Elderly Urinary Incontinence
For many people, a trip to the bathroom is something that can easily be delayed. But for 25 million Americans who experience bladder leakage daily, it’s not that simple. Urinary incontinence is the involuntary loss of urine according to the National Association for Continence (NAFC). Although incontinence can happen at any age, it’s generally more common in senior adults. It can be caused by typical aging, lifestyle choices, or a range of health conditions. Urinary incontinence isn’t something you should simply accept or live with, according to the NAFC. In fact, there are many effective ways to treat elderly incontinence regardless of its cause.
From not drinking enough water to childbirth to a health condition such as diabetes, there are many different reasons behind urinary incontinence. The following health issues can cause urinary incontinence in both women and men:
Common urinary incontinence causes in women include:
Onset of menopause
Pelvic floor atrophy
For men, prostate problems are a common cause of urinary incontinence. As you age, changes in the body can make elderly urinary incontinence more likely. There are six common types of urinary incontinence:
1. Urge incontinence is the most common diagnosis, often referred to as an overactive bladder. It involves an urgent need to urinate resulting in the loss of urine before arriving at the toilet.
2. Total incontinence indicates your sphincter muscle is no longer working. It results in constant and uncontrollable bladder leakage.
3. Stress incontinence occurs when an increase in abdominal pressure overcomes the closing pressure of the bladder. You may feel abdominal pain when you cough, sneeze, laugh, climb stairs, or lift objects. Stress incontinence is more common in women due to pregnancy and childbirth. However, it can affect men who’ve had prostate cancer or surgery.
4. Overflow incontinence occurs when your bladder never completely empties. Sufferers frequently feel the need to go and often leak small amounts of urine. This condition is often caused by an obstruction in the urinary tract system, or by a bladder that either has very weak contractions or isn’t able to contract at all.
5. Functional incontinence is incontinence caused by other disabilities. Neurological disorders, stroke complications, or arthritis can prevent someone from unzipping their pants quickly enough, resulting in an accident. People with functional incontinence feel the urge to urinate but aren’t physically able to plan or carry out a trip the bathroom.
6. Mixed incontinence is a combination of more than one type of incontinence. People with mixed incontinence, especially women, usually have a combination of stress and urge incontinence. But people with severe dementia, Parkinson’s disease, or neurological disorders as well as people who have had strokes can have urge and functional incontinence.
Your loved one may feel embarrassed by their accidents and avoid scheduling a doctor’s appointment. They may be using absorbent pads or protective underwear to help, but urinary incontinence is very treatable with medical assistance. A primary care doctor, geriatrician, nurse practitioner, or urinary specialist are viable options of medical practitioners that can help. If your loved one feels comfortable with their primary care doctor, it’s generally good to start there.
At your medical appointment, you’ll likely have:
A urinalysis to rule out infection or blood in the urine
Blood tests to check on kidney function, calcium, and glucose levels
A thorough discussion of your medical history
A complete physical exam, including a rectal and pelvic exam for women, or a urological exam for men
If those tests and exams don’t point to a diagnosis, the patient could undergo a bladder ultrasound with a post-void residual, cystography, urodynamic testing, or cystoscopy. After a diagnosis is made, behavioral therapy is often the first treatment. This may involve:
Learning to delay urination- You can do this by gradually lengthening the time between bathroom trips. One can also practice double voiding, which is when a person urinates, waits for a few minutes, and then urinates again. This teaches the person to drain their bladder more thoroughly.
Scheduled bathroom visits- This is often effective for people with mobility issues or neurological disorders, even if this means someone else is in charge of taking you to the restroom.
Pelvic floor muscle exercises- Called Kegels, these exercises strengthen the muscles that help regulate urination. Usually, one needs to practice these a few times a day, every day.
Fluid and diet management- Although diet alone can’t cure urinary incontinence, it can improve bladder control. Certain beverages like carbonated drinks and alcohol can cause your bladder stress. Even drinking coffee or tea while taking a prescribed medication can aggravate it. Additional bladder irritants to avoid include milk, tea, honey, soda, and very spicy foods.
Medications are frequently used in combination with behavioral therapies and may include anticholinergic drugs, antispasmodic drugs, antibiotics, etc. In addition to medicinal treatments, medical devices may be prescribed for women such as a urethra insert or pessary. If these treatment methods don’t work, surgery may help. Common surgical procedures for urinary incontinence include sling procedures, colposuspension, or artificial urinary sphincter.
If your elderly loved one suffers from urinary incontinence, self-care can help avoid complications such as skin rashes, urine odors, and accidents.
Cleaning- use a mild soap such as Dove. Petroleum jelly or cocoa butter can protect skin. Make sure to pat the skin dry after urinating.
Avoid falls- If they frequently run to the restroom, slip-and-fall accidents can happen more easily. Try to make the bathroom as accessible as possible at home. Use pads and protective garments or washable underwear until you find a successful cure.
Ask for help- If elderly urinary incontinence is keeping your loved one isolated and unable to enjoy their favorite pastimes, talk to them about treatment options and encourage them to see a doctor.
Sources: Elderly Urinary Incontinence Care | A Place for Mom