During my career as an RN, I worked in a busy emergency department. One day I answered a call light from a patient whose assigned nurse was busy. When I walked into the room, the woman, close to my age and visibly pregnant, was obviously embarrassed. “I’ve been coughing,” she said, “and I’m so sorry, but I wet the bed.” I assured her that this happens all the time and was nothing to be embarrassed of—and I wasn’t lying. Urinary incontinence, the loss of bladder control, is a condition that affects many, many people, and elderly incontinence is very common. It very likely affects your aging loved one because, like pregnancy, aging is one of the contributing factors for having bladder control issues.
People don’t like to talk about elderly incontinence, because whether it is an aging loved one or their loving caretaker, people find it embarrassing. They feel like it is controlling their lives, but don’t want to talk about it. It doesn’t have to be this way. This is a natural condition. Talking about it can help reduce embarrassment, increase awareness, and can allow you and your loved one to take steps that reduce incidents. This allows them to live their lives, and not let a condition define it.
Why Aging Elevates Risk Factors for Urinary Incontinence
As we age, women are more likely to experience urinary incontinence than men, based on anatomical differences in the genitalia, pregnancy, and weakened muscles from vaginal birth. However, older men are also at high risk due to an enlarged prostate. Both men and women are at increased risk of urinary incontinence as they age since bladder muscles weaken. Incontinence can also be caused by neurological conditions such as Parkinson’s disease and multiple sclerosis, where the brain doesn’t effectively communicate the need to use the restroom.
The lady I mentioned before was suffering from stress incontinence, which is caused by an increase in pressure from sneezing, coughing, or lifting something heavy, but there are other symptoms of urinary incontinence; increased urgency and frequency of urination, dribbling, or the inability to feel the urge to go. Many aging adults are also at a higher risk for functional incontinence, which is a change in physical conditioning (such as arthritis, or osteoporosis) that slows movement, meaning the person can’t always make it to the restroom in time. However, the risk of incontinence doesn’t have to be defining. Small changes in lifestyle can help people live independently, and without fear.
Manage Incontinence by Minimizing The Risks
There are ways to minimize the effects of elderly incontinence on activities of daily living.
- Ask your loved one to try limiting drinks that have a diuretic effect, such as alcohol or soda.
- Limiting fluid intake before bed is advisable if the person has nocturnal accidents.
- Planning outings that are a few hours after meals can be helpful, as well as planning activities where restroom facilities are readily available.
- Losing weight is sometimes helpful in minimizing symptoms, since it decreases abdominal pressure on the bladder.
- There are also some really great products such as incontinence briefs on the market. These cannot be detected under normal clothing and act as underwear, but are disposable.
- Pads to protect furniture and bed linens are also available.
- There are also medications that a family physician can prescribe to help, or surgery may be an option.
Accidents can still happen, of course, but following these steps is a great way to reduce incidents while minimizing any negative effects. Remember, following these guidelines doesn’t limit what your loved one can do—it expands it.
Talking About It: How To Overcome Anxiety and Embarrassment
The Urology Care Foundation estimates that as many as ¼ to ? of all Americans suffer from a form of urinary incontinence. This number is hard to estimate because many people who suffer do not report their symptoms. Since the incidence of urinary incontinence is so high, odds are someone you know is affected. As if the physical discomforts of incontinence are not enough, many suffer from psychosocial symptoms such as embarrassment and social anxiety because of the condition.
If your aging loved one suffers from incontinence, they may be hesitant to tell you. Incontinence may symbolize another way in which they feel they are regressing, or losing independence. Broaching the subject may be difficult, but can be made easier if you’re armed with the information that so many people, both old and young, struggle with urinary incontinence. The condition may cause social anxieties or isolation if the person fears having an “accident” in public, or even around friends and loved ones. In extreme cases, it can cause depression as the person’s self image changes drastically, and they no longer feel good about themselves. They may feel frustrated or even be tearful after an episode of incontinence.
Find The Support Your Loved One Deserves
If none of the remedies or medications work, or they still struggle with their self-image and embarrassment, there are support groups that they can join. Many people manage their feelings about the condition through talking with others who also suffer from it. If no support group is available in your area, there are online web communities that you can suggest. These are also a great resource for you as a caretaker.
What can you do when your loved one has urinary incontinence?
- Be understanding. Don’t show emotions such as impatience or anger when your loved one has an accident.
- Let them know you are there for them when they want to talk, or seek help for the issue.
- Don’t force them to talk about it if they appear uncomfortable. This might increase their embarrassment or shame.
- Suggest lifestyle changes and incontinence products, but don’t force the loved one to make the changes. They will when they are ready.
Although urinary incontinence can be embarrassing and frustrating, symptoms can be successfully managed. It does not necessarily have to limit the independence of your loved one. It is important to realize the psychological effects of the condition, and help your aging relative find the help, support, and acceptance they need.
Talking about even basic conditions can be challenging for aging people and their caretakers. It doesn’t have to be. At the Institute on Aging, we provide the tools everyone needs talk about and deal with issues facing our loved ones, letting them grow older with dignity and independence. Contact us today to learn more about our services.