It’s not easy to watch someone you love struggle with something as personal as incontinence. The embarrassment they feel, the frustration you experience, and the awkwardness of handling such an intimate issue can feel frustrating.
You may worry about their comfort, dignity, and how to deal with elderly incontinence while at the same time not straining your relationship. If this hits close to home, just know that you’re not alone.
There are many ways to navigate these sorts of challenges of taking care of your elderly and to make this journey less stressful for both you and your elderly, we will answer all the questions on incontinence and how to take care of someone with this problem.
Is Urinary Incontinence a Normal Part of Aging?
Urinary incontinence, the involuntary loss of urine, is a common issue among older adults as their bodies undergo natural changes with age. It is estimated that 25-33% of adults in the U.S. experience some form of incontinence, impacting their quality of life and often leading to embarrassment or frustration.
However, it’s important to note that while incontinence is common, it is not an inevitable part of aging and can often be managed or treated with appropriate interventions.
Elderly urinary incontinence manifests in various forms. Some individuals may experience occasional leakage, while others might struggle with constant dribbling.
In severe cases, both bladder and bowel control can be compromised. Women are particularly affected, with one out of two women over the age of 65 reporting bladder leakage, according to the Urology Care Foundation.
However, after the age of 80, urinary incontinence occurs in men and women at roughly equal rates, demonstrating that this condition is not exclusive to one gender.
Despite its prevalence, urinary incontinence doesn’t have to diminish one’s quality of life. Understanding its causes, such as weakened pelvic muscles, underlying medical conditions, or side effects from medications, is the first step toward finding effective treatments.
Causes and Support of Urinary Incontinence in the Elderly
Urinary incontinence can arise suddenly (acute incontinence) or develop gradually, influenced by various health factors.
Common Causes of Urinary Incontinence
Here are the common general causes and some causes that only apply to women or men:
General Causes:
- Dehydration or inadequate water intake
- Stress or pressure on the bladder
- Infections, such as urinary tract infections (UTIs)
- Neurological conditions, including Parkinson’s disease, Alzheimer’s disease, stroke, and multiple sclerosis
- Constipation
- Obesity
Causes in Women:
- Pregnancy and childbirth
- Menopause and pelvic floor atrophy
Causes in Men:
- Enlarged prostate (benign prostatic hyperplasia)
- Prostatitis or prostate inflammation
- Nerve or muscle damage
Common Causes of Bowel Incontinence
Bowel incontinence, or fecal incontinence, can result from conditions such as irritable bowel syndrome (IBS), Crohn’s disease, or nerve damage.
Types of Urinary Incontinence
Urinary incontinence can take different forms, and each type can have distinct causes and symptoms. While some classifications list six types, others group them into four main categories.
Here’s a breakdown of the types of urinary incontinence:
- Stress Incontinence
Stress incontinence occurs when physical activity or pressure on the abdomen causes urine leakage. Actions like coughing, sneezing, laughing, climbing stairs, or lifting objects can trigger this.
It’s more common in women due to pregnancy and childbirth, though men who’ve undergone prostate surgery may also experience it.
- Urge Incontinence
Often referred to as overactive bladder syndrome, urge incontinence involves a sudden, intense need to urinate, resulting in leakage before reaching the toilet. This is one of the most common forms of incontinence.
- Overflow Incontinence
Overflow incontinence happens when the bladder cannot fully empty, leading to frequent dribbling of urine. Causes include blockages in the urinary tract, weak bladder muscles, or a complete inability of the bladder to contract.
- Functional Incontinence
This type occurs due to physical or cognitive impairments, such as arthritis, neurological conditions, or stroke complications. While individuals feel the urge to urinate, mobility or planning issues prevent timely trips to the bathroom.
- Mixed Incontinence
Mixed incontinence combines characteristics of multiple types, such as stress and urge incontinence.
Women, in particular, often experience this combination, though it can also affect individuals with neurological disorders or dementia.
- Total Incontinence
Total incontinence results in constant, uncontrollable bladder leakage, often due to a non-functioning sphincter muscle. It is more common in elderly individuals and can be challenging to manage.
If you’re experiencing any type of incontinence, consulting a healthcare professional can help identify the cause and explore treatment options.
Seeking Help and What to Expect with Urinary Incontinence
Urinary incontinence can be a sensitive issue, and your loved one may feel embarrassed or hesitant to seek medical help. They might rely on absorbent pads or protective underwear to manage accidents, but this condition is often very treatable with the right care.
