom until it is too late.
Reduced Caffeine and Alcohol Intake
Caffeinated beverages and alcoholic drinks have a diuretic effect, which can make the need to go to the toilet much more pressing. Encourage the seniors in your care to avoid those beverages if they are not sure when they will be able to make the next trip to the toilet.
What to Do When Things Go Wrong
Incontinence is hard to deal with. It can be stressful and frustrating, and since toilet issues are a taboo in many cultures it can be difficult to talk about. If someone has an accident, then you should deal with it promptly and discreetly. It’s a good idea to have a change of clothes in your bag or car when you are out and about with someone who has incontinence issues so that they are not stuck wearing soiled clothing.
Sanitary pads, pessaries and incontinence pads can be useful for people who struggle with bladder control. Carrying these in your purse, and reminding the person in your care to change or wear them is a good idea. Sometimes, a person may ‘leak’, and assume that other people won’t notice, so you will need to deal with the issue promptly and sensitively so that they can sort it out without alerting others to what is going on.
It takes planning to go out shopping or socializing with someone who suffers from incontinence. Develop some ‘code words’ that you can use to communicate with the person in your care without having to worry about them becoming embarrassed. Perhaps you need to go to the restroom with them to administer medication, for example.
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Some public places have large disabled stalls that you can go to when you need to help the person in your care change their clothes or freshen up. Not all places offer this, however, so you may sometimes need to enter a public bathroom. In some states, a person is allowed to enter the opposite gender’s toilets in order to provide care for a family member or disabled person, but this is not always the case, so check the law in your area before you do so.
If you are struggling, consider bringing in home help or a caregiver to share the burden. Sometimes, depending on your own age and health, caring for someone with incontinence is a huge challenge. This can especially be true if the person you are looking after is stubborn and resists care. Having someone from outside the family to help often reduces the burden significantly.
Remember You Are Not Alone
Most importanty, remember that you are not alone. If using pads, pessaries or clothing does not help, and you find that the incontinence cannot be controlled with bladder training or exercises, seek advice from a doctor. There may be incontinence support groups in your area, or a network of carers that can offer help and support.
When treated early, incontinence is not a serious issue, and it does not need to limit a person’s quality of life. Many people with incontinence manage to keep it as their ‘little secret’ and still play competitive sports and enjoy a busy and active life. It does not have to limit you.
What tips do you have for dealing with incontinence in older adults? Please share your thoughts, opinions, and ideas in the comments below!