A good first step is consulting a primary care doctor, geriatrician, or nurse practitioner. If specialized care is needed, both men and women can visit a urologist, while women have the option to see a urogynecologist. Starting with a primary care provider is often the most comfortable route for many.
What Happens at a Doctor’s Appointment?
During a medical evaluation for urinary incontinence, the healthcare provider may perform:
- Urinalysis to check for infections or blood.
- Blood tests to assess kidney function, glucose, and calcium levels.
- A thorough discussion of medical history and symptoms.
- A physical exam tailored to gender, such as a pelvic or rectal exam for women and a urological exam for men.
Patients might also be asked to maintain a bladder diary to monitor:
- Types of beverages consumed.
- Frequency and timing of urination, both day and night.
- Urine volume, measured using a special cup.
- Details about accidents, including when and how often they occur.
This detailed information helps the doctor develop a personalized treatment plan to improve quality of life.
Diagnosing Urinary Incontinence
When initial tests and exams fail to identify the cause of urinary incontinence, several procedures can help pinpoint the diagnosis:
- Bladder Ultrasound and Post-Void Residual (PVR): After urination, an ultrasound wand scans the bladder to detect any residual urine. This painless procedure takes 5–10 minutes. In some cases, a catheter may be used to drain and measure the remaining urine.
- Cystography: A catheter delivers dye into the bladder, and X-rays are taken while the patient urinates. This test provides a detailed view of the urinary tract, including the bladder, kidneys, and ureters.
- Urodynamic Testing: This test measures bladder pressure at rest, during filling, and while emptying. It evaluates bladder anatomy, functionality, capacity, and the sensations experienced by the patient.
- Cystoscopy: Using a bladder scope, a doctor examines the bladder’s interior for tumors, stones, or cancer and assesses its capacity.
A Common First Treatment
Once urinary incontinence is diagnosed, behavioral therapy is often the initial treatment for urinary incontinence in elderly patients.
These techniques of behavioral therapy aim to improve bladder control:
- Urination Delay Training: Gradually increase the time between bathroom visits to build bladder endurance. Double voiding (urinating, pausing, and urinating again) can also help empty the bladder more completely.
- Scheduled Bathroom Visits: Establishing a routine, often with assistance, can be beneficial for individuals with mobility challenges or neurological conditions.
- Bed-Wetting Alarms: These devices detect moisture and sound an alert to wake the user, enabling timely trips to the bathroom. They can be placed under bed sheets or attached to clothing.
- Pelvic Floor Exercises: Commonly known as Kegels, these exercises strengthen the muscles responsible for regulating urination. Practicing a few times daily can yield significant improvements.
- Fluid and Diet Management: Adjusting dietary habits can enhance bladder control. Avoid irritants like carbonated drinks, alcohol, milk, acidic foods, and spices, which can exacerbate incontinence.
7 Tips on How to Deal with Elderly Incontinence
If your parent is experiencing incontinence, here are seven strategies to help them manage the condition and improve their quality of life:
1. Establish a Bathroom Schedule
Track your parent’s daily bathroom habits to identify patterns. Use this information to set a schedule, encouraging bathroom trips before accidents occur. For example, if your parent typically needs the bathroom at 10 a.m., ensure they go a few minutes earlier.
2. Use Adult Diapers When Necessary
For parents with limited mobility, adult diapers can be a lifesaver. Measure their hip and waist sizes to get the right fit, and choose diapers with appropriate absorbency levels to match their needs.
3. Identify and Avoid Triggers
Certain foods and beverages can worsen incontinence. For instance, caffeine and carbonation in sodas may irritate the bladder. Encourage your parent to stick to water and avoid trigger items.
4. Simplify Access to the Bathroom
Make the bathroom as accessible as possible. Clear pathways of clutter to prevent falls, and install grab bars near the toilet for added support. These adjustments can make a significant difference in avoiding accidents.
5. Help Your Parent Quit Smoking
Smoking can aggravate incontinence due to frequent coughing, which puts pressure on the bladder. Encouraging your parent to quit can alleviate their symptoms and improve their overall health.
6. Promote Proper Hydration
It might seem logical to reduce fluid intake, but dehydration can lead to more concentrated urine, which irritates the bladder. Encourage your parent to drink water regularly, especially when thirsty.
7. Encourage Kegel Exercises
Strengthening pelvic floor muscles can improve bladder control. Teach your parent how to perform Kegel exercises by squeezing and holding the pelvic muscles for 10 seconds, then relaxing for another 10 seconds. Aim for three to four sets of 10 repetitions daily, which can be done discreetly anywhere.
Devices and Medications for Managing Incontinence in the Elderly
Incontinence in older adults is often managed with a combination of medications and behavioral therapies. According to the National Association for Continence (NAFC), commonly prescribed medications include:
- Anticholinergic or Antispasmodic Drugs: These are typically used for urge incontinence. Examples include Vesicare®, Detrol LA®, Ditropan XL®, Oxytrol skin patch®, and Santura®. While effective, they may cause side effects such as dry mouth, blurred vision, constipation, or mental confusion.
- Antibiotics: Prescribed for incontinence linked to urinary tract infections or an inflamed prostate gland.
- Tofranil® (Imipramine) and Sudafed® (Pseudoephedrine): These medications help treat stress urinary incontinence by tightening the muscles around the bladder.
On the NAFC website, you will find a comprehensive list of medications for incontinence and related conditions, so we recommend looking there for something to relieve your incontinence or talking to your primary doctor.
Medical Devices for Treating Urinary Incontinence in Elderly Women
If you would prefer using medical devices instead of medication, common options include:
- Urethral Insert: A tampon-like device placed in the urethra during activities that may trigger incontinence, such as exercising. It allows normal urination and bowel movements and is ideal for active senior women. Safe for up to eight hours, it should be changed regularly to maintain hygiene and prevent health issues.
- Pessary: An intravaginal device resembling a diaphragm, designed to support the bladder. Available in various sizes, it must be removed, cleaned, and inspected by a healthcare provider every three months. Single-use disposable options are also available, but consulting a doctor is recommended to determine the best fit.
- Electrical Stimulation Devices: These devices deliver mild electrical currents to nerves involved in urination, helping to strengthen the bladder, pelvic floor, and lower back muscles. While effective, they carry risks such as tenderness, infection, or minor bleeding.
Consult your healthcare provider to determine which device best suits your needs and lifestyle.
Making Daily Life Easier with a Caregiver’s Help
As we age, tasks that once seemed simple can become more challenging, and that’s natural. A caregiver can step in to help your elderly and make their everyday life easier. This extra set of hands allows older adults to focus on the things they enjoy most, without the burden of daily upkeep.
Caregivers also help with medication reminders and health monitoring, which can significantly enhance physical well-being. But in the sense of supporting individuals with incontinence, here’s what our caregivers can do for you.
How Can a Home Carer Support Individuals with Incontinence?
For those experiencing prolonged issues with incontinence, a home carer can provide a lot of support through regular visits. This personalized assistance ensures that care is delivered with sensitivity, respect, and an understanding of the unique needs of elderly individuals.
Here’s how a home carer can help:
- Encouraging Healthy Fluid Intake: A carer can promote adequate hydration while discouraging overconsumption of fluids at inappropriate times, helping to manage symptoms effectively.
- Supporting a Balanced Diet: They can prepare meals rich in fiber and avoid feeding your elderly their trigger foods. This way they can help reduce pressure on the bowel and bladder, easing symptoms of incontinence and constipation.
- Facilitating Pelvic Floor Exercises and Bladder Training: Following a GP or specialist’s recommendations, carers can assist with strengthening pelvic floor muscles and implementing bladder training techniques to reduce leakage and improve control.
- Providing Discreet Support in Public: A carer provides them with necessary hygiene products and offers quiet assistance when needed, allowing individuals to feel more confident while out and about.
- Monitoring Toileting Patterns: Our carers can keep track of routines, and therefore give gentle reminders at appropriate times.
- Assisting with Nighttime Needs: Our carers can help with safe trips to the toilet or with using a portable commode. A carer makes sure that nighttime incontinence is managed smoothly and respectfully.
So, if you or someone you know needs help when it comes to incontinence, you can count on Firefly Home Care to take care of you and all your needs.
Firefly Home Care assures that everyone can live confidently and comfortably by addressing both practical and emotional requirements. Our services can be customized to your specific lifestyle and interests, resulting in an experience that promotes your elderly’s happiness and health.
